What Is Oppositional Defiant Disorder (ODD)?

Oppositional defiant disorder is a type of conduct disorder that includes an ongoing pattern of behavior including anger, and opposing or defying authority figures, including parents. Oppositional defiant disorder (ODD) isn't typical childhood or adolescent rebellion, but is a condition that can negatively impact school life, relationships, and family life. In this article we'll take a closer look at what oppositional defiant disorder is, how it can affect a child's behavior, who is at risk, and what parents can do to help.

Which children are at risk for ODD?

Researchers have not singled out a cause for oppositional defiant disorder, as it is a complicated issue. There are, instead, several risk factors that may lead to developing this conduct disorder. Risk factors for oppositional defiant disorder include:

• Personality factors. Children who have difficulty regulating emotions, or have low frustration tolerance may be at risk
• Parenting or family issues such as abuse, neglect, inconsistent discipline, unstable relationships, substance use, mental health conditions, or lack of supervision
• Environmental factors such as problem behaviors that are reinforced through attention from peers, and inconsistent discipline from authority figures, teachers, and administrators
• Children diagnosed with attention deficit hyperactivity disorder are far more likely to also have oppositional defiant disorder. These are two separate conditions, but often occur together (according to the American Psychiatric Association, around 40% of children with attention deficit hyperactivity disorder are also diagnosed with oppositional defiant disorder or another conduct disorder)

Signs and Symptoms of ODD

Symptoms of oppositional defiant disorder (ODD) may be hard to spot sometimes. Certain behaviors and strong emotions can be part of a child's make up, and certain developmental stages include oppositional behavior. Typically, symptoms of oppositional defiant disorder begin to show up around preschool age, although they may develop later. It's very rare that they don't show up before their teen years.

With oppositional defiant disorder, symptoms are severe and negatively impact family life, school, social life, and the child's relationships. They are also present for 6 months or more to be diagnosed under the criteria of the diagnostic and statistical manual. Symptoms of oppositional defiant disorder may include:

• Frequent temper tantrums
• Frequently argues with parents or other authority figures
• Easily annoyed by other children and adults
• Blames others for problems
• Angry attitude, speaking harshly to others frequently
• Disruptive behavior
• Vindictive behaviors
• Hostile behavior
• Defiant behavior

When Should I Call My Child's Healthcare Provider?

If you notice that your child's behavior has reached the point of disrupting your home life, and affecting their academic life, it may be time to get professional help. If left untreated, oppositional defiant disorder (ODD) can lead to difficulty maintaining social relationships (antisocial behavior), legal problems, poor impulse control, poor academic performance, and substance use disorders. Talk to your pediatrician, who can help you take the next steps to treat ODD.

How is Oppositional Defiant Disorder Diagnosed?

A medical professional will likely get a complete medical history, and ruling out any physical problems will refer you to a child psychologist. A qualified mental health professional will ask about your child's symptoms, find out more about the family situation, behavioral issues, and may ask for reports from their school. They will rule out other mental health conditions, including similar behavior disorders like disruptive behavior disorder.

If the child psychiatrist or psychologist determines that the symptoms match those of oppositional defiant disorder (ODD) as laid out by the DSM-5, that these symptoms have been present for at least 6 months, and that they are disruptive and impact other family members, relationships, and occupation, then they will move into treatment options.

How is Oppositional Defiant Disorder Treated?

Talk therapy is the most common treatment for oppositional defiant disorder. Cognitive behavioral therapy, or family therapy, is most commonly used by mental health professionals. The mental health provider will work with the child on problem solving skills, social skills training, and encouraging more positive behaviors. They will also treat any co-occurring mood disorders, like anxiety disorders or depression, and work on improving low self esteem.

The child's parents may also be referred to parent management training, which can help them learn positive parenting skills. It also teaches parents ways to identify and target behavior problems, while reinforcing positive behavior. They may also attend family therapy with their child and other children to ensure that everyone is on the same page in understanding how to deal with defiant behavior.

Your child's care team also often involves the school system itself. School-based interventions for children with this mental health condition include training and education tools to improve behavior in the classroom, techniques for prevention of behavioral problems, and social skills training.

Can I help prevent ODD in my child?

Depending on the child's temperament, it can be difficult to prevent oppositional defiant disorder. However, positive, consistent parenting may help a child who may otherwise develop conduct disorder. If you are concerned about your parenting style, or have suffered past abuse or neglect, talk to a therapist about parent management training.

Why Treatment is Important

It is important to treat ODD behaviors because, like other mental health disorders, ignoring symptoms can make the child worse over time. Many children with ODD are at greater risk of developing a conduct disorder (a more severe behavior disorder). And because younger children with ODD also have a greater risk for anxiety disorders and other challenges, they can ultimately struggle with a number of issues over their lifetime if they don't get help. Contact the child's healthcare provider for testing and a referral to an child or adolescent psychiatrist or psychologist who can help them and family members manage symptoms and ultimately improve quality of life.

ODD Support in Brooklyn

If your child displays behaviors that you suspect may be part of oppositional defiant disorder, or your child's healthcare provider has recommended treatment, know that help is available. Many children have overcome this challenge with the skills learned in therapy.

At Williamsburg Therapy Group, our team of doctoral-level psychotherapists offer both adult and child therapy to learn the necessary skills for supporting you child's behavior in both home and school settings.

Give us a call today, and our patient coordinator will help you find the right child therapist in Brooklyn to offer tools and support to manage behaviors and identify the underlying causes. Therapy can not only help your child act better, but also feel better and be better as well.