Misconceptions – Oppositional Defiance Disorder

by Victoria B., posted in Mental Health, Prescription Drugs, Tools
Misconceptions

Twenty years ago I believed that about 95% of the population engaged in drinking. The other 5% were religious freaks, woman who were pregnant, or geeky nerds. I was so wrong. After I stopped drinking, I realized that most people did not drink and almost no one drank like me.

When I was single, I thought children should be banned from airplanes. Parents who brought children on trips were inconsiderate to the other passengers. Boy, did I feel stupid after I had kids. Especially when the pilot started taxing the plane back to the runway (to remove my child during a tantrum).

I also thought that people had “fake” disorders and diseases. Things like migraines, fibromyalgia, and chronic fatigue were all made-up problems. Don’t get me started on the child disorders, because those were just excuses for bad parenting.

May I have a napkin to wipe the piece of egg off my face? Because, my sweet child, is having a few challenges in first grade. I am learning that, once again, I need to open my mind, if I am to find solutions to enable his success. The bottom line: I have been learning about child-related disorders.

Oppositional Defiant Disorder

I have gone my who life without knowing about Oppositional Defiant disorder (ODD). It is a behavioral disorder, commonly found in children and adolescents. It is seen as a pattern of hostile and disobedient behavior. Normally this behavior is directed at adults and figures of authority (like teachers). Sufferers argue with adults and have a hard time controlling their behavior. The most common behaviors are negativity, hostility, defiance and aggression.

There is no single test that can diagnose ODD, but typically, a medical professional can determine if a child has the disorder by looking at their pattern of behavior.

Children with ODD show an ongoing pattern of extreme negativity, hostility, and defiance that:

Last six months or more
Is consistent
Disrupts family and school
Is aimed at adult family members and of figures of authority
Is extreme when compared to other children

Symptoms that are associated with ODD:

Temper Tantrums
Questioning and not following rules
Blaming others
Revenge seeking
Purposefully annoying and upsetting others
Sudden outbursts of anger
Often touchy and annoyed
Types of Treatment

Treatment usually consists of a combination of:

  • Parent-Management Training Programs and Family Therapy to teach parents and other family members how to manage the child’s behavior. Parents, family members, and other caregivers are taught techniques in positive reinforcement and ways to discipline more effectively.
  • Cognitive Problem-Solving Skills Training to reduce inappropriate behaviors by teaching the child positive ways of responding to stressful situations. Children with ODD often only know of negative ways of interpreting and responding to real-life situations. Cognitive problem solving skills training teaches them how to see situations and respond appropriately.
  • Social-Skills Programs and School-Based Programs to teach children and adolescents how to relate more positively to peers and ways to improve their school work. These therapies are most successful when they are conducted in a natural environment, such as at the school or in a social group.
  • Medication may be necessary to help control some of the more distressing symptoms of ODD as well as the symptoms of coexisting conditions, such as ADHD, anxiety, and mood disorders. However, medication alone is not a treatment for ODD.
More about Medication

Medication may be a useful part of a comprehensive treatment plan to help control specific behaviors and to treat coexisting conditions, such as ADHD, anxiety, and mood disorders. Successful treatment of coexisting conditions often makes ODD treatment more effective. For example, medication used to treat children with ADHD has been shown to lessen behavioral symptoms when ODD and ADHD coexist. When children and adolescents with ODD also have a mood disorder or anxiety, treatment with antidepressants and anti-anxiety medications has been show to help lessen the behavioral symptoms of ODD. (1)

Outlook

It was once thought that most children would outgrow ODD by adulthood. We now know this is not always true. While some of the symptoms of ODD can go away over time, and many children outgrow the disorder, some children with ODD will continue to experience the consequences of ODD during their later years.

For those who do not receive treatment, ODD can develop into Conduct Disorder (CD), a more serious behavioral disorder. Of those with CD, almost 40 percent will develop antisocial personality disorder in adulthood.(2)

Early diagnosis and treatment can help these individuals learn how to cope with stressful situations and manage their behavioral symptoms.

Psychotherapy, parent-management training, skills training, and family therapy work. Research shows that children and adolescents respond well to therapy for ODD. In fact, for those who receive treatment, many are symptom-free once therapy has concluded and will go on to lead rewarding and happy lives.

Prevention

Be consistent about rules and consequences at home. Don’t make punishments too harsh or inconsistent. Model the right behaviors for your child. Abuse and neglect increase the chances that this condition will occur.

If your child or someone you loves need help for Oppositional Defiance Disorder, get help.

800RecoveryHub.com
Our 800RecoveryHub site offers free and confidential help

1.Connor DF, Glatt SJ, Lopez ID, Jackson D, Melloni RH (2002), Psychopharmacology and aggression: I. A meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD. J Am Acad Child Adolesc Psychiatry 41:253-261.

2.Zoccolillo M, Pickles A, Quinton D, Rutter M (1992), The outcome of conduct disorder. Psychol Med 22:971-986.

