What are the statistics on ODD?

ODD is the most common psychiatric problem in kids. Over 5% of kids have this. In younger kids it is more common in males than females, but as they grow older, the rate is the same in males and females.

It is exceptionally rare for a psychiatrist to see a youngster with only ODD. Usually the youngster has some other neuropsychiatric disorder along with ODD. The tendency for disorders in medicine to occur together is called co-morbidity. Understanding co-morbidity in pediatric psychiatry is one of the most important areas of research at this moment.

If a youngster comes to a clinic and is diagnosed with ADHD, about 30-40% of the time the youngster will also have ODD.

==> My Out-of-Control Child

Children & Stealing: What Parent Can Do

Hi Mark, It's been a long time since we were last in touch. I'm afraid the relationship between my son and us has completely broken down. We've left London and now live in Leeds, my son K__ didn't want to come with us, so he stayed with his grandmother who has served to cause further damage between us. We've recently started living with one of my husband's two sons, J__.

I was really pleased to be living with him, but he has brought an entirely different problem to us: He steals. From his family. So far he has stolen from four of his cousins and from my mother. He was living with my sister-in-law for a while before my husband and I were able to move to Leeds at the beginning of June. Within three weeks of living with her he had stolen over £100 - he is only twelve years old. He lies and doesn't care about the pain and upset he causes, he will just deny that he has stolen anything for months on end. When he finally admitted to stealing from his aunt's house, he went around there with the intention of apologising for as little as he could get away with. In the end, because I told him I would only forgive him when he made a full apology for stealing from all of the people he had really stollen from, he finally admitted to it and told what he had done with the money, how he had spent it, etc.

He can no longer stay at his aunt's house. So, he is staying with us at my mother's house until our home is renovated (hence him not living with us in the first place). The only thing is, he stole from my mother the very next day after making his "full apology" at his aunt's house. He has not apologised for stealing from my mother, nor has he admitted to it or given the money back. Today, it has come to light that he has stolen from his six year old cousin (on my side of the family) whilst she was staying here at my mother's with her parents and other siblings.

I'm really annoyed with him and by him. He is SO polite all of the time and yet he could steal without the least bit of conscience at all. He told me once that when he steals it's nothing personal, he doesn't dislike the person he steals from. He said that he didn't see the point of apologising or giving the money back because it's like when you squeeze out too much toothpaste from the tube; you can't put it back in so what's the point of trying?

I really don't know what to do about him. I can already feel resentment building because I don't like the idea of bringing a thief into my mother's home so that he can take what he pleases. He has created financial impacts on us because my husband has taken time off work to deal with his misbehaviour (he only gets paid when he works) and we have to pay the money back he keeps stealing because he doesn't get much pocket money. I want his stealing to stop. I know what I would do if he were my son, but he isn't so it's very difficult for me. Do you have any advice? With thanks in advance, N.

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Hi N.
 
Regardless of why kids steal, the stealing itself must be handled by following the steps below. Knowing what lies behind the stealing helps you recognize patterns that may be occurring in other parts of your youngster's life. It also assists you in understanding needs that aren't being met in his life that you can teach him to meet in socially appropriate and effective ways. These are the primary reasons kids and adolescents steal:

• It is a way of seeking attention.
• It is done for revenge or to hurt somebody.
• It may support a drug habit.
• Older kids may like the risk.
• They may not have learned to respect the rights of others.
• They think taking something is the only way they can get what they want.
• They think they can get away with it.

WHAT TO DO—

When kids take items like money, toys, pens, pencils and erasers, they think that is the only way to easily get these items. Brainstorming ideas with your youngster about how to appropriately get what he wants lets him know you want him to meet his needs successfully. If he receives an allowance, offer suggestions about how he might earn extra money to buy the school supplies or toys he wants. Assist him in planning a savings budget for wanted items. 
 
 
Model for him how to ask for the extra money he desires. For example, you might say, "It is not okay for you to take money from my purse (your sister's room, etc.). If you want or need money, come to me and say, 'I need extra money for pencils', or 'I want money for candy.' Sometimes we might work out a loan. Sometimes I will say that I can't give you the money. When that happens, we'll see if we can create a plan together."

If stealing is done to seek attention, the youngster usually does it in such a way that he is easily caught. Handle the stealing straightforwardly but give no extra attention to it. Do not discuss it past the time of returning or replacing the taken item. Look for positive behaviors the youngster exhibits and begin acknowledging them regularly. When kids feel acknowledged for appropriate behavior, they seek less negative attention.

Sometimes kids steal to hurt their victim or to get revenge. This can be a way siblings inappropriately handle hurt feelings with each other. Their motive is, "I'm going to make you feel as bad as you make me feel." If your youngster wants to hurt you because she feels picked on or misunderstood, she may take money from your purse or wallet. She may take something from your dresser drawer. What better way to arouse your hurt and concern?

