The psychiatric diagnosis of Oppositional Defiant Disorder (ODD) in a child means more than youthful stubbornness. It is sometimes a free-standing disorder and sometimes exists co-morbidly with other diagnosable and treatable conditions. There is significant risk in leaving it untreated.
Normal child development always includes certain episodes or periods in which a youngster becomes stubborn, argumentative and yes, even occasionally belligerent. When these behaviors, though, become prevalent and consistent over time, they may suggest the presence of a specific disorder called ODD (Oppositional Defiant Disorder.)
If ODD is present, it may not simply go away by itself but require some professional attention and help for both the child and parenting people.
ODD is one of the more prevalent childhood disorders, estimated variously by the American Academy of Child and Adolescent Psychiatry to effect nearly 16% of school-age children (with a heavier degree of boys) and by the Surgeon General at somewhere in the much lower range of from 1 -6%.
The characteristics of ODD, taken singularly, are generally not of significant concern. This is especially true if the child seems to be doing OK in all other ways. However becoming evident as a package, neither parental denial nor pleading is apt to successfully bring the situation and condition under control.
This article will first address the visible symptoms of ODD and then review some of the better known and effective mode of treating it. The article concludes with some cautions about the risks of not having the condition treated.
The Signs of ODD:
Many of these behaviors are ‘normal’ in two-three years old, thus the common idea of the “terrible twos.” However, when they are severe, persistent and seem to be noticeably more severe and dramatic than other children of the same age whether at home, school or both, further attention may be warranted.
These behaviors may include but are not necessarily limited to:
– Often being touchy or frequently annoyed by others,
– Frequent temper tantrums,
– Spiteful attitude and revenge-seeking behavior,
– A seemingly reflexive “No” as a response to most requests,
– Frequent anger and resentment,
– Deliberate attempts to upset or annoy people,
– Active defiance and refusal to adhere to reasonable adult requests and rules,
– Mean and hateful talking when upset,
– Excessive arguing with adults,
– Blaming others for their own mistakes
These behavioral symptoms may be visible in all settings but are often more pronounced in one or the other: Sometimes they are more dramatic at home, sometimes at school, sometimes in other environments. But many of them are present, to one degree or another, across the board.
While the causes of ODD are not well understood, parents often report that the child was somehow more rigid and demanding than others even at a very early age.
Frequently confused with being ‘bad,’ ODD is a specific disorder that may be amenable to intervention with both the child and parents.
Because ODD so often co-exists with other disorders (Mood Disorders, ADHD, etc) a good professional workup is always a good place to start. That way if what appears to be ODD is actually a symptom of something else, the core problem can be addressed and treated.
If there is, in fact, some underlying ADHD or Mood Disorder, specific medications may be considered by a licensed physician and recommended to parents to help control the impact of those disorders. There is no generally used medication for ODD per se.
Many successful treatment interventions with ODD are based on a combination of parent management training to help parents learn techniques that elicit better results from their own child along with some psychotherapy for the child. Even the youngest of children develop feelings and some core self identity based on the way they are regarded.
Positive parenting techniques seem to help, but are not to be confused with holding the child harmless from appropriate consequences for their actions.
If their behavior results in them being seen as being bad, they are not unlikely to begin to think of themselves that way. This is the area that the child psychotherapy can be used to help with.
Family Therapy can also contribute to the successful resolution of an ODD situation by working on the nature of communication, responsibilities and authority in the home.
Possible Consequences of Not Getting Treatment:
Parents are sometimes slow to acknowledge that a child has a problem and, consequently, interventions sometimes begin later than might have been ideal. On the other hand, it is never too late when it comes to a young child.
Left untreated, the symptoms that justify the diagnosis of Oppositional Defiant Disorder in a youngster can morph into what is called a Conduct Disorder, a very serious condition where, in essence, the person knows the difference between what is right and what is wrong but does not feel that those standards apply to themselves.
Conduct Disorders, unlike childhood ODD, are notoriously difficult to treat and the prognoses for change are far less hopeful.
Parents who have reason to suspect that ODD may be what they are experiencing with a child are advised to begin by seeking out a good professional evaluation. If it is a ‘phase,’ it will go away itself. If it is ODD, it will probably require some intervention to resolve.