What Parents Need to Know About Oppositional Defiant Disorder in Their Child

It's not unusual for kids -- especially those in their "terrible twos" and early teens -- to defy authority every now and then. They may express their defiance by arguing, disobeying, or talking back to their moms and dads, teachers, or other adults. When this behavior lasts longer than six months and is excessive compared to what is usual for the youngster's age, it may mean that the child has a type of behavior disorder called Oppositional Defiant Disorder (ODD).

ODD is a condition in which a youngster displays an ongoing pattern of uncooperative, defiant, hostile, and annoying behavior toward people in authority. The child's behavior often disrupts the child's normal daily activities, including activities within the family and at school.

Many kids and adolescents with ODD also have other behavioral problems, such as attention-deficit/hyperactivity disorder, learning disabilities, mood disorders (such as depression), and anxiety disorders. Some kids with ODD go on to develop a more serious behavior disorder called conduct disorder.

Symptoms of Oppositional Defiant Disorder—

Symptoms of ODD may include:

• Actively refusing to comply with requests and rules
• Being spiteful and seeking revenge
• Blaming others for your mistakes
• Deliberately trying to annoy or upset others, or being easily annoyed by others
• Excessively arguing with adults
• Having frequent outbursts of anger and resentment
• Saying mean and hateful things when upset
• Swearing or using obscene language
• Throwing repeated temper tantrums

In addition, many kids with ODD are moody, easily frustrated, and have a low self-esteem. They also may abuse drugs and alcohol.

 

==> My Out-of-Control Child: Parenting Children With Oppositional Defiant Disorder

Causes of Oppositional Defiant Disorder—

The exact cause of ODD is not known, but it is believed that a combination of biological, genetic, and environmental factors may contribute to the condition.

Genetics: Many kids and adolescents with ODD have close family members with mental illnesses, including mood disorders, anxiety disorders, and personality disorders. This suggests that a vulnerability to develop ODD may be inherited.

Environmental: Factors such as a dysfunctional family life, a family history of mental illnesses and/or substance abuse, and inconsistent discipline by moms and dads may contribute to the development of behavior disorders.

Biological: Some studies suggest that defects in or injuries to certain areas of the brain can lead to serious behavioral problems in kids. In addition, ODD has been linked to abnormal amounts of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms of ODD, and other mental illnesses. Further, many kids and adolescents with ODD also have other mental illnesses, such as ADHD, learning disorders, depression, or an anxiety disorder, which may contribute to their behavior problems.

How Common Is Oppositional Defiant Disorder?

Estimates suggest that 2%-16% of kids and adolescents have ODD. In younger kids, ODD is more common in boys. In older kids, it occurs about equally in boys and in girls. It typically begins by age 8.

How Oppositional Defiant Disorder is Diagnosed—

Mental illnesses in young people are diagnosed based on signs and symptoms that suggest a particular illness like ODD. If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose ODD, the doctor may use various tests -- such as X-rays and blood tests -- to rule out physical illness or medication side effects as the cause of the symptoms. The doctor also will look for signs of other conditions that often occur along with ODD, such as ADHD and depression.

If the doctor cannot find a physical cause for the symptoms, he or she may refer the youngster to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses in kids and adolescents. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a youngster for a mental illness. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitude and behavior. The doctor often must rely on reports from the child's moms and dads, teachers, and other adults because kids often have trouble explaining their problems or understanding their symptoms.

 

==> My Out-of-Control Child: Parenting Children With Oppositional Defiant Disorder

How Oppositional Defiant Disorder is Treated—

Treatment for ODD is determined based on many factors, including the youngster's age, the severity of symptoms, and the child's ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following:

• Medication: While there is no medication formally approved to treat ODD, various drugs may be used to treat some of its distressing symptoms, as well as any other mental illnesses that may be present, such as ADHD or depression.
• Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the youngster develop more effective ways to express and control anger. A type of therapy called cognitive-behavioral therapy aims to reshape the child's thinking (cognition) to improve behavior. Family therapy may be used to help improve family interactions and communication among family members. A specialized therapy technique called parent management training (PMT) teaches moms and dads ways to positively alter their youngster's behavior.

