Q. What is Oppositional Defiant Disorder (ODD)

A. The cause of ODD is not completely understood, but is felt to be related to both genetic and environmental factors. ODD is a psychiatric disorder that is characterized by two different sets of problems - aggressiveness and a tendency to purposefully bother and irritate others. This behaviour is so frequent and consistent that it stands out when compared with other children of the same age and development.

In children with ODD, their behavior causes significant impairments in their social, academic, or occupational functioning. Co-morbidity is also a factor as ODD usually does not occur alone. When ODD is present with ADHD, depression, Tourette's, anxiety disorders, or other neuronpsychiatric disorders, it makes life with that child far more difficult.

Q. What are some characteristics of ODD?

A. Oppositional Defiant Disorder often occurs along with other behavioral or mental health problems such as attention-deficit/hyperactivity disorder (ADHD), anxiety or depression. The symptoms of ODD may be hard to distinguish from those of other behavioral or mental health problems.
Specific criteria for diagnosing ODD include having the behaviors for at least six months, with at least four of the following patterns:

1. often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful and vindictive

Q What can be done to help someone with ODD?       

A. A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention deficit hyperactive disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop conduct disorder.

Treatment of ODD may include: Parent Training Programs to help manage the child's behavior, Individual Psychotherapy to develop more effective anger management, Family Psychotherapy to improve communication, Cognitive Behavioral Therapy to assist problem solving and decrease negativity, and Social Skills Training to increase flexibility and improve frustration tolerance with peers. A child with ODD can be very difficult for parents and teachers. Parents and teachers can help the child with ODD in the following ways:

• Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
• Take a time out or break if conflict appears to make the child worse, not better. This is good modeling for the child. Support the child if he decides to take a time out to prevent overreacting.
• Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want the child to do. If you give the child a time out for misbehavior, don't add time for arguing. Say "your time will start when you go to your time-out location."
• Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
• Maintain interests in other children other than the child with ODD, so that managing the child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with the child. 
• Manage your own stress with exercise and relaxation. Use support care as needed.

Behavior modification certainly has its place as a form of treatment. But it’s not a panacea, nor is it always the treatment of choice. A child and adolescent psychiatrist, may diagnose and treat ODD and any coexisting psychiatric condition with medication. All the research is preliminary and just suggests that certain treatments may help. ODD rarely exists in isolation and there is no medication designed specifically for the treatment of ODD. This disorder is more like a fever than a disease, usually symptomatic of something else, or several other factors, that are creating havoc in the psychological and emotional center of the child. There have been no extensive studies using alternative medicine. However, an alternative medicine that helps with ADHD should be effective with ODD for example.

References

Mayo Clinic

American Academy of Child & Adolescent Psychiatry

DocSpeak

Back to School with Family Education

Institute of Child Education and Psychology (ICEPE) Professional Development Courses