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Oppositional defiant disorder interventions


Oppositional defiant disorder (ODD) - Diagnosis and treatment

Diagnosis

To determine whether your child has oppositional defiant disorder, a mental health provider does a thorough psychological exam. ODD often occurs along with other behavioral or mental health problems. So it may be difficult to tell which symptoms are from ODD and which ones are linked to other problems.

Your child's exam will likely include an assessment of:

  • Overall health.
  • How often the behaviors occur and how severe they are.
  • Emotions and behavior in different settings and relationships.
  • Family situations and interactions.
  • Strategies that have been helpful ― or not helpful ― in managing problem behaviors.
  • Issues experienced by the child and the family due to the problem behaviors.
  • Other possible mental health, learning or communication problems.

Treatment

Treatment for oppositional defiant disorder primarily involves family-based interventions. But treatment may include other types of talk therapy and training for your child — as well as for parents. Treatment often lasts several months or longer. It's important to also treat any other problems, such as a mental health condition or learning disorder, because they can cause or worsen ODD symptoms if left untreated.

Medicines alone generally aren't used for ODD unless your child also has another mental health condition. If your child also has other conditions, such as ADHD, anxiety disorders or depression, medicines may help improve these symptoms.

Treatment for ODD usually includes:

  • Parenting skills training. A mental health professional with experience treating ODD can help you develop parenting skills that are more consistent, positive and less frustrating for you and your child. In some cases, your child may join you in this training, so everyone in your family develops a consistent approach and shared goals for how to handle problems. Involving other authority figures, such as teachers, in the training may be an important part of treatment.
  • Parent-child interaction therapy (PCIT). During PCIT, a therapist coaches you while you interact with your child. In one approach, the therapist sits behind a one-way mirror. Using an "ear bug" audio device, the therapist guides you through strategies that reinforce your child's positive behavior. As a result, you can learn more-effective parenting techniques, improve the quality of your relationship with your child and reduce problem behaviors.
  • Individual and family therapy. Individual therapy for your child may help them learn to manage anger and express feelings in a healthier way. Family therapy may help improve your communication and relationships and help your family members learn how to work together.
  • Problem-solving training. Cognitive problem-solving therapy can help your child identify and change thought patterns that lead to behavior problems. In a type of therapy called collaborative problem-solving, you and your child work together to come up with solutions that work for both of you.
  • Social skills training. Your child also may benefit from therapy that will help them be more flexible and learn how to interact in a more positive and effective way with peers.

As part of parent training, you may learn how to manage your child's behavior by:

  • Giving clear instructions and following through with appropriate consequences when needed.
  • Recognizing and praising your child's good behaviors and positive traits to encourage desired behaviors.

Although some parenting techniques may seem like common sense, learning to use them consistently in the face of opposition isn't easy. It's especially hard if there are other stressors at home. Learning these skills requires routine practice and patience.

Most importantly, during treatment, show consistent, unconditional love and acceptance of your child — even during difficult and disruptive situations. Don't be too hard on yourself. This process can be tough for even the most patient parents.

More Information

  • Family therapy

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Lifestyle and home remedies

At home, you can work on improving problem behaviors of oppositional defiant disorder by practicing these strategies:

  • Recognize and praise your child's positive behaviors as close to the time you see them as possible. Be as specific as possible. For example, "I really liked the way you helped pick up your toys tonight." Providing rewards for positive behavior also may help, especially with younger children.
  • Model the behavior you want your child to have. Watching you interact well with others can help your child improve social skills.
  • Pick your battles and avoid power struggles. Almost everything can turn into a power struggle if you let it.
  • Set limits by giving clear instructions and using consistent reasonable consequences. Discuss setting these limits during times when you're not arguing with each other.
  • Set up a routine by developing a regular daily schedule for your child. Ask your child to help develop that routine.
  • Build in time together by planning a weekly schedule that includes you and your child doing things together.
  • Work together with your partner or others in your household to ensure consistent and appropriate discipline procedures. Also ask for support from teachers, coaches and other adults who spend time with your child.
  • Assign a household chore that's needed and that won't get done unless your child does it. At first, it's important to set your child up for success with tasks that are fairly easy to do well. Gradually blend in more-important and challenging jobs. Give clear, easy-to-follow instructions. Use this as an opportunity to reinforce positive behavior.
  • Be prepared for challenges early on. At first, your child probably won't cooperate or appreciate your changed response to their behavior. Expect behavior to worsen at first after you tell them the new things you now expect. At this early stage, staying consistent even if the problem behavior worsens, is the key to success.