Outlook for Kids with Oppositional Defiant Disorder—

If your youngster is showing signs of ODD, it is very important that you seek care from a qualified doctor immediately. Without treatment, kids with ODD may experience rejection by classmates and other peers because of their poor social skills and aggressive and annoying behavior. In addition, a youngster with ODD has a greater chance of developing a more serious behavioral disorder called conduct disorder. Treatment is usually very effective when started early.

Prevention—

Although it may not be possible to prevent ODD, recognizing and acting on symptoms when they first appear can minimize distress to the youngster and family, and prevent many of the problems associated with the illness. Family members also can learn steps to take if signs of relapse (return of symptoms) appear. In addition, providing a nurturing, supportive, and consistent home environment with a balance of love and discipline may help reduce symptoms and prevent episodes of defiant behavior.

==> My Out-of-Control Child: Parenting Children With Oppositional Defiant Disorder

Teenagers and School Behavior Problems: Tips for Parents

"My 13-year-old daughter has been acting-up quite a lot at school - especially in the lunch room. She has had 3 referrals in just the last week and may get suspended if she gets any more this month. Any advice would be appreciated. Thanks."

While kids can display a wide range of behavior problems in school, from disruptive talking in the classroom to fighting and name-calling on the playground, the reasons for bad behavior are usually simple. If your daughter is acting out a lot in school, my assumption is either that she's having strong feelings and needs a hand with getting those feelings out, or that something in school is really not working for her. As a parent, you can do a number of things at home to help your child deal with her feelings. You can also change the situation in school so your child has a better time there.

How to help your child at school:

Assess the situation— Start by spending time in your daughter's classroom (volunteer as an aide for a day or two) to see what's going on. Or have a child therapist, school psychologist, or learning specialist evaluate your daughter in the classroom. You could even ask a friend or relative — your child's favorite uncle, say — to go to her school for a day. Look at the teacher's teaching style and your child's learning style: Is a mismatch in the teacher-child relationship causing your daughter to feel misunderstood or angry? Go out to the playground at recess: Is your daughter being teased or frightened and then acting out in an attempt to get someone to notice she's in trouble? You may learn a lot by spending a day in your child's environment and paying attention to her interactions with the people around her.

Check out your child's relationship with her teacher— This basic dynamic can make or break a child's experience in the classroom. Often when a child is having behavior problems in school, it comes down to a feeling that the teacher doesn't like her. To be able to learn and to act well, it's really important to kids to feel liked. Often it's enough just to bring the problem to the teacher's attention, but if your daughter somehow pushes the teacher's buttons in a way that makes it difficult for the teacher to like her, as a last resort you can look into moving your child to a different classroom. Or see if an adult who likes your daughter (such as a teacher's aide) can be added to the classroom; sometimes this is enough to smooth out troublesome behavior.

 

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Get outside help— If you think it's necessary, get recommendations for a good therapist for your child. Interview possible candidates on the phone, and tell them you're looking for someone who can help your daughter work through the emotional issues that are making her act out at school. Tell them you're not interested in a medication approach, but are looking for someone who can work with your child's teacher and the school system and give the teacher ideas on how to handle her behavior.

Give your child a break— Sometimes the daily grind of going to a place where she is not succeeding can push a child into behavior problems. If you can, try taking a day off from school and work every once in a while to do something with your child that she really enjoys, whether it's playing a Monopoly marathon, spending the day at the beach, or just hanging out in the backyard listening to the radio. Take advantage of the times when she is home sick to get close and pay special attention to her.

Help your child remember that you care about her— Knowing that she is loved can pull a child out of a downward spiral. It can sometimes work to give your daughter a special reminder of you, something she can put in her pocket, like a little note that says ‘I love you and you're great’ – or put a picture in her lunchbox of the two of you hugging.

