Oppositional Defiant Disorder (ODD) in Children


Oppositional behavioral tendencies are common in every child and are sometimes triggered by hunger, being tired, stress, upsets, being or failure to accomplish an expectation. During such incidents, the child will show defiance from orders, total or partial disobedience, talk back to an elder or frantically argue with their parent. This is considered normal for children aged two to three years, and early onsets of adolescence.

Normally, this behavior does not last long, and dwindles gradually with time, parental counseling and solving of the immediate problem, such as after rest, eating or being assisted to solve a stressful situation.  However, in some cases, the situation turns out serious and does not stop or reduce as expected. The child becomes increasingly defiant, hostile and openly uncooperative. When this type of behavior becomes consistent, frequent and more pronounced, despite efforts to offset its development, then it’s time to act. The child might be suffering from oppositional defiant disorder (ODD), which if not tamed might affect his/her child’s social, academic and developmental aspects of life.

Causes

No scientifically proven triggers are known to cause ODD in children. However, researchers associate the condition with a variety of developmental and learning factors.

Developmental factors:

According to the developmental theory, ODD gradually develops beginning at toddler years with the child experiencing troubles that gradually led them to develop a temperament, and becomes quick to anger. In most cases, researchers cite the separation of parents or other family troubles as catalysts of ODD. The child might have no chance of developing independence and related values due to absence of parents who could have helped nature this skill. Consequently, the child may have weak emotional control and treats everything hysterically.

Learning factors:

The child might acquire defiance from parents and those around him/her. These negative reinforcements make the child adapt ODD behaviors, which s/he learns from an authoritative parent, or a hostile mother, who is always hostile to her neighbors.

Other causes:

ODD is also associated with injuries, such as accidents that led to shock in some parts of the brain, biological factors, mainly genetic predisposition, and environmental factors, such as living in a hostile neighborhood, substance abuse and inconsistent parental involvement in behavioral regulation. Children with mood or anxiety disorders, attention-deficit hyperactivity disorder (ADHD), and general conduct disorder are also highly at risk of ODD.

The symptoms

Symptoms of ODD can be categorized into:

  • Anger and irritability, characterized by:
    • Temperamental behavior-the child easily loses his/her temper
    • Resentfulness and frequent anger outbursts
    • Utters harsh words to anyone
  • Argumentative and defiant behaviors including:
    • Often questioning and disobeys  rules
    • Argues with everyone, including adults
    • Refusal to comply with regulations
    • Blames others for the child’s own mistakes
    • Generally being impatient
  • Vindictiveness, which is characterized by:
    • Mean behaviors, which include not accepting personal mistakes
    • Spitefulness and endeavors to seek revenge
    • Utters mean words at slightest provocation
    • Deliberately annoying other people when s/he suspects them talking about hi,/her

Common effects of ODD in Children

Children with Oppositional Defiant Disorder (ODD) have problems with others, especially authoritative figures, like parents, elder siblings, teachers, or supervisors. This makes them unable to sustain friendships or relationships with people. Common effects of ODD in children include:

  • Poor academic performance
  • Problems with impulse control
  • Antisocial behaviors
  • Suicidal tendencies
  • Possibility of engaging in drugs/substance abuse

How does the doctor diagnose a child for ODD?

ODD occurs along with some mental health illnesses, and its symptoms may mimic a mental health problem, like ADHD, depression, or stress.  When conducting an evaluation, the child and adolescent psychiatrist will seek the presence of the parent, the teacher, or other close relations to the child. Typically, s/he will conduct his/her assessment using various means. These include:

  • The child’s overall health
  • Behavioral aspects suspected to point to ODD
  • Intensity and frequency of these behaviors
  • Behaviors and emotions depicted when the child is in different settings
  • A child’s relationships with others
  • Lab tests and other psychological screenings to help rule out mimicking disorders
  • An observation of behavioral responses, such as the child’s attitude after s/he asks questions.

Treatment of ODD

The choice of the best treatment will depend on various factors, including a child’s age, severity of the condition/symptoms, and the child’s response to specific therapies or medications. Common treatment methods include the following:

  • Medications:

Although there may be no specific medication specifically dedicated for treating ODD in children, medications used in treating other mental health disorders may be effective in treating ODD. They include stimulants commonly used for treating ADHD, such as dextroamphetamine (Dexedrine) and methylphenidate (Ritalin), antidepressants used for treating anxiety and depression (e.g. fluoxetine (Prozac) and escitalopram (Lexapro)) and medications used to treat disruptive behaviors which include aripiprazole (Abilify), clonidine (Catapres) and guanfacine (Tenex).

  • Psychotherapy:

Psychotherapy is commonly used in assisting the child to develop better ways of expressing emotions (such as anger) and control these emotions. Types of therapy that may be useful for an ODD victim include:

  • Cognitive-behavioral therapy. This helps the child realize when s/he is vulnerable to negative emotions, and better ways to control them by using positive emotions or behaviors. This helps them develop mechanisms of controlling anger and impulses.
  • Family therapy. Family therapy is meant to help the family adjust and make necessary changes that help the child change for the better.  For instance, family therapy may help the family improve interactions and communication, which will help the members realize the problem, and support the child to recover.
  • Peer group therapy. This type of therapy is meant to help the child develop better social skills, such as interpersonal skills like empathy, which will help improve from negative behaviors like spite, vengeance, temper, and vulnerability to anger while with friends.

Role of the parent

Though children with ODD can be difficult to handle even by their parents, it’s important to know that parental support is critical for improvement. To support the child, the parents should:

  • Avoid aggravating the problem. Prioritize on ways to improve moods, rather than engage in power battles with the child.
  • Give adequate support. Provide all basic needs, including a balanced diet. . Encourage the child to take physical exercise with you.
  • Be a listener. Encourage open communication with your child; understand their plight and advice politely.
  • Give positive reinforcements to encourage good behavior.

Learn more on how you can assist your child to recover from ODD here.

Last Updated on September 22, 2021