This guide is for parents and teachers, to help them understand how children with Oppositional Defiant Disorder (ODD) are built differently, and the techniques that work best to guide them.
This research-based, easy-to-understand guide will help you understand:
- What are the causes of oppositional defiant disorder?
- How are children with oppositional defiant disorder different from other children?
- How can parents and teachers help children with oppositional defiant disorder?
ODD affects both boys and girls, so these blog posts will switch between male and female language. Instead of using clinical terms or psychological labels, I’ll describe your child’s behaviour, thoughts and feelings in plain language. I’ve also found that the imagery of a car and a journey helps parents understand and remember the important points.
There’s so much to say about Oppositional Defiant Disorder, so the article will cover ODD: What it is, and what it is NOT.
Other posts in this series:
- What makes a child with ODD and ADHD go (and stop)? The gas and the brakes
- What about punishment? Know the risks and discover the alternatives
- Staying on track: Successful communication with your defiant child
What exactly is Oppositional Defiant Disorder (ODD)?
Easily annoyed, spiteful or vindictive, angry and resentful. These words are part of the description of a pattern of behavior called Oppositional Defiant Disorder. The term is used by mental health professionals, like psychologists or psychiatrists. This description comes from a guide created by the American Psychiatric Association, called the Diagnostic and Statistical Manual of Mental Disorders (also known as the DSM-V.)
If you would like your child to be assessed, the psychologist or mental health professional will interview you or ask you to complete a questionnaire. You will be asked to share information about how often your child has angry or disruptive behaviour, how long the behaviour has been this way, and how many different situations your child struggles in. Your child’s teacher or other family members may be asked to participate in the assessment too.
Oppositional Defiant Disorder: an unhelpful name?
The term “oppositional defiant disorder” might bring to mind a child who enjoys doing the opposite of what he is told, who is willful and deliberately disobedient, and who has a condition that prevents him from obeying or cooperating. In fact, none of these descriptions are helpful or accurate. Children who are diagnosed with oppositional defiant disorder may have developmental delays or difficulty with emotional self-regulation, or they may have a history of challenging behaviour patterns, but every child needs to be approached as an individual, worthy of love, and full of potential.
Does my child have Oppositional Defiant Disorder?
Only a mental health professional who has performed an assessment with your family can give a formal diagnosis. The exact wording of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) can be found here. In plain language, here is what it would mean for your child to meet the criteria for the diagnosis of Oppositional Defiant Disorder. To be diagnosed, your child’s behaviour would match at least four of the following symptoms:
- often loses temper
- is often touchy or easily annoyed
- is often angry and resentful
- often argues with adults
- often actively defies or refuses to comply with requests from authority figures or with rules
- often deliberately annoys others
- often blames others for his or her mistakes or misbehaviour
- has been spiteful or vindictive at least twice within the last three months
What if it’s just grumpiness? Doesn’t everyone get angry sometimes?
Of course, every child (and adult) has angry or irritable moods. To meet criteria for a diagnosis of Oppositional Defiant Disorder, these behaviours would have to be more intense than other typical children, and continuing on a regular basis for at least six months. For a child younger than five years old, these behaviours would have to happen on most days, and for older children, you would be looking for angry or defiant behaviour that happens at least once a week. Again, this is referring to behaviour that is more intense, it’s happening more often, and it’s causing more trouble than what you might see with a child of a similar age, gender and culture. The difficult behaviour also needs to be happening with someone who is not a sibling, causing a disturbance at home, school, with friends, or in other important parts of life.
If your child is struggling with challenging behaviour that meets this criteria, but in only one setting (at home, for instance), then the diagnosis would be “mild.” If your child is having a hard time in two settings, then it would be “moderate,” and of course, there are three or more settings where your child is showing these behavioural and emotional difficulties, then the diagnosis would be “severe.”
Will my child have Oppositional Defiant Disorder for life?
Oppositional Defiant Disorder is not a lifelong condition like diabetes or epilepsy. It is a description of a pattern of behaviour but like most behaviours, it can be changed. 67% of children with Oppositional Defiant Disorder improve within three years or less. Only 30% of people who are diagnosed with Oppositional Defiant Disorder continue to show symptoms after the age of 18.
Is there a treatment for Oppositional Defiant Disorder?
Oppositional Defiant Disorder can be treated. Your child’s behavioural symptoms can be caused by a number of different problems, but with the right help, you and your family should be able to see an improvement.
Remember: Oppositional Defiant Disorder is not the CAUSE of your child’s behaviour. It is only a description. Think of the label like a set of symptoms, like a headache or a stomachache. Some people use the label in a misleading way, e.g., “She’s ignoring you because she has Oppositional Defiant Disorder.” This doesn’t make sense. It would be like saying “My stomach is hurting because I have a stomachache.”
What increases the risk of Oppositional Defiant behaviour?
Biological Causes of Oppositional Defiant Disorder
Brain differences in children can lead to behavioural differences. These differences are sometimes because of genetic variation (signs of genetic causes include a family history of ADHD, ODD, substance abuse disorders and mood disorders.)
Brain differences can also be caused by exposure to toxins during pre-natal development, or by damage sustained during childhood, like traumatic brain injury or malnutrition.
Children with brain differences may have difficulty with impulse control, emotional self-regulation, language processing, problem-solving, and understanding social cues.
