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Oppositional defiant disorder (ODD) 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. Description Oppositional defiant 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 ODD 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 problem. Behavioral Symptoms 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
Having frequent temper tantrums
Many parents report that their ODD 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 ODD 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 ODD 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 ODD.
What is the cause of ODD? The real answer is that nobody knows. However, since as scientist we hate to admit this, we have currently have two theories.
The developmental theory proposes that ODD 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 years.
The learning theory suggests that ODD 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 on ODD.
ODD is frequently goes along with other disorders. 50-65% of ODD 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 ODD 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 ODD.
So what happens to these children? There are four possible paths.
Some will grow out of it. Half of the preschoolers that are labeled ODD are normal by the age of 8. However, in older ODD children, 75% will still fulfill the diagnostic criteria later in life.
The ODD may turn into something else. 5-10 % of preschoolers with ODD have their diagnosis changed from ODD 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 ODD without any thing else. This is unusual. By the time preschoolers with ODD are 8 years old, only 5% have ODD and nothing else.
The child develops other disorders in addition to ODD. This is very common.
Most of these children have some other disorder along with their ODD. Treating this other disorder is the key to proper ODD 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 ODD and ADHD, then giving the child Ritalin may have a significant effect on his ODD, 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 ODD.
Once the other problems are under control, the best treatment for ODD 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 ODD. This is not going to work for everyone, but it is the best treatment that we have available for ODD.
Advice to Parents
That is with regard to your child. If your child has ODD 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 child with ODD. You have to be a person.
Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.
Take time to work on your relationship with your spouse. Raising these children is very difficult and can put a strain on the best of marriages.
Manage your own stress with exercise and relaxation.
Take frequent vacations. This is a must.
It is tough to live with children who have ODD. 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.
Oppositional Defiant Disorder
How to Deal With Oppositional Defiant Disorder
Oppositional defiant disorder (ODD) is a conduct disorder in children and teens. The exact cause is unknown. According to the American Academy of Child and Adolescent Psychiatry (AACAP), biological and environmental factors may play a role. ODD is characterized by extreme defiance towards authority. Symptoms include anger, argumentative behavior, defiance and disobedience, becoming easily annoyed, temper tantrums, unwarranted placement of blame on others and vengeful behavior.
While it is normal for youth to display these behaviors some of the time, excessive displays that consistently affect home and school life are not normal. Some mood disorders and chemical imbalances share the same behavioral symptoms as ODD. Because of this, a diagnosis should only be made by a licensed medical professional, who can perform diagnostic tests and a psychiatric evaluation.
Doctors treat ODD with psychotherapy, cognitive behavior therapy and family therapy. One aspect of family therapy is teaching parents ways to deal with their defiant child. Parents can help their child learn behavioral control through setting boundaries and by using calm and positive parenting techniques.
Make a list of family rules and consequences. Go over the list with your child and answer any questions that arise. Choose consequences for rules broken that make sense and are not too harsh, so that you can apply them when the need arises.
Choose your battles. An ODD child has difficulty following rules. You are trying to win the war, not each individual battle. Focus on enforcing big rules, and let the little ones slide, when necessary, to prevent a huge conflict.
Use positive reinforcement with your child. The basic rule of positive reinforcement is to praise your child for good behavior instead of constantly pointing out bad behavior.
Practice timeouts when your child is angry. Arguing with a defiant and unreasonable ODD child is almost always a sure road to failure. A timeout is when your child goes to a quiet place to allow angry behavior to subside. A common timeout place is the child's bedroom. ODD children need time to gain control of their emotions. If your child refuses to take a timeout break and insists on arguing, maintain your composure and resist the urge to argue. Instead, walk away and say, "I will return to discuss the situation when you have calmed down."
Refrain from punishing your child until you are calm. Losing your temper and arguing will only set off your ODD child's anger. When you feel angry, walk away and regain your composure before speaking with your child and issuing punishments.
