Oppositional Defiant Disorder, or ODD, is a condition that involves symptoms of either opposition or defiance, or a combination of those symptoms, that affect the child’s ability to follow the rules of family, school and society, get along with others and form lasting, quality relationships.
In order to receive a diagnosis of ODD, a child must show a pattern of angry/irritable mood combined with either argumentative/defiant behavior or vindictiveness, or both, which lasts at least 6 months or more.
To show this pattern, the child must have at least 4 symptoms from the following categories:
- Often loses temper
- Is often touchy or easily annoyed
- Is often angry and resentful
- Often argues with authority figures or 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 behavior
- Has been spiteful or vindictive at least twice within the past 6 months
These symptoms may seem like normal childhood behavior, as most children are going to break the rules and defy authority occasionally. Children are children, and they are going to make behavioral mistakes, and these incidences should not be mistaken as ODD.
Young children are more likely to demonstrate oppositional or defiant behavior as a result of their lack of knowledge about how the world works and their need to explore natural life consequences on a regular basis. In addition, because infants’, toddlers’ and preschoolers’ brains are still growing at a rapid rate, their cognitive capacities to understand the rules of society are still developing. A child this age who doesn’t follow a rule, or even many rules, may be doing so out of cognitive capacity—or lack thereof—and shouldn’t be considered “oppositional” or “defiant” or “manipulative” as kids are often called.
In order to distinguish a diagnosis of ODD from age-appropriate child behavior, use these rules:
For children younger than 5 years: All 4 symptoms should occur on most days for a period of at least 6 months.
For children older than 5 years: All 4 symptoms should occur at least once per week for at least 6 months.
This diagnosis also comes with a severity descriptor. This means that the severity of the diagnosis varies depending on how many different settings elicit these symptoms:
Mild: Symptoms occur only in one setting (home, school, peer situations).
Moderate: Symptoms are present in at least two settings.
Severe: Symptoms are present in three or more settings.
ODD—and oppositional and defiant behavior in general—is a very difficult disorder for adults to handle. The symptoms of ODD defy an adult’s understanding of how the world works: I’m in charge, because I’m the adult!
The reactions that adults often give to oppositional and defiant behavior typically include increasing the level of authority; they shout and scream, threaten punishments and use their adult size as a way to warn children that they should listen…or else!
But the problem with responding to opposition and/or defiance in this way is that it assumes the adult’s understanding of how the world is supposed to work, and doesn’t take into account that the child doesn’t seem to care about the rules of society or how the power hierarchy is structured.
Increasing the amount of authority doesn’t help a child who doesn’t care about or respect what society says about authority. The child just doesn’t want to listen or comply with directions…period.
Treatment of ODD, or other disorders that include symptoms of opposition or defiance, primarily includes education for the parent, teachers and other caregivers to learn how to interact with the child differently. Oppositional and defiant symptoms can be decreased significantly by changing the way authority figures think and giving more power back to the child.
This concept can be very difficult to understand for strong disciplinarians who follow an authoritarian style of parenting. They believe that a child should do what’s asked, and when questioned, they’re likely to say, “Because I said so!” But unfortunately, this mentality won’t go far with kids with ODD; and actually, it can make the behaviors worse.
Inclusion of parents, teachers and other caregivers in the treatment of ODD is essential to the success of the child. The way that these authority figures are able to change the way they interact with and respond to the child’s statements and behaviors will set the stage for whether the child will be able to decrease symptoms of opposition and defiance.
But what about the child?
Doesn’t the child need to learn how to follow the rules better because the world isn’t going to cater to him when he gets older?
The answer is, YES!
The child will definitely need to learn some skills to show more compliant, cooperative and friendly behaviors towards adults, and other authority figures, but it’s also likely that the child will need to learn skills in getting along with and respecting peers as well. This takes place in individual therapy.
At Encompass Mental Health, I treat children with ODD or other disorders that include symptoms of opposition and defiance with a combination of parent coaching and/or parenting therapy, family therapy, and individual therapy. When allowed by the child’s parents, I work closely with teachers and caregivers to help them to learn how to relate more effectively with the child to decrease conflict over the child’s oppositional and/or defiant behaviors.
If you are struggling with a child who is regularly oppositional and/or defiant towards adults and other authority figures, call (605) 275-0009 to talk with me about your struggles. I’ll tell you what I can do to help and we can get an appointment set up to help your oppositional child learn how to follow the rules and be more cooperative.
In the meantime, if you’re looking for quick tips to help you with an oppositional or defiant child, check out this blog post: Tips for Taming Opposition for some steps you can take today to manage oppositional behavior in children.