21 thoughts on “Misconceptions – Oppositional Defiance Disorder”

  1. My daughter was diagnosed with ODD when she was 4, and both her and I went through intensive therapy together where I learned needed parenting skills and she was able to work through what we found out later was sexual abuse. I can’t say enough the need for treatment for the parents and children’s sakes. She has been undiagnosed but is now 11 and starting to show signs again. This time I sincerely believe it’s just hormones, she’s not even close to how she was before. Thanks for posting this.

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      1. She has not tried any medication yet, though we are looking into it for her anxiety. We were lucky enough to have access to therapy, parenting classes, support groups, and behavioral preschool. It was amazing.

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    2. HI I have a 3 year old that meets all criteria of ODD. I’m not an alcoholic. Her father is. You mentioned that your daughter was sexuality abused. I would not think she was but I don’t put it passed anyone. My daughter is talkative and smart. I would think she point or try to avoid her Dad if this was the case. Anyways, I’m experiencing all the ODD behavior from the checklist.

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  2. Thank you for this post. My daughter has been exhibiting all of these symptoms for more than 6 months now. She takes the clothes off the hangers and puts them on the floor. Then same with the clothes in the drawers. She puts her dolls all over the floor. As soon as I put things away, she throws them out on the floor again. She has food in her room and does not take the plates or uneaten food to the kitchen.

    By the time I get to clean her room, every 3 days or so, there are levels and levels of piles of everything. Clothes, both clean and dirty, old food, dolls, craft stuff, trash from food all just thrown in piles all over the floor.

    I ask her to try to take her dishes and leftover food to the kitchen and she just sighs and rolls her eyes at me. She gives some excuse or guilt trip to me as to why she can’t remember or why she can’t bother to put her trash in the trash can, rather than on the floor.

    Her room is so bad that I am afraid to have anyone here, in case they would call social services for child neglect. It looks like I have not cleaned the room in years, eve though I pick up every day and clean it every 3-4 days.

    She refuses to do anything that any adults ask her to do. She is bossy, mouthy and always talks over top of other adults especially me. She makes scenes in the store and at her grandparent’s house.

    The new thing is that she is making up things and telling them to her therapist.

    She also has begun to use the “I will tell the therapist” as a tool of threat. She said if her grandparents said anything about what food she chose on thanksgiving she would call the therapist on them.

    She is mad that her sister got a dress which was given to her by a friend. She says I should buy her a dress like that (very expensive) because she has no clothes. She said that I spend much more money on her sister’s clothes than hers. And she may have to tell the therapist.

    I have not had money to take her sister clothes shopping for a year. All of her dresses are old. But my younger one insists that I bought them for her sister this year.

    I am so frustrated and I love her but I do not want to be treated like a servant or threatened that she will report me, like I am a bad child.

    I feel like my entire household and life are becoming out of control.
    She takes all of my clothes and make up as well. I can hardly get ready for work or get into my room to go to bed. Things are on the floor and missing, broken and stained.

    Sorry for the long vent. I am beside myself and this is the first I have ever heard of this disorder which sounds like her.
    Thank you for the post,
    Annie

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    2. I forgot to tell you. I have tried dozens of things to improve our children’s behavior. So far, only three have had results.
      1. Magic 1-2-3 program. There is a book and a CD, your local library will have a copy. It’s demonstrates an easy, yet effective disciple system.
      2. Gluton-free diet (and avoid red food dye). When this was suggested, I thought it sounded like a very stupid suggestion, but it has been easy to follow. There are less spikes in energy.
      3. Boys Town offers free parenting resources – look it up, as they have a lot of information on-line.

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  3. I’m so sorry you’re going through this. One of the biggest indicators of ODD is that the parent/child get into a negative feedback loop where their relationship further disintegrates and the only types of interactions are negative. The child craves some form of attention, so continues to act out even if negative attention is all they will receive. It is vitally important that you start setting boundaries with your daughter, first by not reacting at all to what she does to try to upset you. She wants to see a reaction, she wants to see you upset. If she says something like “I’m going to tell my therapist that you’re abusing me”. You could say “Well, that’s unfortunate, but I know I’m not, and if you did say something like that it would just make life harder on you.”

    This puts the power back with YOU, where it should be. If she continues to try to push your buttons, choices are a good way to go. “You have a choice – If you want to talk to me like that, that’s fine, but you’re not going to have A, B, and C.” Or, you have a choice: You can pick up the dishes from your room and keep your room clean, or you will not be able to watch any TV, play on the computer, or have any screens.”

    If fits ensue, you just do the “broken record” technique, which is where you repeat what you just said and do not give in. Sending my daughter to her room was always what worked for me. “You have a choice, you can talk to me calmly and we can discuss what’s bothering you, or you can go to your room and settle down, and when you’re ready we will talk.”

    All of these tools were taught to me in therapy, but another really important thing to do is provide over-the-top positive reinforcement. For example, if your daughter reacts even semi-normally to a situation that she normally flips out about, you could say “I’m really impressed with how you handled that situation, Good job!” I used to give my daughter high fives, ALL THE TIME.

    These are just a couple of tips, but I would definitely tell the counselor she’s threatening you with telling lies. The counselor, if they are a good one, should know what to do from there.