Have regular family talks to discuss behavioral issues. Family talk times should be an open forum for discussion, where there is no fear of punishment for voicing opinions or feelings. Family discussions allow the family to gain an understanding of one another. Family talk times only work when the family is not in the middle of a conflict. They are best done when everyone is in a good mood.
Support your spouse when dealing with your ODD child. Discuss parenting techniques away from the child, and agree upon methods of dealing with the defiant behavior. Arguing in front of the child causes confusion and takes the focus off the child's defiant behavior, preventing a solution to the problem.
Inform school teachers and school counselors of your child's behavior. Discuss how to handle problems that arise in the classroom setting. Maintain contact with school personnel to keep an eye on your child's behavior and development.
Use the services of a psychologist or psychiatrist to help your child. Therapy is designed to give your child the tools to control undesired behavior. Attend family meetings with the psychologist to gain assistance with problems in family dynamics.
How to Show Your Husband True Respect
"Wives, respect your husbands." Paul seemed to think that was necessary to include in his letter to the Ephesians. As Miss Piggy would say, "Who, moi?" Yes, moi. I'm tired of seeing husbands mistreated by their wives...I did it to mine for years. I learned the hard way, and he paid the price, so let me redeem that hardship by sharing with you how I now show him respect.
COMPLIMENT HIS WORK
Men are very connected with their work, and a lot of self-worth is invested in what they do to make money or otherwise "show" themselves to the world. I take every opportunity, always sincerely, to compliment my husband on any achievement or success, even if it's small, that has to do with his place in the world--especially among other men. I just try to let him know he's my main contender, no matter what!
APPRECIATE HIS HUMOR
When he's being funny (and he often is), I smile and laugh as much as I honestly can. I don't patronize him, but I do try to encourage him! During the years he sheltered his heart I could hardly get him to repeat some silly old joke. When he's humorous with me now, that means he's opening his heart and showing love. And reciprocating the good feeling means I'm respecting him.
HARE HIS THOUGHTS
Part of learning to be a respectful wife was learning to really hear what my husband said. I try to listen carefully, thoughtfully, when we talk together. I want to make my replies intelligent and supportive. It is a strong sign of respect to show him that I value his thoughts and concerns enough to weigh them with love and wisdom before I speak.
LET HIM BE HIM
Day in and day out I shelled my husband with a constant barrage of critical talk. That's right: nagging. He couldn't cook right, talk right, or even watch TV right. I don't know what I thought I was trying to accomplish...but it sure backfired! Now, to show him respect, I try to keep my mouth shut if I don't like something. And if I don't like something, I have to ask myself why, and also, how important is it? Nine times out of 10 it's some quirk I have a thing about that doesn't matter a bean.
USE GOOD TIMING
I used to think that whatever I had to say to my husband had to be said immediately, or as close to immediately as possible. I had a lot of growing up to do! When I learned the value of good timing, communication between us improved dramatically. Men, like women, need space and down time. When he's enjoying a game, time on the computer, or just sitting and thinking, I leave him alone. If I need to talk to him, I keep an eye on his activities, and wait for an appropriate "in." If the topic is unpleasant, I save it for a daytime discussion when he's rested and positive. If I want something, I wait until his team wins!
BE NICE IN PUBLIC
Haven't you seen her? Have you been her? The woman who thinks it's "funny" to insult and undercut her husband in public? This is a surefire way to get him to really hate you. I tried to not do this, too much, but sometimes temptation got the better of me when I wanted to boost my self-esteem at his expense. How much better now when I show him respect instead, by laughing at his jokes, praising him about some accomplishment, and letting him tell a story or have a conversation without interrupting him.
DISTANCE THE KIDS
I used to start arguments with my husband in front of the kids. Oh, what a shame that was. Talk about disrespectful: How about trying to make the most important man in their lives look like a fool? I beg you, women, please don't do what I did. If you feel some serious fracas coming on, keep it down until you can be alone with your husband and have it out, as evenly and quietly as possible. There is untold damage in tearing down a father. Build him up, praise him, respect him instead. It is an incredible blessing for children to have a father that their mother respects.
Illustration from Clyde Mendes column at MetroSexual LA