Oppositional defiant disorder, also referred to as ODD, affects 1 to 16 percent of all school-aged children and adolescents, according to the American Academy of Child and Adolescent Psychiatry. Although many children display oppositional behavior at times, children with ODD display this behavior much more often and much more consistently than peers their same age. Their behavior often negatively affects the child's academic, social and family life if the condition left untreated.
Causes
ODD may be caused by a combination of psychological, biological and social factors. Lack of structure or parental supervision, exposure to abuse, inconsistent discipline practices and exposure to community violence are a few factors which may contribute to a child development this disorder, according to the AACAP. The disorder often occurs in families with a history of substance abuse, mood disorder or attention-deficit hyperactivity disorder.
Symptoms
Symptoms of ODD in children may include excessive arguing, frequent tantrums, refusal to comply with adult request, refusal to follow rules and deliberate attempts to upset people. Children with ODD also often blame others for their own mistakes, and often adopt a spiteful or revenge-seeking attitude when they feel they have been wronged. They frequently question the rules and are often easily annoyed by others. Children must display these symptoms consistently for at least six months and the symptoms must be causing significant problems in school or social activities to be diagnosed with ODD, according to the Diagnostic and Statistical Manual of Mental Disorders. Their pattern of behavior must also be different from other children around the same age and development level to obtain an ODD diagnosis.
Considerations
Many children are not diagnosed with ODD until elementary school, but many begin displaying the behavior as early as preschool. It is often difficult to diagnose a preschooler with ODD, however, because many preschoolers are developmentally oppositional by nature, explains the American Academy of Family Physicians. Since early intervention can prevent needless suffering for both the child and the family, parents of young children should always take their child for a professional evaluation as soon as they are showing symptoms of the disorder.
Co-existing Conditions
Some children displaying oppositional behavior may have another medical or mental condition causing their behavior, so a proper evaluation is necessary to appropriately diagnose the child's condition. Other disorders may co-exist with ODD, including learning disabilities, depression, bipolar disorder, anxiety disorders and attention-deficit hyperactivity disorder. Children with a co-existing condition often need to have the other condition treated to improve the symptoms of ODD, according to the AACAP.
Treatment
Treatment of ODD often includes some form of behavioral counseling for both the child and his parents, but the specific treatment approach often is tailored to the specific needs of the child and family. Parent training programs help parents manage their child's behavior, while family psychotherapy may improve communication and understanding between family members and the child with ODD. Individual cognitive-behavioral therapy promotes the utilization of effective anger management strategies and problem solving. Some children with ODD also take medication to control some of the symptoms of the disorder, especially if the disorder occurs as part of another condition, according to MedlinePlus.
Parental Interventions
Parents can often help their child cope with ODD by making modifications to their interactions with their child. They should praise their child frequently whenever they are displaying good behavior. The consequences for bad behavior should be able to be enforced easily and consistently, and the child should be well aware of the consequences at all times. Parents should walk away from the child and avoid the temptation to carry on an argument when they feel themselves getting upset or emotional. This not only gives the parent a chance to regroup and return to handle the situation calmly, but also provides valuable modeling for the child.
Outlook
The symptoms of ODD resolve within three years of diagnosis in approximately 67 percent of children diagnosed with the disorder, according to AACAP. The organization, however, also notes that 30 percent of the children diagnosed with this disorder will go on to develop conduct disorder, and 10 percent of children with ODD eventually develop a more lasting personality disorder, such as anti-social personality disorder.
References
- "The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition"; American Psychiatric Association; 2000
- American Academy of Child and Adolescent Psychiatry: Oppositional Defiant Disorder
- MedlinePlus: Oppositional Defiant Disorder
- American Academy of Family Physicians: Oppositional Defiant Disorder
- American Academy of Child and Adolescent Psychiatry: FAQs on Oppositional Defiant Disorder
