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What is Oppositional Defiant Disorder?

What is Oppositional Defiant DisorderOppositional defiant disorder, commonly referred to as ODD, is one of the most common mental health conditions among children and adolescents. It is part of a group of behavioral disorders that are classified as disruptive behavior disorders. There is a wide range of estimates for how many people are truly affected by the condition; the American Academy of Child and Adolescent Psychiatry (AACAP) reports that evidence suggests that anywhere between 1-16% of children and adolescents may have ODD, but no certain conclusions can be drawn. 

Oppositional defiance disorder usually appears late in the preschool years or earlier aged school children. Males are more commonly affected than females in the younger years, but ODD occurs relatively equally in school-age children. While parents should expect toddlers and younger children to act out at certain times and during certain seasons, ODD causes one to behave in more unique and unexpected inappropriate ways. These children are often stubborn, spiteful, and defiant, and it is not uncommon for them to exhibit consistent patterns of aggression at figures of authority. 

Children diagnosed with ODD may be more prone to develop other conditions later in life, including attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), anxiety, and depression. Parents need to understand some of ODDs common symptoms so they can adequately asses their own children before making an appointment with a health care professional.

Common Symptoms of ODD

According to the AACAP, the most commonly exhibited behaviors of ODD are defiance, spitefulness, negativity, hostility and verbal aggression. These children typically display excessive or abnormal amounts of rebellion, stubbornness, and refusal to obey. They frequently argue with adults and are often labeled as ‘verbally aggressive.’ It is not uncommon for them to use foul language, to blame others for their mistakes, to resort to violence, to have frequent angry outbursts, or to ignore or challenge rules put in place by parents or other authority figures. 

In toddlerhood, temper tantrums are one of the more common symptoms of ODD. Children often throw tantrums when things do not go the way they want and when they do not get things they want. They will often scream, cry, lay down on the ground and hit others. While this behavior can be occasionally normal for all children, children with ODD tend to throw more temper tantrums than other children their age. 

Possible Causes of ODD

At this time, a clear cause of ODD has not been determined. However, research does indicate that a variety of factors may play a causal role in ODDs appearance and progression. This includes biological factors, psychological factors, and social factors. The following are some examples of each of these different factors (not all inclusive). 

  • Biological factors: Parent with ADD, ADHD or ODD, parent with a mood disorder, a brain chemical imbalance, poor nutrition, exposure to toxins, parent with substance abuse issues
  • Psychological factors: Neglectful or absentee parent, poor relationship with parent(s), difficulty forming or maintaining social relationships 
  • Social factors: Lack of supervision, poverty, chaotic home environment, abuse, inconsistent discipline

When the causes of ODD are discussed, they are often also grouped into two theories: developmental theory and learning theory. Development theory suggests that ODD problems begin in toddlerhood when normal toddler behaviors last too long and push into adolescence. The learning theory suggests that ODD’s negative symptoms are learned behaviors, which are rooted in negative discipline and reinforcement methods employed by parents and authority figures. The factors discussed above can have different impacts inside of either of these theories.

Medical Treatments for ODD

As with most mental health conditions, there is no one-size-fits-all treatment option. Because of this, managing ODD in children can be tough. Treatment strategies are going to be curated based on the specific child, their home life, their symptoms, and the support structures they have in place. 

Treatment for ODD usually occurs via a combination of therapies, problem-solving training, social skills programs, and medication. Note that medication alone is never an appropriate treatment for ODD. Some form of therapy and/or skills training is generally the best strategies for children diagnosed with oppositional defiant disorder. According to the Mayo Clinic, these treatments can include parent training, parent-child interaction therapy (PCIT), individual therapy and family therapy, cognitive problem-solving training, and social skills training.

Parent-child interaction therapy and parent training focus on strengthening the bond between the parent and child, teaching the child to learn how to listen to his or her parent(s) and teaching the parent how to be consistent. Individual therapy allows the child to work with a caring professional and family therapy may bring other members of the family (like siblings) into the therapy session. Social skills training focuses on teaching a child how to appropriately relate to and engage with peers at school and their schoolwork. 

Home Remedies for ODD

In addition to medical treatments, there are some ‘home remedies’ that some parents have found to be successful. This includes orienting the ODD child to a schedule, which should include the things the child must do each day (chores, schoolwork, etc.), as well as an obligation to check things off o the list and ‘track progress.’ Parents can also encourage the child’s good behaviors with positive reinforcement, often in the form of praise or small treats. Ultimately, children diagnosed with ODD do well with structure, set boundaries and clear expectations, so caretakers must strive to create an environment like this for the child.

Related Resource: Top 20 Best Applied Behavior Analysis Programs

Even for the involved, competent, and loving parent, managing ODD in children can be extremely hard. In the early years, it can be difficult to ascertain whether or not behaviors are abnormal. Later on, once a child has an ODD diagnosis, it can then be difficult to create the environment and support they need to thrive. However, parents can be assured that neither they nor their child are alone. Thousands are dealing with ODD in healthy ways and there are plenty of medical professionals who have the strategies needed to successfully manage this disorder. 

ABA Programs Guide Staff

Updated April 2020

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