Your own injured feelings can be a sign that this was your youngster's motive for stealing. Address your own feelings with her; then explore her hurt. You might say something like, "I feel sad and scared when you take money from me. I know you were angry this morning when I yelled at you for missing the bus. I said some unkind things. Taking my money won't solve our problem. I'm sorry I was mean. I know you weren't feeling well and didn't want to go to school." 
 
 
Let her know that she can tell you she is angry. She doesn't need to take your money. If you are wrong about the motive, your youngster will let you know in such a way that you can continue exploring through positive communication. Only attempt this kind of communication when you have time to complete the process.

Kids may steal because they think they can get away with it. This is particularly true when parents are inconsistent in following through with consequences for not complying with household standards or when deviant behavior has been inconsistently addressed in the past. When we are inconsistent in our effective parenting, kids know that they have a strong chance of getting away with inappropriate behavior. In assisting our kids toward appropriate behavior, we must be willing to take the necessary time and energy for following through on set consequences for family standards.

The best way we can assist a youngster in learning to respect the rights of others is to model that respect ourselves. If we take sugar packets from restaurants, don't tell a cashier if we have received too much change or are dishonest in business transactions, we are letting our kids know this behavior is acceptable. If we take items from our kid's rooms or backpacks without asking, we are not respecting their rights. Be a good model. Teach the respect you want your youngster to give to you and others through your own respect for the rights and property of others.

When older kids and adolescents who do not have a criminal history engage in stealing, it may be to experience the high risk factor at play. Like younger kids, the motive is to see if they can get away without being caught. The stakes are high. Shoplifting or taking hubcaps or hood ornaments from cars are common choices. The sooner the adolescent needs to face the consequences of such behavior, the less likely he is to continue in it.

It is important to remember that straightforward and compassionate handling of the problem is called for. Verbally attacking the adolescent will not solve the problem, nor will consequences unrelated to the incident. If the police are involved, the consequences may not be in your hands. You may want to seek professional help if your older youngster or adolescent steals.

Kids and adolescents who are involved with drugs steal to support the drug habit. If you have any reason to believe that this is the motive for stealing, seek professional help immediately. As parents, we don't want to believe our kids use illegal drugs. Closing our eyes to the possibility is not the answer. Neither is demanding answers from our offspring or indiscriminately punishing them. Kids and adolescents who use drugs are hurting. They need guidance beyond what most parents are able to provide. Professional intervention offers the best opportunity for positive outcomes.

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Could you tell me what causes Oppositional Defiant Disorder? Is it inherited? How can you tell if a child has ODD?

No one knows for certain. The usual pattern is for problems to begin between ages 1-3. If you think about it, a lot of these behaviors are normal at age 2, but in ODD, they never go away. ODD does run in families. If a father is alcoholic and has been in trouble with the law, his child is almost three times as likely to have ODD (18% of kids will have ODD if the parent is alcoholic and has been in trouble with the law).

ODD is diagnosed in the same way as many other psychiatric disorders in kids. You need to examine the child, talk with him, talk to the parents, and review the medical history. Sometimes other medical tests are necessary to make sure it is not something else. You always need to check kids out for other psychiatric disorders, because it is common for kids with ODD to have other problems, too.

My Out-of-Control Child

My child has just been diagnosed with Oppositional Defiant Disorder. What is it exactly?

OPPOSITIONAL DEFIANT DISORDER is a psychiatric disorder that is characterized by two different sets of problems. These are aggressiveness and a tendency to purposefully bother and irritate others. It is often the reason that people seek treatment. When OPPOSITIONAL DEFIANT DISORDER is present with ADHD, depression, tourette's, anxiety disorders, or other neuropsychiatric disorders, it makes life with that child far more difficult. For Example, ADHD plus OPPOSITIONAL DEFIANT DISORDER is much worse than ADHD alone, often enough to make people seek treatment. The criteria for OPPOSITIONAL DEFIANT DISORDER are:

A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

• is often angry and resentful
• is often spiteful and vindictive
• is often touchy or easily annoyed by others
• often actively defies or refuses to comply with adults' requests or rules
• often argues with adults
• often blames others for his or her mistakes or misbehavior
• often deliberately annoys people
• often loses temper

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

All of the criteria above include the word "often". But what exactly does that mean? Recent studies have shown that these behaviors occur to a varying degree in all kids. These researchers have found that the "often" is best solved by the following criteria:

Has occurred at all during the last three months—

• blames others for his or her mistakes or misbehavior
• is spiteful and vindictive

Occurs at least twice a week—

• actively defies or refuses to comply with adults' requests or rules
• argues with adults
• is touchy or easily annoyed by others
• loses temper

Occurs at least four times per week—

• deliberately annoys people
• is angry and resentful

If you are not careful, this disorder will destroy you long before it ruins your child. The outcome can be dismal if you do not seek some outside assistance from a professional.

