Oppositional Defiant Disorder (ODD) In Children

Oppositional Defiant Disorder or ODD stretches beyond simply bad behaviour. This is evident when a child loses control over his feelings, behaviour, and thoughts. He becomes non-cooperative and displays a rebellious attitude. Parenting a child with ODD then becomes a huge challenge and demands a professional diagnosis.

What Is Oppositional Defiant Disorder (ODD)?

Oppositional Defiant Disorder (ODD) is a common behavioural disorder in children that leads to defiant and rebellious behaviour. It is defined by irritable moods, disobedience, and defiance against parents, teachers and other authority figures. The child refuses to do things he is asked to and reacts angrily or aggressively when forced to do it. He thinks the tasks instructed to him are not reasonable and hence refuses to carry them out.

How Common Is ODD In Kids?

Oppositional Defiant Disorder is known to affect young kids and children at an adolescent age too. Every one child out of 10 children below 12 years of age is said to be afflicted by ODD. The number of boys affected by ODD is twice that of the girls with ODD.

However, it is estimated that more than 2/3^rd of kids affected by ODD overcome these behavioural changes as they grow in age. Also, children with Oppositional Defiant Disorder do not display a majority of these symptoms by the time they reach 18 years.

Causes

Various factors need to come together for a child to develop symptoms related to ODD. Research has been unable to narrow down one specific reason for the onset of Oppositional Defiant Disorder. Here are a few causes that could cause the development of ODD in children:

• Physical causes: The presence of large amounts of certain brain chemicals are known to enhance ODD traits. The brain chemicals are known as neurotransmitters. An unusually large volume of these neurotransmitters can upset their balance. ODD can occur when the brain is unable to read the communication between various channels properly due to the abnormal volume of neurotransmitters.
• Genetic causes: Children who are diagnosed with ODD often have a family history of different mental illnesses. Mood disorders, anxiety disorders, and personality illnesses are common amongst those found in such cases. This points to the fact that genetic components could lead to ODD in children as against those children who are not exposed to such genetic disorders.
• Environmental causes: The environment in which the child grows up can prove to be a significant contributor to symptoms of Oppositional Defiant Disorder. Homes, where domestic violence, arguments and fights are the order of the day, can prove to be fertile grounds for ODD growth. Children who grow up with friends and peers who are prone to violence or destructive behaviour can display tendencies that are related to ODD.

Sign & Symptoms

Contrary to popular belief, it is not only teenagers who can show a rebellious attitude. Your child could display signs of ODD before he could attain the age of eight. But the line between a strong-willed child and one who has ODD is quite subtle and is difficult to distinguish. Also, signs and symptoms of girls and boys could be different.

If you are keen to determine if your child has ODD or is being plain stubborn, check the following emotional and behavioural symptoms:

• Vindictiveness: These children are quick to develop resentment towards others and can be spiteful towards others. Taking revenge on someone who has wronged them is on the top of their minds.
• Ill-tempered moods: Children who are afflicted with ODD are extremely sensitive. They are easily annoyed and are quickly impacted by other’s actions. They could cry or get angry at the slightest provocation from others.
• Do not own up: Kids with ODD are always finding someone else to blame for any of their negative actions. Not owning up to their mistakes and refusing to take responsibility for their actions are definitive symptoms of ODD in children.
• Regular temper tantrums: The child remains angry throughout and loses his temper more than often. Keep a watch for unrelated outbursts and tantrums that come out of thin air.
• Highly confrontational: ODD children find it easy to challenge and confront people in authority. Parents, teachers or protectors and creators of law are targets for arguments and fights.
• Disrespectful of rules: Such children hate to follow the rules and are disrespectful towards them. They keep questioning the rules and are forever against those who try to implement them.

These signs and symptoms can be categorised as follows:

Cognitive Symptoms

• Difficulty in concentrating
• Does not think before speaking
• Frustration

Psychosocial Symptoms

• Losing self-esteem and confidence
• Unable to make friends
• Feeling annoyed
• Negativity

Behavioural Symptoms

• Deliberately acts in an annoying way
• Hostile behaviour towards others
• Does not compromise or negotiate with others
• Destroys friendships readily
• Seeks revenge over trivial matters
• Does not obey rules
• Always in a confrontational mood
• Aversion to rules and hates authority figures
• Blames others

Diagnosis

While diagnosing ODD, the doctor will have to understand the child’s complete medical history. He will also quiz you to get an insight into your child’s behaviour. The doctor will need information related to the duration of this behaviour, its pattern and a few incidents when you found the child’s behaviour disruptive. To understand if there is a physical cause of these behavioural symptoms, you can provide inputs about your kid’s physical health.

