Oppositional Defiant Disorder Treatment
Oppositional Defiant Disorder is a psychiatric behavior disorder that
is characterized by aggressiveness and a tendency to purposefully bother and
irritate others. These behaviors cause significant difficulties with family and
friends and at school or work.
Oppositional Defiant Disorder is sometimes a precursor of conduct disorder.
Much of the literature tends to lump these two conditions together. However,
they seem to be distinct entities and, although conduct disorder does have a
genetic component, ODD does not.
Oppositional Defiant Disorder children show a consistent pattern of refusing to follow
commands or requests by adults. These children repeatedly lose their temper,
argue with adults, and refuse to comply with rules and directions. They are
easily annoyed and blame others for their mistakes. Children with Oppositional Defiant Disorder show
a pattern of stubbornness and frequently test limits, even in early childhood.
These children can be manipulative and often induce discord in those around
them. Commonly they can incite parents and other family members to fight
with one and other rather than focus on the child, who is the source of the
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Common behaviors seen in Oppositional Defiant Disorder include:
- Losing one’s temper
- Arguing with adults
- Actively defying requests
- Refusing to follow rules
- Deliberately annoying other people
- Blaming others for one's own mistakes or misbehavior
- Being touchy, easily annoyed
- Being easily angered, resentful, spiteful, or vindictive.
- Speaking harshly, or unkind when upset
- Seeking revenge
- Having frequent temper tantrums
Many parents report that their Oppositional Defiant Disorder children were rigid and demanding from
an early age.
Normal children, especially around the ages or 2 or 3 or during the teenage
years display most of these behaviors from time to time. When children are
tired, hungry, or upset, they may be defiant. However, children with
oppositional defiant disorder display these behaviors more frequently and to
the extent that they and interfere with learning, school adjustment, and,
sometimes, with the child's social relationships.
The Diagnosis of Oppositional Defiant Disorder
The diagnosis of Oppositional Defiant Disorder is not always straight forward and needs to be made
by a psychiatrist or some other qualified mental health professional after a
comprehensive evaluation. The child must be evaluated for other disorders
as well since Oppositional Defiant Disorder usually does not come alone. If the child has ADHD,
mood disorders, or anxiety disorders, these other problems must be addressed
before you can begin to work with the Oppositional Defiant Disorder component.
If you feel your child may have Oppositional Defiant Disorder, there is a quick screening test. Go to:
Oppositional Defiant Disorder Test
The Causes of Oppositional Defiant Disorder
What is the cause of Oppositional Defiant Disorder? The real answer is that nobody knows. However,
since as scientist we hate to admit this, we have two current theories.
The developmental theory proposes that Oppositional Defiant Disorder is really a result of incomplete
child development. For some reason, these children never complete the
developmental tasks that normal children learn to master during the toddler
The learning theory suggests that Oppositional Defiant Disorder comes as a response to negative
interactions. The techniques used by parents and authority figures on these
children bring about the oppositional defiant behavior.
ODD is the most common psychiatric diagnosis in children and it usually
persists into adulthood. One would think a lot of research would be done on
this condition. That is not the case. While there are hundreds of research
studies on ADHD and childhood mood disorders, there is very little research
Oppositional Defiant Disorder is frequently goes along with other disorders. 50-65% of Oppositional Defiant Disorder children
also have ADHD. 35% of these children develop some form of affective
disorder. 20% have some form of mood disorder, such as depression or anxiety.
15% develop some form of personality disorder. These children frequently
have learning disorders and academic difficulties.
If your child has Oppositional Defiant Disorder it is important to know there are other co-existing
problems. These other problems usually must be addressed before you can
begin to help your child with Oppositional Defiant Disorder.
The Prognosis of Oppositional Defiant Disorder
So what happens to these children? There are four possible paths.
- Some will grow out of it. Half of the preschoolers that are labeled
Oppositional Defiant Disorder are normal by the age of 8. However, in older Oppositional Defiant Disorder children,
75% will still fulfill the diagnostic criteria later in life.
