Examples of Oppositional Defiant Behavior

Here are three examples of how Oppositional Defiant Disorder [ODD] looks across ages. These examples stress some of the common features of ODD:

Pre-school Shelby—

Shelby is now 4 years old. Her parents were very excited when she turned four that perhaps that would mean that the terrible twos were finally over. They were not. Her parents are very grateful that the Grandparents are nearby. The grandparents are grateful that Shelby's aunts and uncles live nearby. Shelby's Aunt is grateful that this is her niece, not her daughter. Why? Shelby requires an incredible combination of strength, patience, and endurance.

Shelby begins her day by getting up early and making noise. Her father unfortunately has mentioned how much this bothers him. So she turns on the TV, or if that has been mysteriously disconnected, bangs things around until her parents come out. Breakfast is the first battleground of the day. Shelby does not like what is being served once it is placed in front of her. She seems to be able to sense how hurried her parents are. When they are very rushed, she is more stubborn and might refuse it altogether. It would be a safe bet that she would tell her Mom that the toast tastes like poop. This gets her the first “time out” of the day.

In the mornings she goes to pre-school or goes off with her grandmother or over to her aunts. Otherwise Shelby's mother is unable to do anything. Shelby cannot entertain herself for more than a few moments. She likes to spend her time purposefully annoying her mom, at least so it seems. Shelby will demand over and over that she wants something (e.g., play dough). She knows it must be made first. So her mom finally gives in and makes it. Shelby plays with it about one minute and says, "Let’s do something". Her mother reminds her that they are doing something, the very thing that Shelby has been demanding for the last hour. "No, let’s do something else."

So after Shelby's mother screamed so hard she was hoarse when her husband came home, Shelby gets to go out almost every morning. At preschool she is almost perfect, but will not ever do exactly what the teacher wants. Only once has she had a tantrum there. Shelby gets along with the other children as long as she can tell them what to do.

Her grandmother and Aunt all follow the same “time out” plan. This means she goes to a certain room until she calms down. The room is empty now at Shelby's grandmother. Shelby broke the toys, and they were removed. She banged the furniture around and it was removed. What sets Shelby off is not getting to do what Shelby wants. She screams, tells people she hates them, and swings pretty hard for a four old. After a half hour it is usually over, but not always. Shelby will usually tell her mom or Grandmother about these tantrums. The story is always twisted a little. For example, Shelby will tell her Grandmother that her mom locked her in her room because she was watching TV.

Her grandmother used to believe these stories, and Shelby could tell the whole story of how she was watching this show, and her mom just came in and dragged her to her room. Now it turns out that Grandma doesn't think much of TV anyways, and so this made a certain amount of sense to her. This led to more than one heated argument between the Grandma and her mom. Of course there was almost no truth to this at all. It took the tables being turned for the Grandma to really believe that her Granddaughter could set up an argument like this. Shelby came home and told her mom that Grandma let her eat four cookies and an ice cream cone for a treat and that she was very full. Shelby's mom doesn't think much of treats, and could see how this might happen and thought she would have to talk to her mom. Finally they both realized what Shelby was doing.

Most of the afternoon with Shelby is spent chasing her around trying to wear her out. It doesn't seem to work, but it is worth a try. When she is at her aunts, she tries to wreck her cousin’s stuff. When is she good? When there are no other cousins around and she has the complete attention of her Aunt or Grandpa.

Shelby loves the bedtime battle. She also loves to go to the Mall. But she never gets to go there or hardly anywhere else. She acts up so badly that her family is very embarrassed. Her mother shops and visits only when Shelby goes to preschool. It is hard to know who is more excited about Shelby going to school next year, her mother or Shelby!

Elementary School Cody—

Cody is 10. Cody's day usually starts out with arguing about what he can and cannot bring to school. His mother and his teacher have now made out a written list of what these things are. Cody was bringing a calculator to school and telling his teacher that his mother said it was alright. At first his teacher wondered about this, but Cody seemed so believable. Then Cody brought a little (Cody's words) knife. That led to a real understanding between the teacher and Cody's mother.

