At some point, all children can be oppositional and defiant. The toddler years even have a nickname, "The Terrible Twos," to describe this phenomenon. Adolescents are also known for their ability to defy adults. However, some children exhibit characteristics that go beyond the norm and may require special intervention if they begin to interfere with the child's social, emotional or academic life, according to the American Academy of Child & Adolescent Psychiatry. In this case, a child may have oppositional defiant disorder.
Characteristics
To be diagnosed with oppositional defiant disorder, a child must have at least four of the following behaviors for a period of six months: frequent temper loss; often spiteful or vindictive; argumentative with adults; actively defies or will not comply with adult requests; often angry, resentful; easily annoyed by others; deliberately annoys people and frequently blames others for mistakes. A child must exhibit these characteristics more often and more intensely than his peers, according to MayoClinic.com.
Causes
No single factor causes oppositional defiant disorder. Rather, it appears that a combination of environmental, biological and psychological issues influence oppositionally defiant behavior. These behaviors tend to be found in families that also have attention deficit disorder, substance abuse or mood disorders, including depression or bipolar disease. There is evidence that an oppositionally defiant child's brain may process reasoning, judgment and impulse control decisions differently than a child without this disorder.
In addition, environmental factors that include lack of structure, a low level of parental supervision, exposure to violence or abuse, and inconsistent discipline may trigger this disorder in a child with risk factors.
Treatment
The generally accepted treatment for oppositional defiant disorder includes psychotherapy and training for both the child and parents. Individual and family therapy is a treatment cornerstone and can help your child deal with feelings of anger, and help you learn how to improve communication and relationships.
Parent-child interaction therapy is a special kind of treatment where a therapist coaches a parent on ways to reinforce positive behavior with the child. Some children benefit from social skills training as well. Finally, parent training programs help you find strategies to interact positively with your child and lessen frustration.
Medication may improve some of an oppositionally defiant child's behaviors, particularly if he has been diagnosed with other disorders that include attention deficit disorder.
Prevention
For preschool children, intervention strategies that include Head Start and home visits for at risk children may reduce the likelihood of oppositional defiant disorder. For school-age children, several programs have shown promise. Cognitive interventions, anti-bullying programs, skills training and strategies that reduce anti-social behaviors have shown promise in reducing oppositional defiant disorder.
Tips for Parents
Parenting an oppositionally defiant child can be stressful for everyone involved. Consider counseling so that you can get support. Though it can be difficult, parents should remain calm to model appropriate behavior to a child with this disorder. Developing interests outside your family and taking time for yourself can be key stress-reducing techniques. Forgive your child for things that have happened in the past and start each day with a clean slate so that you are not distracted by past issues.
References
- American Academy of Child & Adolescent Psychiatry: Children With Oppositional Defiant Disorder
- MayoClinic.com: Oppositional Defiant Disorder
- AACAP: Causes of Oppositional Defiant Disorder
- MayoClinic.com: Treatment of Oppositional Defiant Disorder
- MayoClinic: Tips for Parents of Oppositionally Defiant Children