ODD specialists like therapists and psychologists are capable of handling ODD diagnosis. They often use questionnaires to supplement their diagnosis and collect details. By doing so, you will know if the child has been afflicted with ODD, or if he is reacting to a situation at home or school.

It is necessary to be open to the therapist, or the diagnosis may not be accurate. Give them a clear picture of the child’s social and emotional behaviour. Describe how he reacts to various situations at home, with friends or at school. This honesty will go a long way in making the right diagnosis and then begin the necessary treatment.

Risk Factors

The following risk factors could contribute to the occurrence of Oppositional Defiant Disorder (ODD) and enhance its growth:

• Family conflicts
• Exposure to violence
• Erratic nurturing as a child
• Dysfunctional family life
• Facing abuse or neglect as a child
• Mental disorder within the family
• Exposure to drug/substance abuse
• Inconsistent interaction with parents
• Unpredictable disciplinary levels

Complications Of Childhood Oppositional Defiant Disorder

If ODD is left untreated, it can cause a fair amount of stress and worry for parents. Apart from the effect on the family, the child will face some difficulties too. Therefore, an early diagnosis of his condition can help in preventing future complications in his/her life. These complications could be long term and short term and include the following:

• Definite lack of confidence and self-esteem
• Difficulties in studying and concentration
• Expulsion from school
• Drug/alcohol abuse and addiction
• Anti-social behaviour
• Disorderly Behaviour
• Less or no friends
• Poor communication skills
• Legal problems
• Severe criminal conduct

At times, children suffering from ODD could develop mental health issues like anxiety or mood disorders, language disorders, learning disorders and ADHD- Attention Deficient Hyperactivity Disorder. The last mentioned is known to be a frequent companion with ODD. The therapist will learn about such added complications during the child’s diagnosis.

Treatment

Treatment for Oppositional Defiant Disorder includes long-term psychotherapy coupled with behavioural training for the child and family members. The method of treatment is dependent on the following factors:

• The child’s behavioural symptoms
• Intensity of ODD
• The surrounding environment

Medications are not prescribed for ODD unless it is accompanied by any other mental issue or behavioural disorder.

The following types of treatments are recommended for children diagnosed with ODD:

• Cognitive behavioural therapy: This is used to help the child develop problem-solving skills and apply them in daily life. Unwanted behaviour can be changed through this method, and the child learns to handle stressful situations competently.
• Parent management training: Parents can deal with an ODD child and the situations that arise from it. They are taught the latest ways and methods of interacting with the child and deal with their problems. Family members like parents and siblings along with teachers are included in this training to give them better control over the situation.

• Social skills training: ODD children, especially adolescents need social skills training so that they can do better while interacting with peers. It teaches them how to perform better at school. Such training is a part of group activities and is conducted in an open environment.
• Medication: When ODD is accompanied by conditions like ADHD or mood/anxiety disorders, medication forms an important part of the treatment. It helps control severe cases of ODD and prevents any further growth.

Activities For Children With ODD

Activities and games are at the top of the list when it comes to modifying your child’s behaviour. Although it may be difficult for you to get him to join, you could try the following activities:

• Problem-solving sessions for learning collaboration. The child will learn to trust and respect you through this.
• Role plays give the child a different perspective on the existing situation. Let the child take over your role while you enact his.
• Give your child a chance to cool down when he gets defiant. Ask him to speak only when he has cooled down. This will teach him to control his anger and refrain from reacting.
• Use exercise sheets to help your child deal with various emotions. It will help channelise emotions like anger and revenge.
• Play fun games where the child has to do the exact opposite of the instructions you give. They score points when they do so, and this helps one to look at ODD in a fun way.

How Can You Help Your Child?

As a parent, you are entirely empowered to help your child to deal with ODD. The following things can make life better for your child and help them get rid of the disorder:

• Work on your relationship with your child and reiterate the fact that he/she is of paramount importance to you. Spend quality time with him and give undivided attention to underline the fact that he matters most.
• Praise encourages positive behaviour. Use it effectively to enhance such behaviour on a regular basis. For every negative comment that you use, give six positive comments. Refrain from threats and negative consequences.
• Giving short, to-the-point instructions are useful in conveying your thoughts to the child. Ask him if he wants to study after dinner or right away. These specific choices can help you elicit the desired response from the child.
• Create a reward chart for every positive behaviour displayed by your child. Kids between the age group of 3 to 8 years respond well to this.
• Address unwanted or uncooperative behaviour immediately. Consider withdrawing a specific privilege if the child does not respond to instructions after a couple of requests.

Since ODD is a behavioural disorder developed due to various conditions around the child, do not take it personally. If you focus on changing the child’s behaviour, you will be able to make a sea change to the child’s personality.