Before You Look for Information on ODD

Resources for learning more about oppositional defiant disorder

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If your child has been diagnosed with oppositional defiant disorder (ODD) you may be at a loss as to where to begin. It can be daunting to wade through information to find what is worth reading and what is a waste of your time.

Let's begin with some basic information along with resources for learning more, addressing specific behaviors, and getting support so you can best help your child with ODD.

Oppositional Defiant Disorder (ODD): the Basics

Oppositional defiant disorder (ODD) is a mental health disorder in which a child demonstrates aggression and purposeful misbehavior.

Thought to affect roughly 10 to 20 percent of school-age children, it is more common in boys than in girls. When thinking about these behaviors, it's important to realize that many children without ODD exhibit some of these behaviors from time to time. So what are normal behavior problems and what are not?

ODD is a pattern of defiance, negativity, and hostility which is essentially constant. The diagnosis is not usually made until these behaviors have been ongoing for at least 6 months. Symptoms of ODD in contrast to normal child behaviors may include:

  • Frequent angry outbursts
  • Lying and blaming others for mistakes
  • Refusal to follow rules
  • Questioning authority
  • Excessive arguing with parents and other authority figures
  • Being easily annoyed or provoked
  • Purposefully irritating and annoying others and intentionally causing conflict
  • Vindictiveness, being spiteful of others
  • A seeming lack of conscience
  • Frustration and lack of concentration for the child, along with a reduced self-esteem and difficulty forming and keeping friendships

    These symptoms can vary from mild to severe, but usually, arise during the preschool years and almost always before puberty. The behaviors often create significant dysfunction at both homes and in the school setting. Fortunately, while these behaviors can cause havoc for parents and teachers, around two-thirds of children out-grow their disorder in their late teens.

    It's not known exactly what causes ODD but is most likely a combination of factors. Genetics can play a role and may increase susceptibility to the disorder. Abnormal levels of neurotransmitters in the brain may play a biochemical role. While ODD can develop in children from loving and stable families, it's not uncommon for these children to have had a dysfunctional home life and/or exposure to violence.

    ODD may occur along with other conditions, such as attention deficit disorder (ADD), anxiety disorders, bipolar disorder, and language disorders. Sometimes it takes some time to distinguish between ODD and other common behavioral disorders in children such as ADD/ADHD and conduct disorder. (While two-thirds of children outgrow the disorder, around 30 percent will go on to develop conduct disorder).

    When Your Child Is First Diagnosed With ODD

    When your child is first diagnosed with ODD, it's helpful to learn as much as you can about the disorder. Not only will this help you learn methods for coping with the behaviors, but it can be reassuring to learn that the majority of children outgrow the disorder. Knowing this alone may give you more strength to cope with difficult behaviors today.

    Parenting programs can be extremely helpful in getting you up-to-date on how to parent a child with ODD quickly. Some of these include:

    Depending on who diagnosed your child, you may also need to find a therapist who can walk beside you as you learn tools for managing your child's behavior. Therapy has been found to work well for children with ODD and also reduces the chance that ODD will progress to conduct disorder later in childhood or antisocial personality disorder as an adult. You can ask your doctor or therapist if she knows of anyone who specializes in treating children with ODD or ask in one of the online support communities.

    Parents who have been living with a child with ODD have often learned by trial and error and may offer you valuable tips in finding the right person. Most commonly, it will be a child or adolescent psychiatrist who cares for a child with ODD.

    Don't be afraid to interview different providers. It's important that you find an ally who can support you in helping your child.

    If you haven't seen your child's pediatrician, this is an important first step as well. There are some medical conditions which may result in behaviors that could be mistaken for ODD, so a thorough physical is recommended.

    Preparing the School for Your Child With ODD/Special Education

    If your child is in school, it's important to meet with your child's teacher or others at the school who will be involved in his education. Combining a school-based program with positive parenting at home is most effective.

    Special education services can provide support and accommodations for your child. The Individuals With Disabilities Education Act (IDEA) is a federal law which mandates that children with disabilities be provided with services to allow him to function in the school setting. This usually requires that the disorder impairs his academic performance. You can request an evaluation for your child at any time.

    If your child does not qualify for IDEA (usually under the "other health impaired" category) he may still qualify for an individual accommodation plan under Section 504.

    You may also wish to contact your school district, State Department of Education, or your state Parent Training and Information Center.

    Discipline

    You may have read everything you can get your hands on, but how do you discipline a child with ODD? Having a child with ODD can grate on your nerves, but despite ample opportunities to give negative attention, finding opportunities to give positive attention can really help. Even though negative consequences will likely be needed at times, positive attention is often more effective. Thankfully, these "positive" consequences seem to make negative consequences more effective when needed. Avoiding harsh punishment and focusing on behaviors rather than the child is also helpful. The programs listed above provide many examples for working with a child with ODD.

    Understanding Treatment Options and Approaches

    As noted above, therapy is often very effective for children with ODD and may prevent the condition from progressing to conduct disorder or antisocial personality disorder. Options found to be helpful for children with ODD include:

    • Parent management training
    • Family therapy
    • Cognitive problem-solving skills training
    • Social skills programs
    • School-based programs
    • Medications

    Of note, there are not any specific medications recommended for ODD, and medications alone should not be used to treat the condition. Medications may be helpful, however, in controlling some of the behaviors or for coexisting mental health conditions.