Cody does not go to school on the bus. He gets teased and then retaliates immediately. Since it is impossible to supervise bus rides adequately, his parents and the school gave up and they drive him to school. It is still hard to get him there on time. As the time to leave approaches, he gets slower and slower. Now it is not quite as bad because for every minute he is late he loses a dime from his daily allowance. Once at school, he usually gets into a little pushing with the other kids in those few minutes between his mother's eyes and the teacher's. The class work does not go that badly now. Between the daily allowance which is geared to behavior and his medicine, he manages alright. This is good for everyone. At the beginning of the school year he would flip desks, swear at the teacher, tear up his work and refuse to do most things. Looking back, the reasons seem so trivial. He was not allowed to go to the bathroom, so he flipped his desk. He was told to stop tapping his pencil, so he swore at the teacher.

Recess is still the hardest time. Cody tells everyone that he has lots of friends, but if you watch what goes on in the lunch room or on the playground, it is hard to figure out who they are. Some kids avoid him, but most would give him a chance if he wasn't so bossy. The playground supervisor tries to get him involved in a field hockey game every day. He isn't bad at it, but he will not pass the ball, so no one really wants him on his team.

After school was the time that made his mom seriously considers foster care. The home work battle was horrible. He would refuse to do work for an hour, then complain, break pencils and irritate her. This dragged 30 minutes of work out to two hours. So, now she hires a tutor. He doesn't try all of this on the tutor, at least so far. With no home work, he is easier to take. But he still wants to do something with her every minute. Each day he asks her to help him with a model or play a game at about 4:30. Each day she tells him she cannot right now as she is making supper. Each day he screams out that she doesn't ever do anything with him, slams the door, and goes in the other room and usually turns the TV on very loud. She comes up, tells him to turn it down three times. He doesn't and is sent to his room. She calculated that she has made about 1500 suppers since he was five years old. Could it be that they have gone through this 1500 times? She decides this is not a good thought to follow through. After supper Cody's dad takes over and they play some games together and usually it goes fine for about an hour. Then it usually ended in screaming. So Cody's grandmother had the bright idea of inviting them over for desert at about 8:00 pm most nights. But what about days when there is no school? Cody's parents try very hard not to think about that.

High School Terri—

Terri is 15. She is in ninth grade and from her marks you would say there is no big problem. She is passing everything, but her teachers always comment that she is capable of much more if she tried. If they gave marks for getting along with others, it would be a different story. Terri's best friend is currently doing a 6 month sentence for vandalism and shoplifting. Terri and Sylvie have been friends since fall, if you can call it that. Since Terri has almost no other friends, she will do anything to be Sylvie’s friend. At least that is what her parents think. Terri thinks it is "cool" that Sylvie is at the Shelburne Youth Center. One sign of this friendship was that Terri almost always gave her lunch money to Sylvie. Why? Because Sylvie wanted it.

Terri thought that Sylvie was her friend, but everyone could see that Sylvie was just using her. What seemed saddest to Terri's parents is that Terri could not see this at all. But this was nothing new. She would make a friend, smother them with attention, and that would be the end of it. Or, the friend would not do exactly what Terri wanted and there would be a big fight, and it would be over. But mostly Terri complained that everyone bugged her. What seemed to save Terri was the nursing home. Somewhere along the way Terri got involved working there. To hear the staff there talk about her, you would never guess it was the same girl. Helpful, kind, thoughtful - they couldn't say enough good things about her. In fact her parents joked that maybe if they all moved to the nursing home, it would stop the fighting at home. They figured it out when another teenager volunteered to help one of the same afternoons as Terri. Unfortunately the "other" Terri came out. She was tattling, annoying, disrespectful and hard to get along with. Terri could get along with any one, as long as they weren't her age, a teacher, or a relative!

My Out-of-Control Child: Help for Parents of ODD Children

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.

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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. 

 

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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." 

 

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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

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