While it is developmentally appropriate at certain ages for children to challenge adults and other authority figures, children with Oppositional Defiant Disorder (ODD) have a pattern of negative, hostile and defiant behavior that is developmentally inappropriate. Furthermore, children with this disorder have problems in school, relationships and family life that cause disruption for themselves and others. It is believed that one in 10 children may have this disorder during childhood or adolescence (Mayo Clinic Staff, 2007). Unlike their peers, however, children with Oppositional Defiant Disorder do not function successfully in the normal activities of daily living. In order to be diagnosed with this disorder, at least 4 of the characteristics of the disorder must be present that are listed below. These are the standard symptoms that a physician will consider when making the diagnosis of Oppositional Defiant Disorder (American Psychiatric Association, 2000).
These symptoms must last for at least 6 months and must occur more frequently than in children of similar development and age. Additionally, these symptoms must create significant problems in social, academic and/or family life in order to indicate that the child does have Oppositional Defiant Disorder.
Other Conditions that Frequently Occur with Oppositional Defiant Disorder
Some other conditions that may be present in a child with Oppositional Defiant Disorder are Attention Deficit Disorder (ADHD), learning disorders, depression, other mood disorders and anxiety. The child who is diagnosed with Oppositional Defiant Disorder should also be evaluated and treated for these and any other co-existing conditions that a physician suspects may be present. Children with Oppositional Defiant Disorder who also have another condition improve significantly when both are treated. Co-existing disorders can not only compound daily difficulties, but can dramatically interrupt a child’s development and lead to significant consequences such as medical, social and academic difficulties.
The Impact of Oppositional Defiant Disorder upon Children and Their Families
A child’s oppositional and defiant behaviors can be very disruptive. Development, academics, relationships and family life can all be seriously affected. Children with untreated Oppositional Defiant Disorder are at high risk for school failure, low self-esteem, social rejection, isolation, aggression, legal problems, truancy, running away, depression and anxiety. The parents and families of a child with Oppositional Defiant Disorder frequently experience episodes of anger, conflict and power struggles that create a very stressful and challenging family life. Siblings of children with this disorder are likely to react with their own symptoms of distress as the home is disrupted with negative behaviors and the parents’ frustration and helplessness. Furthermore, children with untreated Oppositional Defiant Disorder are also at risk for developing significant problems later in life. Some of these are substance problems, problems with other authority figures such as employers and even legal problems.
Treatment Options
Children with Oppositional Defiant Disorder do respond to treatment. In fact, the majority of children who receive treatment are likely not to have the disorder after 3 years (Remsing, 2007). Parents who become involved in treatment will dramatically increase the child’s chances of learning more appropriate behavior. The most effective treatment approach in the management of Oppositional Defiant Disorder is a parent training program in which parents are taught effective ways to manage the child’s behavior. In such programs, for example, parents learn to reinforce positive behavior, effectively discipline negative behavior, reduce their own stress, eliminate power struggles and involve their children in positive, age-appropriate activities. Parents who learn such coping skills can provide support for their children as they work in treatment to manage anger, learn how to resolve conflict and solve problems appropriately, interact with others in acceptable ways and build positive relationships with both adults and peers. Additionally, some children will also need to improve self-esteem, decrease depression and anxiety, learn relaxation techniques and practice more positive thinking. Physicians may also prescribe medication to help manage attention problems, hyperactivity, impulsivity, mood instability, depression and/or anxiety. Most children with Oppositional Defiant Disorder are successfully treated with a combination of these approaches.
References
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, D.C.: American Psychiatric Association.
Mayo Clinic Staff. (2007, December 19). Oppositional defianct disorder (ODD). Retrieved March 29, 2009, from MayoClinic.com: http://www.mayoclinic.com/health/oppositional-defiant-disorder/DS00630
Remsing, S. a. (2007). Practice Parameter for the Assessment and Treatment of Children and Adolescents With Oppositional Defiant Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46:1 , 126-141.