With regular and consistent effort, using these methods can result in improved behavior and relationships.

Coping and support

It's challenging to be the parent of a child with oppositional defiant disorder. Ask questions and tell your treatment team about your concerns and needs. Consider getting counseling for yourself and your family to learn coping strategies to help manage your own needs. Also seek and build supportive relationships and learn stress management skills to help get through difficult times.

Learning coping and support strategies can lead to better outcomes for you and your child because you'll be more prepared to deal with problem behaviors.

Preparing for your appointment

You may start by seeing your child's health care provider. Or you may choose to make an appointment directly with a mental health provider. A mental health provider can make a diagnosis and create a treatment plan that meets your child's needs.

When possible, both parents or caregivers should be present with the child. Or take a trusted family member or friend along to support you and help you remember information.

What you can do

Before your appointment, make a list of:

  • Symptoms your child has been experiencing, and for how long.
  • Key family information, including factors that you think may be linked to changes in your child's behavior. Include any stressors and changes in the family, such as parents' separation or divorce and differences in parenting styles, including what's expected from your child.
  • Your child's school performance, including grades and areas where your child does well or poorly in school. Include any learning disorder assessments and any special education services.
  • Issues that you, your family and your child have been experiencing because of the problem behavior.
  • Your child's key medical information, including other physical or mental health conditions your child may have.
  • Any medicines, vitamins, herbal products and other supplements your child is taking, including the doses.
  • Questions to ask your health care provider or mental health provider to make the most of your appointment.

Some questions to ask your child's mental health provider include:

  • What do you believe is causing my child's symptoms?
  • Are there any other possible causes, such as other mental health conditions?
  • Is this condition likely temporary or long lasting?
  • What issues do you think might be contributing to my child's problem?
  • What treatment approach do you recommend?
  • Is my child at increased risk of any long-term complications from this condition?
  • What changes do you suggest at home or school to improve my child's behavior?
  • Should I tell my child's teachers about this diagnosis?
  • What else can my family and I do to help my child?
  • Do you recommend family therapy?

Feel free to ask other questions during your appointment.

What to expect from your doctor

Here are examples of questions that your mental health provider may ask.

  • What are your concerns about your child's behavior?
  • When did you first notice these problems?
  • Have your child's teachers or other caregivers reported problem behaviors in your child?
  • About how often over the last six months has your child had an angry and irritable mood, argued with or defied people in authority, or purposely hurt others' feelings?
  • In what settings does your child show these behaviors?
  • Do any specific situations seem to trigger problem behavior in your child?
  • How have you been handling your child's problem behavior?
  • How do you usually discipline your child?
  • How would you describe your child's home and family life?
  • What kinds of stress has your family been dealing with?
  • Does your child have any other medical or mental health conditions?

Be ready to answer your mental health provider's questions. That way you'll have more time to go over any other information that's important to you.

By Mayo Clinic Staff

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Samaritan Behavioral Health – Solutions to Oppositional Defiant Disorder

Solutions to Oppositional Defiant Disorder

“I hate you, you’re such a bitch, I am too going to wear my red dress! You promised me yesterday, and if I can’t wear it today, I’m not getting ready for school!” Molly had been arguing about the dress for the past forty-five minutes. It was 8:05, mom was running late, and the dress was filthy. That overwhelming exhausted feeling enveloped mom and, once again, she caved. “Go ahead and wear it,” she screamed.

