Oppositional defiant disorder (ODD) is a childhood behaviour problem characterised by an angry or irritable mood and constant disobedience and hostility. Around one in 10 children under the age of 12 years are thought to have ODD, with ODD occurring more frequently in boys.

Early intervention and treatment is important, as untreated ODD may continue, impacting on a child’s relationships with family, peers, teachers. When problem behaviours and defiance persists, it can result in significant impairment with relationships, career prospects and quality of life.

Some children with ODD will develop the more serious conduct disorder (CD), which is characterised by aggressive law-breaking and violent behaviours. Children may also have co-morbid problems. These can include ADHD, anxiety and mood problems.

Problem oppositional and defiant behaviours usually appear during the pre-school or primary years, and rarely emerge later than early adolescence.

A child with ODD will display a pattern of angry or irritable mood, or argumentative, difficult behaviour, defiance of rules or vindictiveness. While most parents can probably identify those traits in their children from time to time, children with ODD persist in these behaviours for at least six months.

Negative and defiant behaviours may be expressed by persistent stubbornness, resistance to directions, and unwillingness to compromise, give in, or to negotiate with adults or peers. Defiance may also include deliberate or persistent testing of limits, usually by ignoring orders, arguing, or failing to accept blame for misdeeds.

The quality of parenting seems to be an important factor and the central focus of therapy with oppositional defiant disorder (ODD) is usually behavioural, implemented through a mix of parent training and child sessions. This is designed to help the parents better manage and interact with their child. It typically includes learning behavioural techniques that reinforce good behaviour and discourage bad behaviour.

This is the primary form of treatment and the research shows that is usually the most effective. Parent training can often be done in a group setting (to help reduce costs and increase social support), or privately.

Parents learn specific behavioural techniques which help increase the likelihood of maintaining control in the relationship with their child. Gradually shaping the child’s behaviour toward more age-appropriate or acceptable behaviours is accomplished through the implementation of a behavioural monitoring and reward program.

Mindworx Psychology offers parent training courses such as 1-2-3 Magic and Emotion Coaching and Engaging Your Adolescent.

Functional family therapy may also be helpful to teach all family members to communicate and problem-solve more effectively. Parents may find a parent training class to be more effective as well as less expensive; it therefore is typically tried first before family therapy.

Finally, consistency of care is important – meaning all carers of the child (including parents, grandparents, teachers, child care workers and so on) need to be consistent in the way they behave towards and manage the child.

• ODD behaviours are almost always present at home, although they are not always evident at school, or in the community.
• Usually children and adolescents do not regard themselves as oppositional or defiant, but justify their problem behaviour as a response to unreasonable demands or circumstances.
• Early intervention and treatment is important, as untreated ODD may seriously impact relationships with family, peers and teachers.

If you recognise four or more ODD behaviours, then it’s important to seek professional help.

• RESPOND WITHOUT ANGER. Try to stay calm and be matter of fact. Acknowledge the behaviour, describe it as you see it, explain what needs to be different and then remove yourself to avoid arguments. You have to pick your battles and decide what’s important to you, and ultimately to your child, and this is an area parent-training can help with.

• BE CLEAR. BE CONSISTENT. When a child displays a great deal of difficult and oppositional behaviour, we know that parents often report feeling worn down. Often they give in because it’s exhausting. Consistency and rules go out the window. It’s important to be clear, strong and consistent, but sometimes you need support too. That’s where parent groups can really help.

• AVOID POWER STRUGGLES. As hard as it might be, it will help if you can remain as neutral and objective as possible. Try not to take your child’s difficult behaviour personally. We know it’s not easy. Learning and practicing calm parenting and understanding what’s going on in the relationship, or what’s driving their child’s behaviour can be helpful for many parents. Psycho-education is a big part of parent-training.

• Help and support is essential. Parenting can be hard, and parenting a child with oppositional behaviour can feel relentless. It’s important to visit your GP or Paediatrician to rule out anything biological that could be underlying difficult behaviours, and to get an accurate diagnosis, so that you can tackle the issues by focusing on what’s most important.

• Parenting is not friendship. There are times when your child won’t like your disciple or your rules. They may even shout “I hate you” or call you names. Ultimately, teaching your child to manage other’s setting reasonable and consistent limits is a life skill they will need for success. Sometimes, tough love is harder on parents than children. Make sure you take time to take care of yourself during times when it is challenging.

• Looking after your own physical and emotional wellbeing is important, and more so during times of stress. It’s difficult to parent effectively when you have lots of stress or your own mental wellbeing is low. Find 5 minutes every day to do something you enjoy, whether it’s a peaceful cup of tea in the sunshine, listening to a podcast or music, or going for a walk.