- Oppositional Defiant Disorder may turn into something else. 5-10 % of preschoolers with
ODD have their diagnosis changed from Oppositional Defiant Disorder to ADHD. In some
children, the defiant behavior gets worse and these children eventually
are diagnosed with Conduct Disorder. This progression usually
happens fairly early. If a child has ODD for 3-4 years and he hasn't
developed Conduct Disorder, then he won’t ever develop it.
- The child may continue to have Oppositional Defiant Disorder without any thing else. This is
unusual. By the time preschoolers with ODD are 8 years old, only
5% have Oppositional Defiant Disorder and nothing else.
- The child develops other disorders in addition to Oppositional Defiant Disorder. This is very
The Treatment of Oppositional Defiant Disorder
Most of these children have some other disorder along with their Oppositional Defiant Disorder.
Treating this other disorder is the key to proper management. This
frequently means giving medication. Although this type of medical intervention
does not make the children "normal", it can make a big difference. It often
allows other non-medical interventions to work much better.
For example, if a child has both Oppositional Defiant Disorder and ADHD, then giving the child Ritalin
may have a significant effect on his Oppositional Defiant Disorder, also. This positive effect does not
seem to be related to the severity of the ADHD. That means even if the child
has mild ADHD and could do without Ritalin, if he is treated medically, you
might see an improvement in his behavior.
Once the other problems are under control, the best treatment for Oppositional Defiant Disorder is
parent training. In a study published in 1998, eighty-two research studies were
evaluated were examined for efficacy. Approaches focusing on parent training
were the most affective techniques.
The main point is that some parent-training program is essential in addressing
Oppositional Defiant Disorder. This is not going to work for everyone, but it is the best treatment that
we have available.
Advice to Parents of Oppositional Defiant Disorder Children
That is with regard to your child. If your child has Oppositional Defiant Disorder you need to take care
of yourself, also. No child needs a martyr as a parent. Here are some of the
things you can do:
- Maintain interests other than your Oppositional Defiant Disorder child. You have to be a
- Try to work with and obtain support from the other adults (teachers,
coaches, and spouse) dealing with your child.
- Manage your own stress with exercise and relaxation.
- Take frequent vacations. This is a must.
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- Parenting information and parent training programs are still the most effective means of dealing with ODD in children and teens.
The two main drawbacks of most of these programs are the expense and the limited availability.
Some practitioners charge $100 or more per visit and considering the program will take several months costs add up. Insurance usually will not pay for such programs. Many parents complain to me that they can not afford the program that their child so desperately needs.
In addition, these programs are not available everywhere. Over the years, numerous parents have told me that where they live there are no programs to help them with their child. Other parents tell me that they found programs online programs, but
these programs didn't their child's particular needs. Some of them are 'for children of all ages' type programs and they ignore the
differences between teenagers and younger children. Big mistake!
How to Improve Your Child's Behavior for parents of children ages 2-11 and How to Handle Your Difficult Defiant Teenager for parents of children ages 12
to address all of these problems. It allows parents to help their children regardless of where they live and at a cost that is less than one or two office visits.
Over the past five years
How to Improve Your Child's Behavior and How to Handle Your Difficult Defiant Teenager
have proven time and again to help parents gain control of their Oppositional Defiant Disorder teens and defiant children.
Get more information on
ODD Child Behavior Help for parents of children ages 2-11 or
ODD Teen Behavior Help for parents of teens ages 12.
It is tough to live with children who have Oppositional Defiant Disorder. What is worse is that there
does not seem to be any cure. However, if you make sure that your child
has his other problems addressed and you improve your parenting skills by
enrolling in a parent training program, you can do a great deal to improve
your child’s condition and your own.
Anthony Kane, MD
ADD ADHD Advances
"If Child Behavior Issues are a Problem in Your Home,
it is Definitely Worth Your While
to Check This Out."
Help for Difficult Child Behavior for parents of children ages 2-11
Help for Difficult Teen Behavior for parents of children ages 12 and older