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Oppositional Defiant Disorder is a psychiatric disorder that is characterized by two different sets of problems. Children with this label are aggressive and tend to purposefully bother and irritate others. Oppositional Defiant Disorder should not be confused with normal acting out behaviors of children. ALL children (and adults) will display oppositional defiance at times, especially preschool children and adolescents. However, in order to receive a diagnosis, the child must have frequent inappropriate behaviors that lead to difficulties in the child’s social, academic and/or occupational life.

What are the symptoms?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition:

• A pattern of negativistic, hostile and defiant behavior lasting at least six months during which four or more of the following are present:
• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply with adults’ requests or rules
• Often deliberately annoys people
• Often blames others for his/her mistakes or misbehavior
• Is often touchy or easily annoyed by others
• Is often angry and resentful
• Is often spiteful and vindictive

Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.

The disturbance in behavior causes clinically significant impairment in social, academic or occupational functioning.

The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.

Criteria are not met for Conduct Disorder, and if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.

How often is "often"?

Some recent research suggests that the following is considered “often”. Behaviors that have occurred within the past three months:

• Blames others for his/her mistakes or behavior
• Is spiteful and vindictive

Occurs at least twice a week:

• Is touchy or easily annoyed by others
• Loses temper
• Argues with adults
• Actively defies or refuses to comply with adults requests or rule

Occurs at least four times per week:

• Is angry and resentful
• Deliberately annoys people

Children usually first display these symptoms at home with their parents. These behaviors may not be present at school or with other adults until later.

Is Oppostional Defiant Disorder common?
Oppositional Defiant Disorder is rarely the only diagnosis and is usually evident before age 8. ODD usually does not start after early adolescence. It is more frequently diagnosed in boys in early childhood, however, in adolescence the ratio is equal in both boys and girls with rates of 2% to 16% being reported. A residual rate of 75% of children diagnosed Oppositional Defiant Disorder will still fulfill the ODD criteria years later. In some cases, Oppositional Defiance is present before a child is later diagnosed with Conduct Disorder. Many of the characteristics are the same in the two disorders. However, the disruptive behaviors of Oppositional Defiance are not as severe as Conduct Disorder and typically do not include aggression toward people or animals, destruction of property or theft.

How do these children get help?
There are many approaches to helping children with Oppositional Defiant Disorder. Sometimes a child may benefit from medications prescribed by a psychiatrist. The most common approach and the most essential is psychotherapy for the child with education and support for the parents. Psychotherapy may come in different techniques, however the most important aspect is to establish a strong working relationship between the child, the parent and the therapist. Therapy requires a clear understanding between the parents and the therapist that respects the parents’ role and views the family as a strength to overcome the difficulties they face…..and not as a source of the child’s problem.

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What help can I expect from the school?
It is not uncommon for these children to act out at home, perhaps for months or years, before the school begins to see the behaviors. According to the IDEA law (Individuals with Disabilities Education Act), each child is entitled to a Free Appropriate Public Education (FAPE). If a child’s behavior is interfering with his/her or others learning, parents should request in writing that their child be evaluated for Special Education. Once the child qualifies, an Individualized Education Program (IEP) is written with the parents and school personnel. A Functional Behavior Assessment (FBA) may be necessary to target on and off task behavior, problem behavior, possible interventions, patterns of behavior, etc. Once the FBA is complete, a Behavior Plan can be implemented.

Survival Tips
Children with Oppositional Defiant Disorder are difficult children to raise. Parents are often overwhelmed by the constant testing of rules and unpleasantness that seems to follow these children everywhere they go.

• Try to spend one-on-one time with each of your children. The children with ODD are usually more pleasant in one-on-one situations and the siblings appreciate their time as the parent focus.
• Make time to be alone with your partner. Make monthly dates and DO NOT focus on the children. Children with ODD are tough on marriages and relationships. Take advantage of respite.
• Blaming and fault finding accomplishes nothing. These children are rarely oppositional because of one particular “thing”. A combination of strategies is necessary to help these children.
• Explain Oppositional Defiant Disorder to family members and extended family, so there is a basic understanding from which to work. Ask for their help in building a support network for yourself.
• Take time to relax and regroup. Everyone needs times to recharge. These children are draining.
• Attend conferences and workshops on Oppositional Defiant Disorder to learn current information, strategies and ideas for success.
• Take advantage of parent groups in your area and online. There is information that crosses the disabilities, such as school issues. Talking with other parents can be reassuring.
• Maintain regular contact with the school regarding your child’s education and progress. Handle upsets immediately for the best results.
• Stress your child’s strengths!

For more information on Oppositional Defiant Disorder, contact UPLIFT. We have information on ODD, as well as our lending library.

*The educational series is intended for informational purposes only and
not to replace professional evaluation and treatment.

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