What is Oppositional Defiant Disorder?

Raising children who are disobedient and difficult is hard for any parent.  Those more difficult children are often diagnosed with Oppositional Defiant Disorder. 

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Oppositional Defiant Disorder is a diagnosis from the Diagnostic and Statistical Manuel of Mental Disorders published by the American Psychiatric Association[1].  Oppositional Defiant Disorder is diagnosis but is also a descriptor of a disruptive thought and behavior pattern.  The “oppositional” part refers to the thoughts or pattern of thinking that a child has when not wanting to listen or conform to the rules of family, school, or society.  The “defiant” part of the term refers to negative behaviors the child may be exhibiting.  The term Oppositional Defiant means there is a negative pattern of negative thoughts followed by negative behaviors toward those in authority or rules associated with authority. 


Oppositional Defiant Disorder in children can be distinguished in many forms, but can be described as “unruly” “argumentative” “mean” “out of control” or “a behavior problem.”  While this could all be true, these behaviors must be something that occurs quite a bit and not just a child that is acting out every once in a while.  Plus the negative behaviors have a negative impact on social, family, or educational purposes. 


The parents and teachers of children with Oppositional Defiant Disorder should be aware that some behaviors are associated with normal search for identity or normal developmental stages.  When the behaviors last for longer than 6 month or are of a serious nature that the child or others are getting serious hurt, then something should be done to stop the negative behaviors. 


I sometimes call this the teenager disorder.  Most teenagers are searching for their new identity and will disobey or argue with the rules.  It is when the negative thought patterns are associated with the defiant behaviors that we may be dealing with ODD.


Symptoms of Oppositional Defiant Disorder (ODD)

The general hallmark of ODD is a defiant behavior toward adults, especially those with roles of authority.  These could include teachers, parents, police, baby sitters, or etc.  The behaviors usually do not get people hurt, but the child may go too far with the behaviors and people could. 


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Anger is usually associated with this disorder.  The child becomes angry at the rules or those imposing the rules and will be disobedient.  He or she will lash out verbally or with some minor physical aggression in protest of having to follow the rules. 


Along with the anger is the fact these children are usually very irritable or easily annoyed.  They are fine with dishing it out to others, but the slightest inconvenience is blown out of proportion by these children. 


Children with ODD will argue with the adults to the point they will forget what they are even arguing about.  My mother used to say I would argue with a stop sign that it meant go.  I was not ODD but I did have some of the symptoms.  If you think back, you probably did at sometime too.  Again, we have to distinguish the normal from the abnormal in these cases and it can be a fine line. 


Those diagnosed with Oppositional Defiant Disorder will lose their temper quite often.  Throwing temper tantrums at least once a day is not uncommon in younger children but as they get older they should learn to control it more.  By age five there should be no more than 5 small temper tantrums a day lasting no more than 5 minutes.  By the time they are 6, this should be down to less than that. 


Blaming other is another symptom of the disorder.  A lot of people do not want to accept responsibility for their actions.  They will blame society, government, or the people next door for why they did or did not do something.  Those with Oppositional Defiant Disorder will blame everyone for every thing that does not go their way. 


They will perform action or have behaviors that are deliberately annoying to others.  They will pick on their siblings or other just to get a reaction and with the hope that the other person will get into trouble. 


Revenge is not uncommon for these children and teens.  They will have small plans and elaborate plans for revenge.  However, most of the time it is not physical in nature.  When the plan is to start harming people, we must consider looking at Conduct Disorder as a possible diagnosis.  Conduct Disorder is generally the next level of progression with ODD but with treatment it can stop before it gets to that point.  


Treatment of Oppositional Defiant Disorder

Behavior modification is the technique that is shown to have the most effectiveness with these children.  The behavior modification program must be implemented in school and at home. ODDCredit: health.howstuffworks.com


Behavior modification is really just a bunch of techniques that rewards behaviors that are good and desired as well as not rewarding behaviors that are not desired.  For instance, a child is not brushing their teeth because they are ODD, a star chart can be set up and when the child brushes their teeth, they get a star, when they do not they do not receive a star.  The stars can be saved to get something the child wants in the future when a certain amount of stars are obtained.  Schools use these techniques quite a bit.


You might say, I am not going to reward for something that the child should already be doing, but behavior modification is seen everyday in adult’s life as well and can be a valuable teaching tool for children.  We as adults go to work and are reward with a paycheck. If we do not work, then we do not get a paycheck, unless it is vacation or sick time.  If we are speeding a police officer may pull us over and we are not rewarded with a ticket to the St. Louis Cardinals game, but instead with a ticket that takes away from the money we earned at work.  Behavior Modification is the way of the world. 


When behaviors are starting to get more out of hand and the parents or teachers are unable to change with just behavior modification, psychotherapy will be needed.  Cognitive-Behavior Therapy has seemed to make great progress with Oppositional Defiant Disorder.  Behavior modification is discussed with parents and child in a family therapy session.  There are no secrets and each participant is told the rules.  Both are expected to follow.  Consistency from the parents is one of the most important things that can be done to stop and control the ODD child.  


Other resources about Oppositional Defiant Disorder

The American Academy of Child and Adolescent Psychiatry have wonderful readings about the disorder.  However, their articles are very hard to understand for parents and teachers because they are using jargon that is mostly used in the field. 


The Department of Justice have good articles when discussing juveniles, but they write from a perspective of law enforcement and I would hope we can stop it before it gets to that point. 


 I have read about the topic from the National Institute of Health and National Institute of Mental Health, but again they fall short of describing what parents and teachers need and instead focus on research.  That is their primary job, though. 


The best information I have read come from the American Psychological Association. The articles they produce are “down to earth” and give valuable resources to find more information. 


I know it is a cliché, but the children are our future and we need to stop these behaviors and teach them the right ways to adjust to the rules of society.  I find a correlation between the violence we see today and the over populated prisons with the continued rise of untreated Oppositional Defiant Disorders in children. 

The Defiant Child: A Parent's Guide to Oppositional Defiant Disorder
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Oppositional Defiant Disorder and Conduct Disorder in Children
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