Children normally disagree with parents from time to time over toys, chores, homework and a multitude of other daily activities. However, if your child's defiance becomes persistent or threatens his emotional, physical or social well-being, oppositional defiant disorder, or ODD, could be the cause. His seemingly out of control behavior might stretch your patience to the limit, but effective treatment and parental support exists for children and families coping with ODD.
Identification
In general, children with ODD have an ongoing pattern of uncooperative, defiant and hostile behavior, according to the American Academy of Child and Adolescent Psychiatry. Symptoms may include frequent, excessive temper tantrums, constant arguing with adults and a general refusal to comply with rules. Children with ODD often deliberately try to annoy other children or adults. They frequently blame others for their misbehavior, become annoyed easily and might plot or carry out revenge on peers or adults they believe caused their defiant behavior.
Causes
Mental health professionals do not clearly understand what causes ODD, but many believe a combination of biological, psychological and social factors may contribute. Environmental issues that may play a role include neglect or abuse, harsh or inconsistent discipline and lack of adult supervision. However, ODD also affects children from "normal, healthy" families. Medline Plus notes that some studies indicate the disorder affects more boys than girls. Interestingly, parents often report that children with ODD demanded more attention in infancy and fussed more than their siblings did at the same age.
Considerations
The experts at AACAP caution that some defiance is a normal developmental process for 2- to 3-year-olds and adolescents. Professionals gauge the intensity, persistence and adverse affects of defiance when evaluating for ODD, and such behavior must exist for six months or longer before they decide on a formal diagnosis of ODD. Additionally, attention deficit disorder, depression, learning disability and anxiety can cause similar symptoms. Therefore, children exhibiting symptoms of ODD need a comprehensive evaluation to rule out other causes for their behavior.
Treatment
Health-care providers generally chose a combination of parent management training, individual psychotherapy for the child and family therapy to address the challenges associated with ODD. Children with ODD often require training in problem-solving skills and social skills to help them learn how to interact appropriately with peers and adults. For severe behavioral issues, psychiatrists might try medication, especially when the child has concurrent issues such as depression or anxiety.
Expert Insight
The AACAP advises parents to avoid isolation when it comes to parenting a child with ODD. They recommend you ask teachers, parents or coaches you trust for support and tips on behavior management styles. Your family physician or therapist may know of a support group in your area that focuses on parenting. Additionally, including time in your schedule for routine exercise and other healthy activities will help decrease stress and may improve you overall health.
References
- American Academy of Child and Adolescent Psychiatry: Children With Oppositional Defiant Disorder
- U.S. Substance Abuse and Mental Health Services Administration: Conduct Disorders in Children and Adolescents
- Medline Plus: Oppositional Defiant Disorder
- Healthy Children: Behavioral and Disruptive Disorders
