Oppositional defiant disorder: Everything you need to know

At one point or the other kids test the boundaries of their peers, parents and authority figures by having outbursts of anger, vindictiveness and disobedience to established rules which may occur mostly when your child lacks attention from parents, the child is strong-willed, when there’s discord in the family.

This sudden change in the attitude of the child does not necessarily mean a child has the oppositional defiant disorder. An oppositional defiant disorder is a childhood disorder defined by defiant, negative, vindictive and aggressive behavior primarily focused on parents and authority figures which can be diagnosed when the pattern is repeated after a 6-month duration.

Oppositional defiant disorder (ODD) is defined by The Diagnostic and Statistical Manual for Mental Disorders as a pattern of irritable mood, argumentative behavior and vindictiveness evidenced by a minimum of four (4) symptoms (out of many) usually exhibited towards at least one person who isn’t a sibling. It is more than being stubborn or seeking an argument, children with the disorder have a hard time controlling their temper and are suspicious of all authority figures.  

The cause of ODD is unknown and thought to be a combination of factors from internal factors like generics, mental history of family lines to external factors like socio-economics and social interaction factors.

Statistics show that up to 16% of adolescents today have some form of oppositional defiant disorder which usually occur in children before the pre-school and early school age. At a younger age, ODD is common in boys than girls however, as they grow older, girls tend to develop ODD in an equal rate with boys. Children with ODD can come from any background but this disorder is a lot more frequent with children from families with low socio-economic power.

Seven out of ten kids do not receive a diagnosis of ODD by the age of 18 and a diagnosis can be determined by a medical professional. Children diagnosed with ODD have a great chance of resolving the disorder within 3 years.

Children with ODD also stand the risk of suffering Attention Deficit Hyperactivity Disorder (ADHD), kids who develop ODD before 10 years old stand the chance of developing some conduct disorder and when kids develop the conduct disorder, the stand a higher chance or developing a long-lasting personality disorder called the anti-social personality disorder (APD), which could lead to anxiety and depression.

Teenagers who go into individual therapy programs stand a chance of resolving ODD within months and half the kids with ODD go on to abuse substance later in life which it is a difficult situation for families to endure. It is more than the typical rebellious behavior displayed by kids in their quest for self-discovery and independence.

Research confirms that children overcome the symptoms ODD and have more control when interventions are carried out from the start of those symptoms. Understanding ODD entails knowing the statistics which will translate into a better approach to treatment consequently making the disorder a distant memory in the child’s life.

ODD is hard to detect sometimes because children at different stages of their development exhibit oppositional behavior, ODD starts to manifest during the pre-school and early teens which cause serious impairment to family, social activities and work. As stated earlier on, in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) the criteria for diagnosing ODD includes both emotional and behavioral features that are persistent for a minimum of 6 months.

In kids, these are the symptoms that manifest are: 

Such emotions are identified by: 

• Often losing temper
• Touchy and easily annoyed
• Resentful for no reason

Look out for your child when he or she displays such behavior persistently: 

• Argues with authority figures
• Deliberately hurting others
• Not taking responsibility for their actions

Once again, to take note if such behavior persist: 

• Spitefulness
• Showing vindictiveness at least twice in 6 months.

These are the general behaviors and signs to look out for as ODD: 

• Anger towards the world
• Feeling disliked and misunderstood all the time
• A continuous dislike for authority and supervisors at work
• Rebellious conduct
• Vehemently defending oneself and not open to correction
• Not taking responsibility for one’s actions
• Antisocial behavior
• Substance abuse

ODD usually vary in severity with such classifications: 

• Mild:  With mild ODD, symptoms occur in only one setting which could be either the house, school, home or work.
• Moderate: Moderate ODD is when the symptoms occur in at least two settings
• Severe:  This occurs in three or more settings

In treating mild ODD, parents can help their children manage it by​:​​​​​​

• Increasing positive reinforcements
• Consistently punishing bad behavior
• Using immediate parenting methods
• Reducing situational triggers

Teachers can treat mild ODD by:

• Holding the child accountable for their actions
• Placing class rules in a visible place
• Knowing what behavioral modification that will work on the student.

For the child or adolescent who recognizes the need to work on taming his/ her ODD. These are a few ways to remind and reduce ODD:
 

• Accepting responsibility for their actions or behaviors
• Being mindful in other to avoid defensive and rash attitudes
• Exercising or joining a sports club which will help relieve stress
• Talk to his/ her peers and open up on ODD and how they can help and be forgiving in times of outrage that was unintentional

Making sure your surroundings and overall daily life are under control. Certain stress trigger such as overexerting of school work or bullying in school trigger mood disorders and anxiety. These will worsen the symptoms of ODD. It is necessary to identify and manage these challenges first before talking to a professional who may have an opinion on what treatment method to use.

Providing warnings is an effective way of managing ODD, a typical example is telling your kids it’s bedtime and they have to stop watching TV. You can tell them it’s 10minutes to bedtime so that you don’t catch them off-guard. This way you have warned them about what to expect and they tend to flow in the direction of instruction.

A behavior therapist will be very handful to go in-depth to find out the root cause of ODD. If it is a biological factor, the therapist will train the child and parents on ways to maintain or minimize ODD. Skills like anger management, communications, impulse control and problem-solving will be taught during the sessions with the therapist.

Both positive and negative re-enforcements are useful tools, positive reinforcement is the act of rewarding a child when they behave in an expected way. By doing this, the child is likely to do the exact same thing again thus creating a new pattern. Positive reinforcement is great in treating ODD. A great tool will be to use a reward chart to emphasize on the positive action that was done by the child.

Parents often teach children accountability and problem-solving but they never really get around to implementing the consequences, natural consequences could mean when your child refuses to eat their food, they stay hungry. The logical consequences could occur when the child refuses to log off their iPad on time then they don’t get to use it for two weeks. By doing this, you are treating your child’s ODD, the goal is to establish a different behavioral pattern.

It is hard to continuously deal with your child’s outbursts and anger and explosive behavior, it does wear you out but you have to remember that the child behaves that way primarily because they want to have their way, don’t let them, consistently stand your ground on the rules that you have established in the family.

Common symptoms manifest for a variety of reasons and this may be a reflection of different diagnosis, therefore, it is not in your interest or that of the child to jump to conclusions, a health care professional is in a proper position to thoroughly evaluate your child having regard for a broad range of symptoms before coming up with a diagnosis of ODD.

When a child starts acting defiant, it could be linked to other disorders like ADHD, obsessive-compulsive disorder. ODD is one of the most misdiagnosed disorders and is characterized by symptoms such as outbursts of anger, vindictiveness, negativity, and an irritable and argumentative behavior that persists for 6 months and over. It is a lot more common with boys than girls however when girls grow older they tend to lean toward having this disorder. 

ODD if left untreated can follow a child into adulthood where he would have constant anger towards people, resentment for supervisors and unaccountability. ODD could be mild, moderate or severe and at every level and different treatment approaches can be used to tackle the disorder. It can be treated in several ways by being accountable, consistency, using a parent-child interaction therapy, engaging in positive interactions and so many other strategies can be employed to treat ODD.