Oppositional Defiant Disorder | COACH Live!

Contributed by David L. Bastin (2012) [David Lee Bastin studies social work as a graduate student at Tennessee State University. David?s interest in social work stems from his work as a therapist for the Tennessee state mental institution. David plans to continue working with those suffering from serious mental conditions such as schizophrenia and psychotic disorders. Follow David on Twitter @DAVIDBASTIN2]

Oppositional Defiant Disorder (ODD) is a disruptive behavior recognized in children and adolescents.?It is not to be confused with Conduct Disorder, but sometimes it is.?A child with ODD may often feel bad about their behavior. This is one important difference between ODD and Conduct Disorder. In Conduct Disorder, a lack of feelings often persists.

DSM IV (1994) describes Oppositional Defiant Disorder (313.81) as a pattern of behavior which supports negative, defiant, disobedient, and hostile actions toward authority figures which last for at least six months.?These behaviors must occur fairly frequently and be characterized by at least four of the following behaviors.

1)?Losing temper.
2)?Arguing with adults.
3)?Actively defying or refusing to comply with the request or rules of adults.
4)?Deliberately doing things that will annoy other people.
5)?Blaming others for their own mistakes or misbehavior.
6)?Being touchy or easily annoyed by others.
7)?Being angry or disrespectful.
8)?Being spiteful.

Diagnosis of ODD is dependent on the above behaviors displayed by the child/adolescent at a more frequent rate than by their peers.?These behaviors must also cause a significant impairment of social, academic, or occupational roles.?After puberty, ODD is generally equal between males and females, however before puberty males are more likely to present these symptoms (DSM IV, 1994).

Contributors to Oppositional Defiant Behavior

Family and health habits are important in the development Oppositional Defiant Behavior.?Family issues which may contribute to ODD are:
1)?Child care that is switched often between a series caregivers.
2)?Harsh treatment of the child by family members or caregivers.
3)?Inconsistent treatment of the child by family or caregivers.
4)?A pattern of neglect or neglectful care while raising the child.

DSM IV (1994) also notes that Attention-Deficit/Hyperactivity Disorder is common in children diagnosed with Oppositional Defiant Disorder.?Also, Learning Disorders and Communication Disorders are sometimes linked to ODD.?

The family should be aware that ODD symptoms usually start before 8 years of age or will surface at the onset of early adolescent years.?Such oppositional behavior may increase with age. These symptoms usually begin in the home, but often stretch-out to other settings like school or day-care over a period of time.

ODD diagnosis has a demonstrated link to parental history of Mood Disorder, ODD, Conduct Disorder (as a child/adolescent), Anti-Social Personality Disorder, and/or Substance-Related Disorder.?Also, families with serious marital discord present a higher rate of children with Oppositional Defiant Behavior (DSM IV, 1994).

Caution and Supporting Autonomy

Caution should be taken. A child/adolescent should not be given this diagnosis too swiftly.?Developmental periods like preschool and adolescence are often riddled with periods of defiant behavior (DSM IV, 1994). Early assessment and intervention are key to healthy progress of the child or adolescent through the typical developmental stages.?

Do not panic if your child shows signs or symptoms of ODD.

Some opposition by a child is normal.?It shows they are becoming an individual that can practice autonomy and say ?no? to external pressures.?Many times in developmental stages, children may have low self-esteem, pressure from teachers, parents, and peers, frustration through academic or social events, and all the efforts and activities which go into child and adolescent development.?Children adapt differently and cope with situations in a unique way.?Therefore, attention to the child as an individual is very important.

A child will use their own mechanisms to deal with anxiety or frustration.?So, it is very important for those wishing to intervene, to know how the child uses their own defense mechanisms and to know what ?fears? the child may internalize.?A younger child may have a more primitive mechanism of defense. Frightening feelings may be more likely to permeate their thoughts.?An older child or adolescent may keep their feelings in the unconscious because it conflicts with the wishes of adults and the demands of reality (Wachtel, 1994).?Remember, to some extent, this behavior is a part of development, but be aware of on-going symptoms and the need to intervene when necessary.

Intervening with Oppositional Defiant Behavior

However, oppositional behavior which goes beyond developmental usefulness can be destructive to the child?s social or academic standing in the society.?Adults dealing with the child/adolescent can be frustrated with this behavior. A vicious cycle of defiance-punishment-defiance may develop between the adult and the child (Wachtel, 1994).

Keeping age sensitive and psychological aspects of the child or adolescent in mind, the most sustainable solutions will account for the individuality of the child, the family and social structure of the home, and the health behaviors of the child.?Perspectives on intervention may include:

1.?Intervene early when the signs and symptoms of ODD occur.
2.?Intervene proactively to model and influence sustainable behavior rather than responding only after defiant behavior.
3.?Intentionally increase acceptable behavior rather than purposing to decrease unsustainable behavior.

Self-Control. Self-management an important skill the child can practice. The competent social worker will research evidence-based practice methods specific to self-control. One possible practice in self-control is tied to developing attention skills through memory. With younger children, this can involve recall games utilizing music lyrics, drum patterns, or memory games found in your local toy store. With adolescents, music lessons, recording equipment operation, or other process/step-based activity can improve self-control. Also, the practice of writing in a journal or planning the day ahead can be instructive.

Parent-training. Parents themselves may need help with social skills or control issues. Also, assessment skills for determining the child?s issues can be invaluable to addressing the defiant behaviors. As indicated, the environment of the home and models present do bear a relationship to the child or adolescent?s behavior.

Health. Healthy lifestyles may improve a child?s behavior, as well.?Sleep, nutrition (which supplies natural vitamins), drinking plenty of water, and an active interest in the out-of-doors. Even if the adolescent does not like sports, structure goal-based out-door activities. Walking in city parks, hiking, or nature scavenger hunts are a few examples. Tie distances, speed, or list completion to simple rewards. Teaching meditation at an early age may help the child to discipline the brain and the body.?

Modeling. Develop a level of communication with the child or adolescent or find a mentor or strong family member who can help.?Communicate sustainable choices and ability to deal with challenges through action as well as words. Success can be improved when parents reinforce sustainable choices with the model of their own behavior and their responses to their child?s behavior.

Above all, remain encouraged. Many of us have gone through oppositional and defiant behavior and come out the other side by channeling our anger, fear (or lack of), hostility, and refusal of rules into sustainable choices and success. The change does not happen without informed help.

Reference List

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, D.C.: American Psychiatric Association.

Wachtel, E. F. (1994). Treating troubled children and their families. New York, NY: The Guilford Press.

Source: http://mawmedia.com/COACHMethod/2012/07/20/oppositional-defiant-disorder/

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