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The Effect of Rage on Families

Family ties are one of the strongest contributors to individual character development. Many of us spend years trying to understand, erase, or copy the influence of our family unit. When Rage is part of a family's tradition, it spreads itself much like a virus to future generations. The wider the spread, the more difficult the Rage is to contain.

The effect of Rage in families is usually apparent in the way that members relate with one another. Our earliest experiences communicating and relating to others occurs within the family. Patterns of Rage in relationships are then taken and recreated in later relationships outside the family. Thankfully, a committed, well-designed treatment plan can repair the damage of having been raised in an hostile family system.

Rage in Relationships—

Rage is one of the most common negative patterns in relationships. Couples sometimes report that it is their Rage that makes the relationship feel alive. Rage takes root in insecure relationships where open communication is absent and the emotion of love is buried beneath years of Resentment. There is typically hopelessness in the present and doubt about the future in these relationships. The good news is that individuals committed to improving their relationships through the hard work of therapy are generally rewarded with a renewed sense of hope. Here are some tips on how to limit Rage producing interactions in your relationships:

1. Always consider individual or family therapy in instances where your Rage feels out of control and/or mysterious.
2. Ask yourself if you have legitimate assumptions about the intentions of others.
3. Before feeling attacked or hurt, make an attempt to give others the benefit of the doubt, especially if you have nothing to lose by doing so.
4. Explore your participation in relationships that repeatedly bring out the worst in you.
5. Keep the lines of communication open. When you feel Resentment building, see if you can journal your feelings and then share your thoughts with a loved one.
6. When you have Rage toward another person, start with an internal check of your own emotional state. Ask yourself why you feel the way you do.

How Do I Know If My Family or Loved One Has a Rage Problem?

Hostile individuals are, in most instances, very aware of their problems in controlling Rage. Unfortunately, too many come to accept their Rage as an unchangeable part of who they are and feel hopeless to change. If you feel that you or a loved one may have an Rage disorder, look for several of the following symptoms happening in your life on a regular basis:

1. Becoming more hostile than is appropriate in regard to mild frustration or irritation.
2. Family and/or friends approach you with the concern that you need help managing your Rage.
3. Having chronic physical symptoms such as high blood pressure, gastrointestinal, difficulties, or anxiety.
4. Having feelings of guilt or regret over something that you have said or done in a fit of Rage.
5. Repeated social conflict as a result of Rage outbursts (law suits, fights, property damage, school suspensions, etc.).

Where to Get Help for My Rage—

Fortunately, the mental health profession has been responsive to individuals seeking treatment for help with Rage. Referrals to treatment programs and services are often available and mandated for those individuals suffering moderate to severe social conflict. Many chronically hostile individuals feel shame and guilt about their Rage. There may be times when a friend or loved one may need to request help or plan an intervention for the hostile individual. In such instances, it is critical to take advantage of mental health professionals with a background in Rage management training.

What Kind of Help Will I Get for My Rage?

An effective Rage management plan can include individual or family therapies, which are some of the more common ways people attempt to deal with chronic Rage.

Individual Therapy—

Individual therapy, which explores the root of hostile feelings and behavior, is traditionally a safer, more secure option to working with the entire hostile family at once. Treatment with individuals helps facilitate a thorough focus on the most important emotions beneath the individual's Rage.

Family Therapy—

Family therapy is a powerful way of repairing the damaging effect of long-term Rage interactions. Over time, chronic Rage drives a wedge between family members, resulting in the members becoming disconnected from one another, or overly involved with one another in an unhealthy manner. Therapy would consider each member's role in the Rage interactions, versus assuming any single member is responsible for the family's Rage.

How Marriage and Family Therapy Helps Control Rage—

More often than not, chronic Rage has a lengthy, definable history. Marriage and family therapists are trained experts in identifying Rage patterns that pass from one generation to the next. Identifying these patterns helps to explore individuals' learned perceptions about the appropriateness of Rage expression and suppression. Encouraging a parent to share how emotions were expressed in his or her immediate family allows other family members to understand the family's inherited concepts about Rage.

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Son Won't Poop In Toilet


"I need information on how to potty training my son. He will soon be five years old. 99% of the time he will use the toilet to urinate. But he will not use the toilet to have a bowel movement. He said he doesn’t want to. I have started taking his toys away from him and trying not to spank him. I am raising my son all by myself. His father hasn't been in his life since he was a baby. My son father wasn't potty trained until he was four and he was very strong will also. I do not have enough emotion support and I have not been very social. These issues could be major factors that have lead to his potty training problems. Please send me any advice you have on this situation"

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Your child obviously has bowel control and is very close to being completely potty trained. However, he is uncomfortable sitting on the potty and going number 2, which probably relates to constipation. Sometime in the past when he was potty training, he took a hard poop in the toilet or potty – but he thinks the “hard poop” is related to sitting on the potty and not his diet at the time. His diaper brought him comfort and allowed him to stand in a private place and bear-down when he was ready to poop.