Strategize— I also suggest setting up conferences that include you, your daughter, and her teacher. Brainstorm together about how to make school go well for your daughter. You may want to devise a signal your child can give her teacher, such as raising two fingers, when she's feeling frustrated and restless and is about to start acting out; at these times, the teacher could give her something special to do, such as taking papers to the principal's office. Or the teacher could think of a signal, such as a tap on your daughter's shoulder, to remind her to behave without embarrassing her in front of the class.

 

Tell your child that she can decide where her mind goes— If your child is having a miserable time at school, she can think of you, or of the fun she's going to have after school, rather than stay trapped in bad feelings. A great example of this idea is in Harry Potter and the Prisoner of Azkaban, where Harry encounters some monsters called dementors who suck all the happiness out of their victims. The antidote that a powerful wizard gives Harry is to think of the best time he ever had; this allows him to gain power over the monsters.

Work with the teacher— Just having to sit still during class is a big challenge for some kids. The teacher may be open to letting your child move around or do other activities if you talk to him about it. When one of my sons was making the transition from kindergarten, where he had a lot of space to move and play while he learned, to the older grades, he had a really hard time with sitting still and not talking. One of his educators told him that while she was talking or reading it was fine for him to draw, and once he was able to do that, he stopped getting in trouble.

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"Bargaining" with Your Teenager: A Big Mistake

Moms and dads often fall into the trap of bargaining with their youngster, sometimes to make their own lives easier or because they want to be “friends” with their child, and sometimes because they feel guilt or shame about issues from the past such as getting a divorce, moving the family, or working too many hours.

Moms and dads often fall into the bargaining trap when they are unclear about which rules are negotiable and which are non-negotiable. Although bargaining with your child may resolve the immediate conflict, a pattern of bargaining could indicate an unhealthy disruption in the balance of power in the parent-child relationship.

Bargaining is often a sign that parents are losing authority over their youngster, particularly when they begin bargaining about rules that are, or should be, hard lines in the sand. Teenagers and preteens may feel a misplaced sense of entitlement that begins to wear away at a parent’s authority.

Entitlement is when someone believes they have a right to make a choice that is outside of their power. When moms and dads repeatedly let their youngster make decisions that are outside of the child’s power, the child becomes inflated with a sense of self that is inaccurate in terms of the youngster’s belief in her ability to affect the outcome of events.

Power is given to parents – not kids – for good reason. Moms and dads have the experience, knowledge, and wisdom to keep their kids safe and make good decisions for their youngster. Of course, there are times when it is fair and appropriate to negotiate and compromise with teenagers. Power can certainly be shared, but only when the outcome does not have the potential to harm the child.

Rather than bargaining with your youngster, empower him to influence the outcome of decisions that truly are negotiable and draw clear boundaries in areas that are not up for debate. For example, moms and dads may share power with a child around some of the TV programs the youngster watches. However, the parent should not share decision-making power with the child if a program has content that is too advanced for the child’s age and maturity level. This is an example of a non-negotiable item – there is no discussion or negotiation. Similarly, a middle school-aged youngster should not be allowed to negotiate about which friends she has sleepovers with, what parties she can attend, or how late she can stay out at night. Nor should a middle school child be allowed to choose not to go to school. Permitting a youngster to do so allows him to usurp the parent’s authority on matters that should be non-negotiable because they are in the child’s best interest.

Not only do parents give up their authority in the bargaining process, but they also surrender their personal power – their power to make choices that align with their personal values. For example, a parent gives away personal power when she allows a youngster to speak disrespectfully to adults without any consequences. The parent may feel powerless to stop the child from treating her in a manner that goes against her personal values.

The way to regain personal power is by maintaining boundaries. Knowing which rules are negotiable and which are non-negotiable and sticking to it is the first step. It’s also important for parents to take care of their own mental and physical health by making time for themselves. In doing so, you become a role model to your youngster, showing her how to get her needs met in a healthy way. Knowing what your values and morals are and living by them is another way to set clear guidelines for your child.