If your child has been diagnosed with oppositional defiant disorder (ODD), this scenario may sound much too familiar. According to the Diagnostics and Statistical Manual of Mental Disorders, fourth Ed., oppositional defiant disorder can cause clinical impairment in social, academic, or occupational functioning, and is characterized by a recurrent pattern of negativistic, defiant, disobedient and hostile behavior toward authority figures which persists for a period of at least six months.

Since children pass through many developmental stages as they mature, it is important to understand the differences between normal childhood attempts to defy authority and symptoms of full-blown oppositional defiant disorder. Nine year-old Molly appears driven to defeat adults, is relentless in her pursuit of proving adults to be wrong, stupid, or both, and her thoughts revolve around defeating anyone’s attempt to exercise authority over her. She typically turns every interaction with adults into win/lose situations and is vigorously intent on winning.

Oppositional defiant children share many of the following characteristics:

  • They possess a strong need for control, and will do just about anything to gain power.
  • They typically deny responsibility for their misbehavior and have little insight into how they impact others.
  • The ODD child is socially exploitive and very quick to notice how others respond. He then uses these responses to his advantage in family or social environments, or both.
  • These children tolerate a great deal of negativity – in fact they seem to thrive on large amounts of conflict, anger and negativity from others, and are frequently the winners in escalating battles of negativity.

Besides oppositional defiant disorder, children like Molly may also have another psychiatric disorder. ODD is frequently a co-morbid condition with attention-deficit/hyperactivity disorder. It can also be diagnosed along with Tourette Syndrome, obsessive-compulsive disorder, anxiety and mood disorders, Asperger’s, language-processing impairments, sensory integration deficits, or even nonverbal learning disabilities. What causes this troubling behavior? Some researchers believe that many of the symptoms of these disorders may share common neurobiological mechanisms. If your child is affected by one of these disorders, it is critical to keep in mind that ODD can create additional problems for you and your child.

Many authorities on parenting have indicated that oppositional behavior is more prevalent when structure in the home is out of balance – when there is either too much structure or not enough. In an overly structured environment the parenting is rigid and inflexible. These parents “micromanage” and come down hard on their children, controlling every aspect of their lives. This particular style of parenting only serves to create more opposition and defiance. On the other hand, structure that is too loose can also cause difficulties. Children can exhibit oppositional defiant behavior when parents do not provide enough structure by setting appropriate boundaries, or establishing and following through with consequences for misbehavior. These parents usually give in to all of their child’s demands, either out of fear of the child, or in an effort to keep themselves in the child’s good graces. In order to prevent or reduce oppositional defiant behavior parents should aim towards a firm and loving parenting style in which the structure is balanced. Parents must take charge, and place themselves at the top of the family hierarchy. They must use their authority as parents and, at the same time, make the child feel protected, loved and soothed.

How well the parents get along, whether married or divorced, is another factor to consider in preventing oppositional behavior. When couples are unhappy or oppositional in themselves, they frequently disagree on parenting issues, significantly limiting their success in changing the behavior of their child. Molly is an expert at dividing her parent’s authority, and will most certainly take advantage of exploiting rifts between her parents. Couples counseling may be in order to decrease the hostility and conflict between parents and set the stage for united, successful parenting.

Another factor to consider is how the family is affected by ODD. This can be one of the most stressful conditions a family faces and, when it is secondary to another neuro psychiatric disorder, that stress is compounded. Family counseling may be helpful to resolve family difficulties. The family therapist can provide a controlled environment which offers support and skills training to weary parents.

