Dealing with Oppositional Defiant Behavior (ODD)

ODD is a pattern of disobedient, hostile, and defiant behavior toward authority figures. This disorder is more common in males than in females. Some studies have shown that it affects 20% of school-age kids. However, most experts believe this figure is high due to changing definitions of normal childhood behavior, and possible racial, cultural, and gender biases. This behavior typically starts by age 8, but it may start as early as the preschool years. This disorder is thought to be caused by a combination of biological, psychological, and social factors.

Symptoms include:

• Touchy or easily annoyed
• Spiteful or seeks revenge
• Loses temper
• Is in constant trouble in school
• Has few or no friends or has lost friends
• Blames others for own mistakes
• Argues with adults
• Angry and resentful of others
• Actively does not follow adults' requests

To fit this diagnosis, the pattern must last for at least 6 months and must be more than normal childhood misbehavior. The pattern of behaviors must be different from those of other kids around the same age and developmental level. The behavior must lead to significant problems in school or social activities.

Kids with symptoms of this disorder should be evaluated by a psychiatrist or psychologist. In kids and teens, the following conditions can cause similar behavior problems and should be considered as possibilities:

• Substance abuse disorders
• Learning disorders
• Depression
• Bipolar disorder
• Attention-deficit /hyperactivity disorder (ADHD)
• Anxiety disorders

The best treatment for the youngster is to talk with a mental health professional in individual and possibly family therapy. Moms and dads should also learn how to manage the youngster's behavior. Medications may also be helpful, especially if the behaviors occur as part of another condition (e.g., depression, childhood psychosis, ADHD). Some kids respond well to treatment, while others do not. In many cases, kids with ODD grow up to have conduct disorder as teens or adults. In some cases kids may grow up to have antisocial personality disorder.

Call your health care provider if you have concerns about your youngster's development or behavior. Be consistent about rules and consequences at home. Don't make punishments too harsh or inconsistent. Model the right behaviors for your youngster. Abuse and neglect increase the chances that this condition will occur.

My Out-of-Control Child: Parenting Children with Oppositional Defiance

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"Our 14 year old keeps sneaking out in the middle of the night. We've screwed the windows shut, called police. She says she sorry...but she can't be that sorry if she keeps doing it. What is the best way to handle this? We've told her it is a safety issue more than anything else."

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"What is done in a case where my teenage son (16 years old) will not get out of bed for either school or work without a huge fight everyday?"

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How can I get her to get up in the mornings...

Hi Mark,

I continue to have struggles with my 17 year old. She has not gone to school for this past semester as she was supposed to be taking her classes by correspondence. Unless I stood over and watched her do the courses, she wouldn't do them. I wasn't about to do that as she needs to learn to be responsible. So, needless to say, she is now behind 3 classes in order to graduate next year. She is going to register for regular school for September as this other method does not work for her. She is not motivated at all.

My one big problem with her is that she will not get out of bed in the morning. She has a part-time job that she is supposed to be at 3 days a week. She maybe goes to it 2 times a week if lucky because she just won't get out of bed. She calls in sick so she can sleep in. She will end up losing this job soon. I know she will be exactly the same way once school starts again. She refuses to get out of bed. Then when she does, she thinks she can just go out and hang out with her boyfriend in the evening. Even if we say no, she will leave and go anyways. I am so upset and frustrated by all of this as it has me so stressed out all the time. I dread mornings as I know the hassles we will have. I know that there are "natural consequences" of her actions and she has to be the one that has to live them but we are all living them. Plus, I don't want her to be a high school drop-out and still living at home once she turns 18.

How can I get her to get up in the mornings and to understand that she needs to be more responsible and motivated or she will get nowhere in life?

Thanks,

P.

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Adolescents are notorious for staying up late at night and being hard to awaken in the morning. Your adolescent is probably no exception, but it's not necessarily because he or she is lazy or contrary. This behavior pattern actually has a physical cause — and there are ways to help mesh your adolescent's sleep schedule with that of the rest of the world.

Everyone has an internal clock that influences body temperature, sleep cycles, appetite and hormonal changes. The biological and psychological processes that follow the cycle of this 24-hour internal clock are called circadian rhythms. Before adolescence, these circadian rhythms direct most children to naturally fall asleep around 8 or 9 p.m. But puberty changes an adolescent's internal clock, delaying the time he or she starts feeling sleepy — often until 11 p.m. or later. Staying up late to study or socialize can disrupt an teen's internal clock even more.

Most adolescents need about nine hours of sleep a night — and sometimes more — to maintain optimal daytime alertness. But few adolescents actually get that much sleep regularly, thanks to part-time jobs, homework, extracurricular activities, social demands and early-morning classes. More than 90 percent of adolescents in a recent study reported sleeping less than the recommended nine hours a night. In the same study, 10 percent of adolescents reported sleeping less than six hours a night.

Big deal? Yes. Irritability aside, sleep deprivation can have serious consequences. Daytime sleepiness makes it difficult to concentrate and learn, or even stay awake in class. Too little sleep may contribute to mood swings and behavioral problems. And sleepy adolescents who get behind the wheel may cause serious — even deadly — accidents.

Catching up on sleep during the weekends seems like a logical solution to adolescent sleep problems, but it doesn't help much. In fact, sleeping in can confuse your adolescent's internal clock even more. A forced early bedtime may backfire, too. If your adolescent goes to bed too early, he or she may only lie awake for hours.

So what can you do? Don't assume that your adolescent is at the mercy of his or her internal clock. Take action tonight!

• Stick to a schedule. Tough as it may be, encourage your adolescent to go to bed and get up at the same time every day — even on weekends. Prioritize extracurricular activities and curb late-night social time as needed. If your adolescent has a job, limit working hours to no more than 16 to 20 hours a week.

• Nix long naps. If your adolescent is drowsy during the day, a 30-minute nap after school may be refreshing. But too much daytime shut-eye may only make it harder to fall asleep at night.

• Keep it calm. Encourage your adolescent to wind down at night with a warm shower, a book or other relaxing activities — and avoid vigorous exercise, loud music, video games, text messaging, Web surfing and other stimulating activities shortly before bedtime. Take the TV out of your adolescent's room, or keep it off at night. The same goes for your adolescent's cell phone and computer.

• Curb the caffeine. A jolt of caffeine may help your adolescent stay awake during class, but the effects are fleeting. And too much caffeine can interfere with a good night's sleep.

• Adjust the lighting. As bedtime approaches, dim the lights. Turn the lights off during sleep. In the morning, expose your adolescent to bright light. These simple cues can help signal when it's time to sleep and when it's time to wake up.

Sleeping pills and other medications generally aren't recommended for adolescents.

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