Tips for Avoiding Power Struggles—

While the occasional power struggle is a natural part of parenting, setting up a pattern of bargaining can set the stage for a contentious parent-child relationship during high school and beyond. The following are a few suggestions for avoiding power struggles with your teenager:

1. Always listen to your kids. You can validate their feelings without necessarily agreeing. For example, you may want to say, “I understand that you feel left out because everyone else is going to the party. Nevertheless, I am not comfortable with you going.”

2. Decide which rules or topics are non-negotiable. Talk with your spouse to make sure both of you are on the same page and are prepared to present a united front to your teenager.

3. Do not get stuck in an argument. Too many words are usually a sign that you are negotiating. The longer the conversation continues, the more your teenager feels she can change your mind.

4. Inform your youngster that these particular items are no longer up for negotiation and that when you, the parent, say “no” or that a topic is not up for discussion, you are exercising your legal authority to make decisions in the best interest of your youngster.

5. Inform your child which areas are open for discussion and possible negotiation.

6. Understand that if you have allowed your youngster to negotiate in the past and are trying to regain your personal power in the relationship, the process takes time. You may have to set multiple boundaries and have the same discussion several times. Teenagers will test every rule. For example, “Can I go to Jenny’s house?” “No.” “Can I go to the mall with Jenny?” “No.” “Can I study with Jenny and Sarah?” “No.”

7. Recognize that a youngster who has negotiated before will try to negotiate again – and this time, she’ll press even harder, hoping that you will give in. Parental responses to these pleas for negotiation should be neutral but firm, such as:

• “I’m sorry you’re disappointed, but that is my final word.”
• “If you continue to push this, I will have to _____ (e.g., ground you for the evening for not accepting my decision, take away your cell phone for 24 hours, etc.).”
• “Nevertheless, you will not be going to Susan’s house for an overnight.”
• “This is not negotiable. I am not comfortable with you going to Mike’s house for the reasons we have already discussed.”

The next time your youngster tries to spark a debate on a non-negotiable issue or “win” in a bargaining exchange, remember these tips and do yourself and your child a favor by drawing a clear, but fair boundary. If you have used these strategies in the past and your youngster continues to struggle with respect, rules, and authority, it may be time for a professional intervention.

==> My Out-of-Control Teen: Help for Parents

Parenting the Angry, Defiant Child

The majority of the population does not understand the dynamics of parenting a defiant child. Small expectations on the parent's part can set the defiant child off in ways that are not only indescribable, but also often unbelievable.

Family and friends may think that you - the parent - are the one with the problem. Support is non-existent, because outsiders can't even begin to imagine that children can be so destructive. Where does that leave a parent?

Without strong support and understanding, the parent will become isolated, hurt, demoralized and confused. You begin to question your parenting abilities - and your own sanity.

The ongoing stress can result in disastrous effects on our well-being, literally causing our emotional and physical health to deteriorate - as well as causing us to rage at our child, thus making a bad problem worse.

In parenting a defiant child, you will not escape adverse effects. It is essential to recognize that your feelings are typical under stressful conditions. It is just as essential to accept the fact that extensive stress is unhealthy. By recognizing the symptoms and seeking support, you will strengthen your abilities to cope.

The strains a defiant child puts on your family can be enormous.

Effects on the family:

• A defiant child will play one parent off the other, which could result in a rift between parents.
• Due to the child’s disruptive behavior, parents often withdraw from social functions.
• Parents appear to be unfair, strict and sometimes hostile, as parenting skills used with healthy children do not work with defiant children.
• Siblings and pets can often be targeted and threatened.
• Siblings often feel ignored or overlooked as the defiant child takes up so much of the parent’s time.

Defiant children are not bad - but they are very intense. And they seek intensity from others as well - especially their parents! Unfortunately, they have discovered that their parents are the most intense and exciting when things are going wrong. What parents may have viewed as punishment for their defiant child was actually a reward (i.e., he/she received a bigger payoff for misbehavior).

