Oppositional Defiant Disorder

-- End Ad Box --->mood disorders, there is very little research on ODD.
IntroductionCo-morbidity
Oppositional defiant disorder (ODD) is a psychiatricODD is frequently goes along with other disorders.
behavior disorder that is characterized by50-65% of ODD children also have ADHD. 35% of
aggressiveness and a tendency to purposefully botherthese children develop some form of affective
and irritate others. These behaviors cause significantdisorder. 20% have some form of mood disorder, such
difficulties with family and friends and at school oras depression or anxiety. 15% develop some form of
work.personality disorder. These children frequently have
Oppositional defiant disorder is sometimes a precursorlearning disorders and academic difficulties.
of conduct disorder. Much of the literature tends toIf your child has ODD it is important to know there are
lump these two conditions together. However, theyother co-existing problems. These other problems
seem to be distinct entities and, although conductusually must be addressed before you can begin to
disorder does have a genetic component, ODD doeshelp your child with ODD.
not.Prognosis
DescriptionSo what happens to these children? There are four
Oppositional defiant children show a consistent patternpossible paths.
of refusing to follow commands or requests by adults.1. Some will grow out of it. Half of the preschoolers
These children repeatedly lose their temper, argue withthat are labeled ODD are normal by the age of 8.
adults, and refuse to comply with rules and directions.However, in older ODD children, 75% will still fulfill the
They are easily annoyed and blame others for theirdiagnostic criteria later in life.
mistakes. Children with ODD show a pattern of2. The ODD may turn into something else. 5-10 % of
stubbornness and frequently test limits, even in earlypreschoolers with ODD have their diagnosis changed
childhood.from ODD to ADHD. In some children, the defiant
These children can be manipulative and often inducebehavior gets worse and these children eventually are
discord in those around them. Commonly they candiagnosed with Conduct Disorder. This progression
incite parents and other family members to fight withusually happens fairly early. If a child has ODD for 3-4
one and other rather than focus on the child, who isyears and he hasn't developed Conduct Disorder, then
the source of the problem.he won’t ever develop it.
Behavioral Symptoms3. The child may continue to have ODD without any
Common behaviors seen in oppositional defiantthing else. This is unusual. By the time preschoolers
disorder include:with ODD are 8 years old, only 5% have ODD and
- Losing one’s tempernothing else.
- Arguing with adults4. The child develops other disorders in addition to
- Actively defying requestsODD. This is very common.
- Refusing to follow rulesTreatment
- Deliberately annoying other peopleMost of these children have some other disorder along
- Blaming others for one's own mistakes orwith their ODD. Treating this other disorder is the key
misbehaviorto proper ODD management. This frequently means
- Being touchy, easily annoyedgiving medication. Although this type of medical
- Being easily angered, resentful, spiteful, or vindictive.intervention does not make the children "normal", it can
- Speaking harshly, or unkind when upsetmake a big difference. It often allows other
- Seeking revengenon-medical interventions to work much better.
- Having frequent temper tantrumsFor example, if a child has both ODD and ADHD, then
Many parents report that their ODD children were rigidgiving the child Ritalin may have a significant effect on
and demanding from an early age.his ODD, also. This positive effect does not seem to
Normal children, especially around the ages or 2 or 3 orbe related to the severity of the ADHD. That means
during the teenage years display most of theseeven if the child has mild ADHD and could do without
behaviors from time to time. When children are tired,Ritalin, if he is treated medically, you might see an
hungry, or upset, they may be defiant. However,improvement in his ODD.
children with oppositional defiant disorder display theseOnce the other problems are under control, the best
behaviors more frequently and to the extent that theytreatment for ODD is parent training. In a study
and interfere with learning, school adjustment, and,published in 1998, eighty-two research studies were
sometimes, with the child's social relationships.evaluated were examined for efficacy. Approaches
Diagnosisfocusing on parent training were the most affective
The diagnosis of ODD is not always straight forwardtechniques.
and needs to be made by a psychiatrist or someThe main point is that some parent-training program is
other qualified mental health professional after aessential in addressing ODD. This is not going to work
comprehensive evaluation. The child must befor everyone, but it is the best treatment that we have
evaluated for other disorders as well since ODDavailable for ODD.
usually does not come alone. If the child has ADHD,Advice to Parents
mood disorders, or anxiety disorders, these otherThat is with regard to your child. If your child has ODD
problems must be addressed before you can begin toyou need to take care of yourself, also. No child needs
work with the ODD.a martyr as a parent.
If you feel your child may have ODD, there is a quickHere are some of the things you can do:
screening test. Go to:- Maintain interests other than your child with ODD.
CausesYou have to be a person.
What is the cause of ODD? The real answer is that- Try to work with and obtain support from the other
nobody knows. However, since as scientist we hate toadults (teachers, coaches, and spouse) dealing with
admit this, we have currently have two theories.your child.
The developmental theory proposes that ODD is really- Take time to work on your relationship with your
a result of incomplete child development. For somespouse. Raising these children is very difficult and can
reason, these children never complete theput a strain on the best of marriages.
developmental tasks that normal children learn to- Manage your own stress with exercise and
master during the toddler years.relaxation.
The learning theory suggests that ODD comes as a- Take frequent vacations. This is a must.
response to negative interactions. The techniques usedConclusion
by parents and authority figures on these children bringIt is tough to live with children who have ODD. What is
about the oppositional defiant behavior.worse is that there does not seem to be any cure.
ODD is the most common psychiatric diagnosis inHowever, if you make sure that your child has his
children and it usually persists into adulthood. Oneother problems addressed and you improve your
would think a lot of research would be done on thisparenting skills by enrolling in a parent training program,
condition. That is not the case. While there areyou can do a great deal to improve your child’s
hundreds of research studies on ADHD and childhoodcondition and your own.