The idea of brain differences can be frightening for parents. Remember: brains do change and develop. Children mature with age and also experience. Understanding brain differences can you help you provide the kinds of experiences that help your child thrive and develop. Your child’s brain doesn’t predict who he will be in the future, but it does influence the kinds of strategies you will need to use today.
Some children are naturally more likely to be easily upset, stubborn, energetic, or quick to anger. Children who enjoy taking risks and trying out adrenaline-pumping activities are certainly more likely to break the rules once in a while. Children with these personalities are more likely to be in conflict with others, to have difficulty following expectations at home and at school, and are more likely to be diagnosed with Oppositional Defiant disorder. With the right support, these children can learn the skill needed to get along. They also gain more maturity and self-control over time, given the right environment.
Oppositional defiant behaviour is also related to difficulties with emotional self-regulation. Children with other disorders such as childhood onset bipolar disorder, depression and ADHD may have difficulty controlling their emotions, and are more likely to be diagnosed with ODD.
Here’s the part everyone worries about most: am I a terrible parent?
Room to grow
This guide is not meant to make anyone feel terrible. Some children do have developmental and personality traits that make their behaviour very hard to manage. Naturally, some parents do too! No parent is perfect, and what works perfectly for one child might not be the right fit for another child, so please have compassion for yourself as you read through this list. There’s help available for you if you recognize some emotional or behavioural glitches that might be contributing to your child’s difficult behaviour.
Parents under pressure
Managing difficult behaviour is a big job. Ideally, parents should:
- show empathy
- build emotional bonds
- use positive reinforcement
- monitor behaviour closely
- be consistent in parenting
- stay calm in difficult situations
- keep punishment to a minimum
- express kindness and love
When parents are isolated, under stress, in a difficult marriage or experiencing financial strain, it can be hard to perform all these tasks.
Parents who have psychiatric disorders including ADHD, depression and antisocial personality disorders may have more difficulty using these recommended strategies. Unsurprisingly, parents who are hostile, inattentive, or rejecting are more likely to have children with defiant and aggressive behaviour.
A two-way street
When you and your child interact, your behaviour has an effect on her, and her behaviour has an effect on you. When one of you is having a hard time, things can go downhill for both of you. For example, when your child is behaving in an angry and disruptive way, it’s harder for you to use recommended strategies like positive reinforcement and empathy, even if you have used them successfully with other children in the past. Similarly, when you’re having a hard time in other parts of your life, you might spend less time having positive interactions with your child. This could have an effect on your child’s behaviour and lead to more anger and defiance.
Your child’s difficult behaviour will certainly affect your mood and your feelings about yourself, and maybe even put stress on your marriage. Challenging behaviour can have a financial impact too, especially if your child needs expensive therapy or if you have to take time off work to attend school meetings and cope with repeated school suspensions or daycare exclusions. Research shows that children are more likely to be diagnosed with Oppositional Defiant Disorder if their parents are stressed, socially isolated, and financially disadvantaged, so these factors start looking like a chicken-egg situation. It’s hard to tell what is actually causing this vicious circle, but improving one side usually improves the other.
Sometimes your child’s behaviour is so frustrating that you just want to back off, escape, or give in. Problem behaviours such as screaming, aggression, property destruction or self-injury are frightening and upsetting, so it’s tempting just to avoid them any way you can. A parent might stop trying to manage problem behaviour as closely, or just start to ignore it completely. Even the most persistent parent might eventually run out of steam, and when they reach the end of their patience, back off, or break down in tears. This can turn into an accidental reward for the defiant child. Children notice that their problem behaviours are effective in controlling their parents, so the problems continue.
On the flip side, if children ignores a mild warning but finally responds to us when you yell, you learn that yelling is the only way to get a reaction, and your normal behaviour becomes more and more extreme. If the “nuclear option” is what works best, then that becomes the go-to strategy. Parents and children can unwittingly learn to resort to the worst possible behaviours.
Finding a new path
No one wants to be the sort of parent who gives up or flips out. If you find yourself stuck now, then stick around, because the rest of this guide will help to get you unstuck! You will discover how to prevent some of the everyday collisions, how to navigate around some tricky hazards, and how to stay safe and get back on the road when things go off track.
If you need help right away, a behaviour therapist or psychologist can help you understand your child’s current behaviour and create a personalized solution that works for your family.
Bonus: Q&A Section
Why don’t you use the term “ODD disorder?
Oppositional Defiant Disorder can be abbreviated as ODD, so calling it “ODD disorder” is kind of like calling it “Oppositional Defiant Disorder Disorder.”
Any other terms you don’t use?
In this article, I’ve tried to avoid using loaded terms like “bad behaviour” and “disability.” I don’t want to give the impression that any child is “bad.” I don’t want to describe Oppositional Defiant Disorder as some kind of condition that makes children incapable of cooperation, because that’s not true at all. These kids are “having a hard time, not giving us a hard time,” as Dr. Ross Greene would say, but with the right tools, they can succeed, and so you can you!
What other resources would be helpful?
If you are looking for a book written by someone who has personally worked with hundreds of families with Oppositional Defiant behaviour, and conducted research to show that their methods actually work, I strongly recommend this book as a starting point:
Dr. Ross Greene has used his compassionate insight to help children with severe behaviour problems. He helps parents to empathize and problem-solve, even with children who have trouble staying calm.
If you need help for your family right away, please connect with me and book a free 30-minute phone call. We can talk about your concerns, and map out what resources your family needs most.