    Best of luck, I know it’s a tough road, but it does get better it just takes a different approach then constantly being at each other’s throats (which is understandable when a child is acting that way and showing ZERO respect, but the only solution is to beat them at their own game).

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      1. I am glad I could help! All of this exoerience is from the first 7 years of my daughter’s life, and a little bit to do with my psychology degree. There is support out there it’s just hard to find sometimes.

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    2. Thank you for your very thoughtful response. I read all of it and I will read it again tomorrow to get all of it into my head. I think it is true about the lack of boundaries and disrespect.
      Most of the time she and I get along very well. We watch movies, do crafts and go out to the store together.
      It is only when there is something that she does not want to do, like clean her room or do school work that the defiance materialized.
      I think your suggestions are very good. I do have trouble not getting my feelings hurt. I have so much trauma in my past that any interactions like this are triggering to me and bring up feelings of inadequacy and low self esteem. I know that I need to do better being the parent and not a “friend”. I always thought that I had my daughters to have little friends to play with. That worked while they were little. I had so much fun playing with them and being their friend.
      But now that they are preteen and teen ages, I have to be the parent and not the friend. It is very hard for me, but I will try to do it.
      Thank you again,
      Annie

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      1. Yes it is a very difficult transition, I’ve been going through it too. And it is difficult not to take it personally, but they are going through so many changes and tough transitions themselves. They are looking for strength and boundaries which ultimately equates to feeling safe for them.

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  4. I do find it a little worrying that childhood behavior is increasingly being labelled as a disorder and children increasingly medicated. As the post said, therapy is highly effective because children need to be heard and also need boundaries. Is it really a mental health /behavioral disorder or a natural childhood process of testing boundaries and dealing with new emotions? An interesting article and comments.

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    1. My husband and I spoke about this. The behaviors that the school had issues with would never have been a problem 30 years ago. The classrooms are so big that the teachers can’t deal with any abnormal conduct.

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      1. Exactly. If children are expressing anger and frustration through their actions, it’s a big sign to listen and make sure they feel safe. Children are being treated like the mentally ill and elderly have been historically and given drugs to make them more controllable. It’s a bit George Orwell 😦

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  5. My son was labelled ADHD and learning disabled in 1995. Since then I, as a parent and professional, am involved in childhood and adult disorders of the like. My general observation is that children with behavior disorders are the canaries of the population. The people that are not acting out, have physical symptoms (allergies, autoimmune, sensitivities, digestion) and many are suffering with both mental and physical reactions. This country cannot addressed what is affecting our children’s neurology, endocrinology and immunology, but perhaps the global community of those concerned – can and will.

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  6. You just confirmed it for me. Thank you for putting things so clearly. For several years I have wondered. My grandson displays all of those symptoms. It can also define his three cousins. Does this tend to run in families? Is the cause for ODD environmental?

    We have struggled for 11 years with my grandson. He does, at long last, seem to be getting better control of himself as he begins to understand the actions and intent of the rest of us. He can be sweet and adorable, and then there are times when I just do not like him. He’s also ADHD. His parents are separated so he has always lived in two places. It’s very difficult for him. I wish my son would go to therapy with my grandson. I know it would do them both much good.

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  7. There is not a disease, or disorder. That is normal childhood rebellion. Because we reject what the Bible teaches, we think normal sinful rebellion is a disease. If you believed that we are not born good, but bad, (like we are), you would not be surprised but expect to see intense misbehavior and rebellion and seek to correct it through, love, discipline and God’s grace.

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    1. I don’t know about God but it just makes me laugh that they’ve turned a normal and rational reaction to growing up in a messed up world, into a disorder. So again it’s the child who has the problem, not the parent or wider society.
      I met a homeopath recently who said that when someone came in with a child with an illness, she would always give the medicine to the parent! (When they would accept it that is, because most of the time the parent needed to believe it was the child who had the problem).

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  8. My son had ODD and was very difficult to parent through his childhood. Raising him was probably the hardest thing i have ever done but I can tell you something – he taught me what love really is. It’s not (just) the wonderful, cute, priceless, joyful moments we share (but thank God for those moments!) but it is also those times when we continue to love against a barrage of relentless struggles with no end in sight, when we choose to get through another day even when that seems impossible, and when we simply don;t give up because that is our precious child and someone has to believe in them. All of this is done while the world judges us as bad parents, the school tells us we need to set better rules and routines at home, the older generation tell us that we need to be stricter, the psychologists say we need to change the way we talk to them, in new Zealand the law says we can’t smack them, other parents say that your child is not welcome to be at their houses and EVERYONE has an opinion about where you are going wrong.

    I tell you, dear hard-working, emotionally wrung out parent, that your reward is great! My son is 15 now and we are so close, we can talk about anything and there is no barrier or wall between us… the love flows freely. He will always be an emotional person, always have to work to maintain his temper, and he sometimes struggles with depression but he is strong, smart, capable, and still well supported by his parents and sister.

    if we could only stop judging each other as parents and support and encourage instead then this would be an easier road to walk. Please, instead of offering a bunch of ‘helpful tips’ to a stressed out parent – try offering them an afternoon off!

    Never give up on your child, never give up on yourself xx

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