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Does My Child Have Oppositional Defiant Disorder?

All children will have some good days and some no good, very bad days. And many will act out sometimes. They may even argue, talkback, throw a fit or defy you. But with maturity and proper parental guidance, many children grow out of these behavioral issues. However, for those children who don’t, and it starts to affect their social, family and schooling, they may be demonstrating the symptoms of oppositional defiant disorder (ODD).

“ODD is a disruptive behavioral disorder in children and adolescents that is characterized by intense and pervasive episodes of defiance, non-compliance to rules and poor tolerance to frustration,” said Srinivas Dannaram, MD, a psychiatrist with Banner Thunderbird Medical Center in Glendale, AZ. “ODD is pervasive to home and school, resulting in functional impairments, relationship challenges and discipline issues.”

You may find that your child or teen is defiant, rebellious or oppositional at times, but that doesn’t necessarily mean they have ODD or another mental health condition. That said, if you have concerns, read on to learn more about ODD and what you can do to help your child.

What are the symptoms of oppositional defiant disorder?

Sometimes it can be difficult to pinpoint or recognize the difference between a strong-willed or emotional child versus ODD as it’s normal for children to exhibit oppositional behavior at different developmental stages. However, if you notice their behaviors start to have a negative impact on your child, family, school and social life, you’ll want to talk to their doctor.

ODD can vary in severity, from mild to severe. For mild cases, symptoms are confined to only one setting, such as at home, school or with peers. For moderate cases, symptoms occur in two settings. And for severe cases, they occur in three or more settings. “For some children, you may first see symptoms at home, but over time, these symptoms may bleed into other areas of your child’s life,” Dr. Dannaram said.

What causes oppositional defiant disorder?

There is no one specific cause for ODD, but it may result from a combination of biological and environmental factors, Dr. Dannaram said.

“There are some risk factors which when interacting with the environment can result in ODD,” he said. Some of these risk factors include:

  • Prenatal problems: low birth weight, complications during pregnancy and around childbirth
  • Gender: Male children are at higher risk to have ODD than female children
  • Family Issues: Harsh or inconsistent discipline, domestic violence, parental antisocial behavior, parental mental health or substance abuse and parent-child conflict
  • Temperament: Impulsivity, inattention, aggressiveness and difficulty regulating emotions
  • Environment/Social: Rejection by peers, association with deviant peers or siblings, being bullied, dysfunctional and disorganized schools

How is oppositional defiant disorder diagnosed?

Your child’s doctor will go over their medical and family history and will ask about your child’s symptoms and other emotional or behavioral problems. If your doctor believes your child is exhibiting signs of ODD, they may recommend a licensed behavioral health specialist who will conduct an assessment to confirm a diagnosis.

“Most often this assessment will involve talking to the patient, parents and the school,” Dr. Dannaram. “The evaluation is important as well so you can rule out other conditions that might mimic ODD or to better understand the severity of your child’s ODD.”

For your child to be diagnosed with ODD, they must have a pattern of angry/irritable moods, argumentative/defiant behavior or vindictiveness that lasts at least 6 months including at least four of the following symptoms:

  • Often loses temper
  • Is often touchy or easily annoyed
  • Is often angry and resentful
  • Often argues with authority figures or adults
  • Often actively defies or refuses to comply with requests from authority figures or with rules
  • Often deliberately annoys others
  • Often blames others for their mistakes and misbehavior
  • Has been spiteful or vindictive at least twice within the past 6 months

How is oppositional defiant disorder treated?

If you see symptoms of ODD in your child or teen, get them diagnosed right away as early treatment is beneficial.

“Early treatment is helpful as it is easy to intervene and address symptoms that haven’t become intense or pervasive yet,” Dr. Dannaram said. “Early identification, adequate support through education and therapeutic interventions are helpful.”

When it comes to treatment, there are several options for ODD. Treatment strategies may involve in-home treatment to observe child-parent interactions and advise parents on how to improve communication and positive behaviors. Treatment will also focus on helping your child learn how to better manage their anger and handle frustrations by developing problem-solving skills. Medication and behavioral therapy may be helpful for more distressing symptoms of ODD as well as for symptoms of hyperactivity and inattention.

Tips to help a child with oppositional defiant disorder

You may feel helpless as a parent if your child has ODD, but there are ways to help your child at home and in school. Dr. Dannaram shared the following suggestions:

  • Use positive parenting: Praise and provide positive reinforcement.
  • Give them one-on-one time: Help build trust and emotional relationships.
  • Practice positive communication: Maintain eye contact and use a calm voice while talking to them.
  • Be consistent on rules: Follow through on instruction intended to understand and help. Don’t make empty threats.
  • Find out the why: Process episodes of meltdowns and let your child open up and explain their side of the story or why they are so upset. Maybe they are having a hard time in school or making friends.
  • Address bullying at school: Involve and work with the school on behavioral strategies to help your child overcome behavioral issues.
  • Don’t give up: Your child might call you names or exhibit physical aggressive behavior but remind yourself you aren’t a bad parent—and it’s not personal. Empower yourself to learn more about ODD and treatment and reach out to a licensed behavioral health specialist for help.

You can find a Banner Health specialist by visiting bannerhealth.com. And check out “Choosing the Right Therapist for You or Your Child” for helpful tips on how to find the right one.

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