What is Oppositional Defiant Disorder?
It is common for children and teenagers to display bouts of irritability, frustration, and disobedience over the course of their growth and development. For example, the 4 year old who throws a tantrum because she has to stop playing; the 8 year old who picks on his younger sister; the 13 year old who argues with her mother about going to a movie. Still, there are many families who struggle with child behavior that goes beyond stubbornness or occasional talking back. Some children and teens have such an inflexible and hostile nature and their behavior can be so uncooperative and defiant that they disrupt the functioning of whole households and classrooms, not to mention their own learning and well-being in relationships. One out of every ten children or teenagers displays this type of disposition and behavior with such regularity that they are thought to have Oppositional Defiant Disorder (ODD).
According to the American Psychiatric Association, ODD is characterized by a chronic pattern of negativity, hostility, and non-compliant child behavior that is most often directed toward authority figures and has existed for at least 6 months. This behavior is severe enough that it interferes with everyday functioning at home and, in some cases, at school and other activities, and it stands out as more severe compared with children of the same age and developmental level. Signs and symptoms of ODD:
Act angry or resentful toward others
Deliberately try to annoy or upset other people
Be touchy or easily annoyed by others
Lose his or her temper and throw tantrums
Argue with adults
Actively defy or refuse to comply with adults’ requests or rules
Act spiteful or seek revenge on others
Blame others for his or her mistakes or misbehavior
The exact cause of ODD is not known. Research suggests that it evolves out of a complex interaction of many different factors related to the basic biological, psychological, and social nature of the child and his or her relationships with the family and other environments, such as school. Also, it is not uncommon for children with Attention Deficit/Hyperactivity Disorder (AD/HD), depression, or anxiety to display symptoms of ODD.
Effect on Families & Relationships
Parenting a child with ODD can be a tremendous challenge not only because he or she may seem so willing to defy adult authority, but also because intervention strategies that work with most children, such as time-outs, removal of privileges, and grounding, often do not work with ODD. Studies actually indicate that these children may not respond well to punishments. Other studies have found that children and teens with severe cases of ODD and/or aggression may feel threatened by situations where there are unclear messages, rules, or expectations, which can trigger hostile reactions. In addition, they often have poor frustration tolerance, which only makes it more difficult for them to get through situations where they feel uncomfortable, threatened, or where they may see little pay-off for their efforts. The result of these factors are children and teens who seem to be easily annoyed or angered, yet are difficult to soothe and calm.
This pattern of behavior can leave many families feeling powerless, as if they have to “walk on eggshells” out of fear that one wrong move can cause a serious tantrum. It can also leave the child or teen feeling isolated, anxious, and unsure of herself as others anticipate her irritability and explosive behavior even before it occurs. They likely will be aware of any feelings of disappointment and resentment that other family members feel toward them due to their oppositional and defiant behavior. Unfortunately, it is not enough to help change the behavior.
Parenting Tip: Be Decisive
It is easy for parents who feel like they have to walk on eggshells to become wishy-washy; they are often unsure of when, where, and how, to give directions or enforce rules with their children and teens. However, wishy-washiness can actually be a trigger for ODD behavior. It is important to be decisive!
Most parents with children and teens with ODD have learned the hard way that it is much better to say “no” than to say “we’ll see” if “no” is the answer they really mean. The child may throw a tantrum with either response; however, telling the child “we’ll see” only heightens the intensity of her reaction because it gives her hope that she can still get what she wants. She is then likely to badger the parents until she gets her way or is finally told “no,” with the meltdown that follows being even more intense. So, go ahead and say “no” and stick to it; your child will learn over time that you mean what you say and that goes a long way to curbing anxiety and increasing compliant behavior. This also applies to setting plans for any activity, such as going to school, taking a trip, or running errands. Be clear about what is going to happen and alert and prepare the child before any changes to the plan take effect.
When to Seek Help
It may never be too soon to seek help for your child or teen if they are displaying the type of behavior associated with ODD, as it can be difficult to know whether it is a part of typical development or a problem that needs treatment. The more frequent and severe your child displays the symptoms listed above, the more likely there is to be intense family conflict and the more likely he or she is to have problems with peers, have difficulty maintaining friendships, and suffer academic problems.
The key to successful interventions for ODD is parent involvement. It is critical that parents be firm and consistent not only with their discipline strategies, but also with the love and acceptance in their responses to the child. The most effective interventions are considered to be those that emphasize Parent Training, which provide a framework for understanding the nature of ODD in children and teens and help reinforce specific parenting skills, as well as teach creative strategies for managing ODD behavior.
Parents who are not able to respond to ODD behavior in a manner that can calm and soothe the child only add fuel to the fire. It is a lot to ask of a parent who is constantly under attack from oppositional behavior to react calmly, and it probably seems impossible if you are feeling demoralized and exasperated. This is why it is often a good idea to seek the help of a mental health professional, such as a marriage and family therapist (MFT), who can not only help you learn strategies to confront this kind of extreme behavior, but also learn ways of coping with the stress of parenting in the face of such difficult circumstances.
How MFTs Can Help
MFTs can be a source of significant support and direction for those struggling with a child with ODD. An MFT can help strengthen your parenting techniques as you adapt to meet the challenges presented by ODD. MFTs are specially trained to improve the emotional connectedness and harmony among family members. This is a critical point of intervention, as it is important to have emotional resources and support when dealing with high-intensity, high-demand behavior.
The text of this brochure was written by J. Matthew Orr, PhD.
Use the AAMFT Consumer Update "Oppositional Defiant Disorder" pamphlets to market your practice.