OPPOSITIONAL DEFIANT DISORDER (ODD)
BY CHRISTINE SCHMITT
What is Oppositional Defiant Disorder?
Oppositional Defiant Disorder is a relatively new diagnosis.
It is classified as a disruptive behavior disorder and is defined as a pattern of negative, disobedient, defiant or hostile behavior directed toward authority.
ODD Definition Continued
Periods of difficult behavior are normal.
Toddlers and teens go through periods of difficult behavior as they strive for autonomy and independence.
ODD children display negative or defiant behavior over time that is more often or worse than normal for their age.
Diagnosing ODD
Diagnosis for Oppositional Defiant Disorder must meet certain criteria specified in the Diagnostic and Statistical Manual of Mental Disorders.
A physical exam is performed. A mental health professional can then
determine whether a child or adolescent has ODD.
Symptoms and Signs of ODD
Often loses temper/ temper tantrums
Symptoms Continued
Argumentativeness with adults Refuses to comply with adults’ rules Deliberately annoys other people Often blames others for his/her
misbehavior or mistakes Is touchy or easily annoyed Often angry or resentful May be spiteful or vindictive
Symptoms Continued
Anthony Kane, MD believes there are a few key questions whose answers may be indicative of ODD.
Oppositional Defiant Disorder usually appears by age 8, and usually not later than early adolescence.
Who Has ODD?
Oppositional Defiant Disorder in younger children is more common among boys.
Who? Continued
Among school aged children and adolescents, ODD occurs almost equally in boys and girls.
Who? Continued
1% to as high as 6% of children and adolescents have oppositional defiant disorder to some degree.
Who? Continued
ODD affects all types of families, but it seems to occur more in lower socioeconomic families.
Causes of ODD
DEVELOPMENTAL THEORY LEARNING THEORY
There may be limitations or delays in a child’s ability to process thoughts or feelings.
This suggests that ODD is the result of negative experiences.
Causes Continued
Temperament Theory Many children who are in therapy have higher
maintenance temperaments. Dr. David Rice worked for non-profit
organization…The Preventive Ounce
Temperament Traits Affecting ODD
Adaptability: not being able to quit an activity or be flexible
Persistence: because frustration tolerance is low, the child or adolescent wants problems solved for him/her
Temperament Continued
Mood: reacts to the world negatively
Additional Causes
Inconsistent or harsh discipline Abuse or neglect Lack of supervision Chemical imbalance, i.e. serotonin
Related Disorders
ADD, ADHD: found in 50 to 65% of ODD children
Affective Disorders: 35% (of the above) Personality Disorders: 15% (of the above) Learning Disorders
Risk factors
A parent with a history of a disorder or abuse
Brain impairment Exposure to toxins Poor relationship with parent(s) Neglectful or absent parent(s) Poverty Instability at home
Treatment for ODD
Therapy is the usual treatment for individuals and families.
Therapy
Cognitive problem solving training
Therapy Continued
Parent training: a therapist helps parents develop skills for more positive and less frustration outcomes, especially in regard to temperament
Medication
Ritalin: if ODD co-exists with ADHD
Strattera Risperdal Divalproex Vitamins and
Supplements
Medication alone is not a recommended treatment for ODD
In Schools
For teachers: remember that the ODD student has deficits when it comes to dealing with frustration.
Teachers need to help identify frustrating activities and help develop coping skills.
Clearly state behavioral goals.
Prognosis: What becomes of children and adolescents with ODD?
With treatment, some will outgrow their ODD.
Prognosis Continued
In older children, 75% will retain ODD traits.
Prognosis Continued
The ODD may become something else. The child or adolescent may develop a
conduct disorder. In very few cases, the child may continue
to have only ODD.
Alternate Treatment
Boot camps Clinics Ranches
Prevention
Good parenting
Early intervention
Conclusion
Early diagnosis and treatment are very important.
For those who receive treatment, many can become symptom free and can lead rewarding, happy lives.
Ruth Wells, MS Director of Youth Change
“If you work with kids, but you are not a mental health professional, maybe it’s time to at least learn some of the basics about children’s mental health. And, no matter what your role with children, please consider it your obligation to train your kids to be peaceful. That may be the most important contribution you could make in a world that so thoroughly ensures that every child knows so much about extreme violence, and so little about anything peaceful.”