Here’s a 10-step plan:

1. Talk to your child about pooping in the potty but NOT when he needs to go poop. Ask him why he doesn't like to poop in the potty. Tell him that everybody poops in the potty …mommy, daddy, etc. Explain what constipation is and why it happens.

2. Tell your child that he cannot use diapers – so he needs to learn to poop in the potty. Keep conversation light and remind him your there to help him. Don't create urgency and don't create pressure.

3. Pay attention to what you are feeding him and give him lots of stool-softening foods, such as whole-grain breads and cereals, fiber-rich fruit and vegetables, and plenty of water to wash it all down. Limit food-binders that make the poop hard (e.g., too much apple, too much chocolate, etc.).

4. When he is on the potty or toilet, ensure there is plenty of support for his feet and buttocks, because sitting properly on the potty supports the muscles in his abdomen to help him with pushing. He needs a good fitting potty where he can plant his feet firmly on the floor. If he is using the toilet, get a potty seat insert so that he feels safe and is stable – it will prevent him from falling in the bowl. And don't forget to put a stool under his feet for support.

5. Get your child to lean forward as much as possible while sitting on the potty. This will help to open up and relax the pelvic floor muscles which must occur every time you pass a bowel movement.

6. It could also be that your son has gotten into the habit of a bad routine. So when he needs to poop, he goes in his underpants, or you give him a diaper, and the circle keeps going around. You need to wean him away from the bad habit of pooping his underpants or soiling his diaper by establishing a new bowel movement routine that involves the potty or toilet. Rather than yelling at him for pooping in his underpants or giving in to his request for a diaper, invite him to use the potty in a positive way at that targets the time of day he usually goes number 2 – then give positive reinforcement by praising him for trying or when he has success.

7. If your child is afraid of the toilet, take him into the toilet… put the seat cover down… put him on your lap …and read a book. Flush intermittently to get him used to the noise

8. If you have not had him to a medical doctor, do so to rule out a physical reason. Often soiling is due to emotional reasons. You do not want this to develop into a power struggle with your son. If it turns into a power struggle with him, you will really have problems on your hands.

9. If you have tried many things to remedy the problem – but nothing works, you may want to seek out the help of a child psychologist. Your insurance plan can help you find one – or contact your local university psychology department.

10. This problem requires a great deal of love and gentleness on your part. I would not require him to clean himself up. Don’t punish this “behavior.” He is doing the best he can, and anything that involves shame or force will only back fire.

Mark

How do I know if my son has an emotional disability?

RE: "How do I know if my son has an emotional disability?"

Here's a check list of sorts:

• Ask your son if something has happened to him. Children sometimes act out in an attempt to draw attention to a problem they are having and are afraid of discussing.

• Ask your son's teacher if problems have occurred in the classroom and what things you can do to help your son at home.

• Beware of changes in environment or life events that may alter your son's behavior. Sometimes moving to a new town or school can cause a son to act out aggressively or overly emotionally in an attempt to adjust to the change.

• Have your son professionally tested if you think your son has an emotional disability or if behavioral problems are creating academic, social or other problems for your son.

• Look for emotional cues. Does your son pretend to be physically ill when confronted with a school event or a social situation? Does your son have excessive fear or anxiety associated with certain activities? Does your son cry excessively over seemingly little things?

• Look for patterns of aggressive behavior lasting six months or longer. Does your son consistently bully others or use aggressive force with other children or animals? Does your son initiate fights?

• Set rules. Look for major infractions of rules such as truancy or running away with older children. With younger children, look for consistently breaking rules, aggression toward siblings, stealing and lying.

• Talk openly with your son about the behavior that concerns you. Explain that you are concerned and want to make changes. Be specific and nonjudgmental.

• Watch your son in social peer situations. Is your son withdrawn or rejected by other children? Does your son dominate play, causing other children to not want to play?

• Watch your son when playing independently. Does your son act violently toward toys and inanimate objects? Is your son self-destructive? Does your son seem depressed or uninterested in activity? Does your son cry or become frustrated easily?

The above items will give you some indication as to whether or not he may have an emotional disability.

Mark Hutten, M.A.

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Is your teenager suffering with ODD? Take this quiz to find out:

Oppositional Defiant Disorder Quiz: Is your teenager suffering with ODD? This quiz is designed to help parents understand some behaviors tha...