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Oppositional defiant disorder (ODD) is a behavior disorder. It is usually diagnosed in childhood. Children with ODD have uncooperative, defiant, negativistic, irritable, and annoying behaviors toward parents, peers, teachers, and other authority figures. Children and teens with ODD are more distressing or troubling to others than they are distressed or troubled themselves.
The cause of ODD is not known. But there are 2 main theories offered to explain how the disorder occurs: a developmental theory and a learning theory.
Developmental theory. This theory suggests that the problems begin when children are toddlers. Children and teens who develop ODD may have had trouble learning to separate and become independent from the main person to whom they were emotionally attached. The bad attitudes characteristics of ODD are seen as normal developmental issues that are continuing beyond the toddler years.
Learning theory. This theory suggests that the negativistic symptoms of ODD are learned attitudes. They reflect the effects of negative reinforcement methods used by parents and authority figures. The use of negative reinforcement by parents is seen as increasing the rate and intensity of oppositional behaviors in the child. That’s because these behaviors achieving the child’s desired attention, time, concern, and interaction with parents or authority figures.
Behavior disorders are the most common reason that children and teens are referred to mental health services. Oppositional defiant disorder is reported to affect 1% to 16% of school-age children. ODD is more common in boys than in girls.
Most symptoms seen in children and teens with ODD also happen at times in other children without this disorder. This is especially true for children around ages 2 or 3, or during the teen years. Many children tend to disobey, argue with parents, or defy authority. They do this especially when they are tired, hungry, or upset. But in children and teens with ODD, these symptoms happen more often. They also interfere with learning and school adjustment. And in some cases they disrupt the child's relationships with others.
Symptoms of ODD may include:
Frequent temper tantrums
Excessive arguments with adults
Refusal to do what an adult asks
Always questioning rules and refusing to follow rules
Behavior meant to annoy or upset others, including adults
Blaming others for the child’s own misbehaviors or mistakes
Easily annoyed by others
Frequently having an angry attitude
Speaking harshly or unkindly
Seeking revenge or being vindictive
The symptoms of ODD may look like other health conditions or behavior problems. Always talk with your child's healthcare provider for a diagnosis.
Parents, teachers, and other authority figures in child and teen settings can often identify someone with ODD. But the condition is usually diagnosed by a child psychiatrist or a qualified mental health professional. The diagnosis is made using a detailed history of the child's behavior from parents and teachers, and clinical observations of the child's behavior. In some cases psychological testing may be done. Parents who note symptoms of ODD in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.
ODD often occurs along with other mental health disorders. These include mood disorders, anxiety disorders, conduct disorder, and ADHD. This increases the need for early diagnosis and treatment. Talk with your child's healthcare provider for more information.
People with ODD may need to try different therapists and types of therapies before they find a combination that works. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may include:
Individual psychotherapy. This treatment for ODD often uses cognitive-behavioral methods to improve problem solving skills, communication skills, impulse control, and anger management skills.
Family therapy. This often focuses on making changes in the family system. These changes include improving communication skills and family interactions. Parenting children with ODD can be very difficult for parents. It can also cause problems for siblings. Parents and siblings need support and understanding. They also need help in coming up with more effective parenting and interpersonal approaches with the child who has ODD.
Peer group therapy. This often focuses on developing social skills and interpersonal skills.
Medicine. Medicine is not considered effective in treating ODD. But medicine may be used if other symptoms or disorders are present and respond to medicine.
Some experts believe that a developmental series of experiences happens in the development of ODD. This may start with ineffective parenting. The child may then have trouble with other authority figures and poor interactions with other kids. As these experiences keep happening, oppositional and defiant behaviors become a pattern of behavior.
Early detection and treatment of negative family and social experiences may help to disrupt this series of experiences. The child’s pattern of negative behaviors can be disrupted with early detection and treatment. Treatment may involve learning more effective communication skills, parenting skills, conflict resolution skills, and anger management skills.
This approach is helpful in reducing negative behaviors in relationships with adults and other kids. It can also help the child with school and social adjustment. The goal of early intervention is to enhance the child's normal growth and development. This improves the quality of life for children or teens with ODD.
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