What is oppositional defiant disorder (ODD)?
Even the best-behaved children can be difficult and challenging at times. But if your child or teenager has a frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). As a parent, you don’t have to go it alone in trying to manage a child with ODD. Doctors, mental health professionals and child development experts can help. Behavioral treatment of ODD involves learning skills to help build positive family interactions and to manage problematic behaviors. Additional therapy, and possibly medications, may be needed to treat related mental health disorders.

Symptoms
Sometimes it’s difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It’s normal to exhibit oppositional behavior at certain stages of a child’s development. Signs of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. These behaviors cause significant impairment with family, social activities, school and work.

Angry and irritable mood:
– Often and easily loses temper
– Is frequently touchy and easily annoyed by others
– Is often angry and resentful

Argumentative and defiant behavior:
– Often argues with adults or people in authority
– Often actively defies or refuses to comply with adults’ requests or rules
– Often deliberately annoys or upsets people
– Often blames others for his or her mistakes or misbehavior

Vindictiveness:
– Is often spiteful or vindictive
– Has shown spiteful or vindictive behavior at least twice in the past six months

ODD can vary in severity:
– Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.
– Moderate. Some symptoms occur in at least two settings.
– Severe. Some symptoms occur in three or more settings.

For some children, symptoms may first be seen only at home, but with time extend to other settings, such as school and with friends.

Causes
There’s no known clear cause of oppositional defiant disorder. Contributing causes may be a combination of inherited and environmental factors, including:
– Genetics — a child’s natural disposition or temperament and possibly neurobiological differences in the way nerves and the brain function
– Environment — problems with parenting that may involve a lack of supervision, inconsistent or harsh discipline, or abuse or neglect

Advice for parents:
Use a calm voice when dealing with oppositional defiance.
A child with Oppositional Defiant Disorder is often hoping to engage his or her parents in a battle of wills. Explain in as few words as possible your position or parental requirement then do not continue to discuss the issue. It is difficult for kids to argue when they have no one to argue with them! If you engage in a back-and-forth argument with a defiant child, you have given the child the power to control the exchange. Remember, the house rules apply to everyone in your home. If you break one of the house rules, give yourself a consequence like apologizing or taking a short time-out to gather your thoughts. Since kids with ODD often see themselves as victims, lead by example to show your child that you aren’t too proud to apologize and that the house rules apply to everyone in the family.

Celebrate your child’s successes.
Kids with ODD have trouble regulating their emotions, which can lead to the severe outbursts and tantrums associated with the disorder. If your child is able to successfully manage his or her behavior for a a longer than usual period of time, celebrate those successes with a family dinner at a favorite restaurant or some other fun family activity. Let your child know you notice and appreciate the extra effort. Make time to have fun and connect with your child when he or she is calm and functioning well.

Create a structured environment.
It’s no secret that when children are well-rested, physically fit, and get sufficient nutrition, they are better able to regulate their emotions. Make exercise, healthy meals, and adequate sleep a priority. A structured, healthy lifestyle will not only benefit a child with Oppositional Defiant Disorder but your entire family!

Set a few non-negotiable house rules and enforce them with consequences.
Kids with ODD are often anxious and have an overwhelming need to control their environment and others. Keep house rules simple and limited so kids don’t feel stifled or overwhelmed. For instance, rules may include, “We don’t hurt ourselves, others, or property. We use kind language and don’t raise our voices.” Display house rules and decide ahead of time on consequences for breaking a rule so kids know what to expect if they do. Once your child has completed the consequence, move on from the incident. Show your child that each new day is a chance to make better choices.