    Living With Your Child Who Has ODD

    Living with a child with ODD can leave you on the edge and frustrated. It can be challenging to back up and view the behaviors as separate from your child himself and to stay calm. Here are a few tips that have helped other parents cope with the day-to-day challenges of living with a child with ODD.

    • Limit the number of questions you ask your child.
    • Give your child plenty of time for imaginative play.
    • Provide positive feedback often, even if your child responds in a positive way on a minor issue. Reinforcing the behavior with positive attention may reduce the amount of negative attention her behavior requires.
    • Don't sweat the small stuff. It might be best to ignore minor behavioral problems until you get the major problems controlled. Said in another way, "pick your battles."
    • Schedule daily doses of one-on-one time.
    • Establish clear household rules.
    • "Walk the walk:" Model positive behaviors for your children to observe.
    • Praise your child often.
    • Offer clear consequences, and be aware that consequences are not the same as punishment.
    • Avoid power struggles.

    Finding Professional Help

    Even if you follow all of the tips above for parenting a child with ODD, you may still feel overwhelmed. Take a moment to think about when you should seek help for your child's behavior problems. If your child's behavior problems aren't changing when you incorporate discipline strategies, if his behavior is interfering with school or his social life, or if his behavior is not age appropriate, it's likely time to seek help.

    Reference Resources

    There are a few reference sites which provide good overviews of ODD diagnosis and treatment. The sites mentioned here have information provided by those educated in managing children with ODD and are updated frequently. Reliable sites include:

    Attention Deficit Disorder (ADD) Resources Can Be Helpful With ODD

    As noted earlier, ODD often co-exists with other disorders such as ADD. At times, the management of ODD is similar to that of ADD, but other times it's important to distinguish between the two diagnoses. These sites focused on ADD may offer assistance when your child has ODD as a co-existing condition.

    ODD When Your Child Is a Teen

    ODD is usually diagnosed in the preschool years or shortly thereafter, and for many children resolves by the age of 18. That said, combining "normal" teen issues with the management of ODD can be a challenge. The following sites focus on difficult behavior in teens, including ODD.

    Websites That Are Helpful in Addressing Defiant Behavior

    Websites that offer ideas for parents who have a child with ODD include:

    • DocSpeak offers further information which directly pertains to parents of children living with ODD.
    • Transforming the Difficult Child is designed to help children manage their intensity in different ways.
    • Lives in the Balance is another site which helps assist children in collaborative problem-solving.

    Books That May Help Parents Who Have a Child With ODD

    In addition to websites, podcasts, and Youtube videos, there are entire books devoted to helping parents cope with and care for a child with ODD. Books which may be helpful include:

    • The Explosive Child, by Ross W. Greene
    • The Defiant Child, by Douglas Riley (published in 1997 but still very up-to-date)
    • The Kazdin Method for Parenting the Defiant Child, by Alan E. Kazdin

    Support for Parents Who Have a Child With ODD

    Having the opportunity to talk with other parents living with a child with ODD can be priceless. No matter how thoughtful and understanding your family and friends, there is something special about talking with others who are facing the same challenges.

    In addition to emotional support, online support communities can help you learn about the latest findings and approaches to managing ODD. After all, there is nobody more motivated to understand day-to-day life for a child with ODD more than other parents.

    Online support groups allow you to get understanding and advice from other parents around the world. One of the more active groups is ODD Parents Room. Parenting ODD kids is another one. There are a number of other online groups as well as Facebook groups designed to connect parents who are living with a child who has ODD.

    Bottom Line on Learning About and Finding Resources With a Child Who Has ODD

    Learning that your child has ODD can release a mass of mixed emotions. You may be relieved to finally have a label for your child's behavior but at the same time fear what this means for the future. As parents, the diagnosis can also make you question your own parenting skills. Yet a sense of guilt and shaming is counterproductive to learning how to meet your child's needs. There are many children raised in warm and loving family environments who nonetheless suffer from ODD.

    Once you have a diagnosis you can finally begin to address the behaviors. Talk to your doctor. Find a good child or adolescent psychiatrist. Become involved in support groups. Rest just a bit in the realization that the majority of children "outgrow" these behaviors. That said, therapy can go a long way in reducing the chance your child's behaviors will persist. Check out some of the tips above, and use the resources and links provided to educate and empower yourself as a parent of a child with ODD.

    Sources:

    American Academy of Child and Adolescent Psychiatry. Occupational Defiant Disorder. http://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Children_With_Oppositional_Defiant_Disorder_72.aspx

    Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, and Waldo E. Nelson. Nelson Textbook of Pediatrics. 20th Edition. Philadelphia, PA: Elsevier, 2015. Print.

    Tandon, M., and A. Giedinghagen. Disruptive Behavior Disorders in Children 0 to 6 Years of Old. Child and Adolescent Psychiatric Clinics of North America. 2017. 26(3):491-502.

    U.S. National Library of Medicine. Medline Plus. Oppositional Defiant Disorder. Updated 02/21/16. https://medlineplus.gov/ency/article/001537.htm

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