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Behavioral Problems In School

"What are your suggestions for a 13 yo (boy) who behaves well enough at home, but is in constant trouble at school for arguing and fighting with some of the other students?"

There are all sorts of reasons why kids misbehave in school. By the time a child is reacting with violence, it's too late to institute a quick fix. Newspaper articles about kids whose behavior problems have turned tragic often talk about missed opportunities and why nobody helped. Here are five ways to start dealing with problems or potential problems early, when there is still time to work with teachers and administrators to make school a tolerable place for your youngster.

1. Be realistic about your youngster's abilities— Pushing and motivating and holding high expectations can drive some kids to be all they can be, but it can drive others straight into anxiety and depression. Would you want to work at a job, day in and day out, where you always had to be at the top of your abilities, handling things you weren't quite on top of and hoping things turn out alright? Children can't quit, and they have very little recourse in terms of demanding better working conditions, but they can find all sorts of ways to act out their anger and despair. Be honest and compassionate when considering what sort of classroom your son will learn best in and what sorts of supports he will require. Academics are important, and it's not wrong to make them your biggest concern, but emotional support and feelings of mastery are important, too.

2. Be respectful of authority yourself— We all know how important it is to fight for our kids and be strong, effective advocates. That struggle may lead us to conclude that some teachers and some administrators are not worthy of our respect, and their judgment is subject to doubt. But be very, very careful how you communicate that to your youngster. You may think the message you're giving is that grown-ups can be wrong, and you will always stick up for him, and he should value himself even when others criticize. The message your youngster receives, though, may be that it's okay to be disrespectful to teachers, the rules don't apply to him, and you will clean up every mess he makes. That's an attitude that's sure to cause major problems at school, and beyond. If you teach a kid to question authority, sooner or later he's going to question yours.

3. Listen when your youngster talks— Children don't answer the question "How was school?" because they know moms and dads only want to hear good news. Moms and dads need to reconnect with what it really feels like to be in school -- the uncomfortable desks, the stuffy classrooms, the disengaged teachers, the work that is either too easy or too hard. Think about what it really feels like to be your youngster at school. Ask questions about feelings, and really listen to what he says. Don't be quick with a pep talk and a pat on the back. Having someone to listen, without judging, can help defuse some of the frustration that might later erupt in dangerous behavior. And if you listen closely, you may be able to figure out other ways to lessen your son's emotional burden.

4. Request an FBA— If the school is sending home complaints about your youngster's behavior -- and expecting you to do something about it -- put the ball back in their court by requesting a Functional Behavior Assessment (FBA). This will force school personnel to really think about your youngster's behavior, not just react to it. An FBA examines what comes before bad behavior and what the consequences are for it, what possible function the behavior could serve for the youngster, and what sorts of things could be setting him off. If a youngster finds class work too hard or a classroom too oppressive, for example, getting sent to the hallway or the principal or home could become a reward, not a punishment. Conducting an FBA and writing a behavior plan based on it is probably the best way to head off discipline problems. If teachers and administrators refuse to go along with it, you might need to do a little behavior analysis on them.

5. Volunteer at your youngster's school— Being a presence at your son's school -- whether you volunteer at the library or help in the lunchroom, serve as class parent, or staff special events -- pays numerous dividends. It gets you known by the administration in a non-adversarial context. It lets your youngster know that school is important to you and a place you want to be. It gives you an opportunity to observe what goes on in that building, from the conduct of the children to the morale of the teachers. If you can't spare the time to volunteer during the school day, attend every Home and School Association meeting you can, and be sure to show up for Back to School nights and teacher conferences. When school personnel get to know you as an involved and interested parent, they're more likely to be your ally when problems come up.

==> My Out-of-Control Teen: Help for Parents

What's the difference between ODD and ADHD?

Which is more difficult to treat, ODD or Conduct Disorder?