Once marital and family issues are addressed, parents can begin to train both themselves and their child. If Molly’s mother continues to respond to her quarrelsome behavior as she always has, Molly will continue to tune her out, escalate the arguments, and push mom’s buttons. Most adults engage in an argument with concern for the outcome. The adult’s goal in an argument is to come to a resolution. In other words, what transpires as a result of the conflict is most important. As a parent, from your perspective, if you have determined the outcome of the argument, you are the one in control. For the oppositional child the process of creating an argument is more meaningful to her than the outcome of the conflict. These arguments over insignificant issues may seem pointless however, with such a strong need for control; it is your oppositional child’s goal is to escalate the conflict until you are no longer the one in control. What is important to her is not the issue being argued over, as much as what is going to happen during the argument. In order to control the process of the argument the oppositional defiant youngster attempts to determine the topic and direction of the conflict, and seems to instinctively know when you are feeling most vulnerable and your energy is low. She will bring up conflict-laden issues during these times, aiming towards pushing your buttons and diverting you from issues in which you are likely to be attempting to exert your authority over her. When your ODD child finally pushes your buttons, in her mind, she has gained control of you and your emotions. At this point she has now successfully taken over your position of authority. Furthermore, when you lose control of your emotions, your child’s anxiety level rises along with her defensiveness. When her defenses increase she becomes more oppositional which is her main defense mechanism. As she becomes more oppositional, the situation escalates and we are caught in an endless cycle of conflict.

Strategies for avoiding conflict are essential to de-escalate the situation. It is wise to change the subject if your energy is low, or you suspect that the topic of discussion will result in an argument. Walking away from the conflict is another strategy to consider. If you cannot change the subject, or walk away it is important to keep in mind that the ODD child’s goal is to push your buttons. Think about your endurance, how long can you endure really oppositional button pushing? When you get to the end of your rope, what are your options? It is critical not to take what your youngster says personally. As soon as you defend yourself, your child, by the rules governing arguments, has the right to defend himself against your attack. In turn, you get to defend yourself, and he has now pushed your buttons and gained power. You do not have to defend yourself or try to convince him you are right. Do not lower yourself to the level of your oppositional child. There are two options available for preventing him from drawing you in. Tell him, in an unruffled rational manner, that he has two choices. If he wants to stay around, he can change the subject and stop complaining; or he can go somewhere else in the house to complain if he chooses. Should your child choose to escalate, it is time to use two powerful words which can cut through any argument. These words are “regardless” and “nevertheless”. For example, “nevertheless, this is how it is going to be…” Using these words repetitively (like a broken record), in a calm unemotional manner will serve to de-escalate the situation without allowing your child to draw you into the power struggle.

Utilizing effective consequences for the oppositional child can be difficult since this presents one more opportunity for conflict in which you are likely to lose power. Discussing consequences while you are in the midst of their negative behavior will most likely result in more frustration for you. Therefore, it is critical to focus on consequences that do not require cooperation of the child. Rules and consequences must be clear, and in writing to provide clarity for both child and parent before the conflict occurs. Begin by removing reinforcers and allowing your child to earn the items back as a reward for acceptable behavior. Reinforcers include items such as television, stereos, CD’s computers, video games, telephones, bicycles, skateboards, visiting friends, access to favorite clothing, favorite foods, etc.

Once you have successfully avoided having your buttons pushed and gained some control over your child’s behavior, it is time to go on the offensive to soothe her, and help her get back to an even place. Oppositional kids do not like being soothed by their caretakers. This places them back into the role of being a child, and puts you back into the role as the parent. One of the driving forces behind ODD is that, for whatever reasons, a child is trying to grow up too quickly, and considers herself to be equal to her parents. The ODD child may feel less loved due to the amount of conflict going on, and it is difficult to simultaneously feel loved as a child and try to operate on an adult level. Your child may know intellectually that she is loved, but not feel loved. Parents must be able to show love, and soothe and nurture their child. This is not always easy to accomplish, especially when previous negative behavior patterns have become ingrained.

Non-Medical Strategies for Managing ODD

The essence of this group of interventions is to make it impossible for ODD to “work”. It is a way of making sure all the attempts to annoy or irritate others and to cause fighting are not successful.

  • Adults must work together.
  • Children with ODD are quite successful at placing the blame for their behaviors on others, including parents and/or teachers. Thus, adults must come together and challenge anything that the child tells you about how others treat them. In order for this to work effectively, all parties need to talk directly with each other without the child being present.
  • Talk regularly with teachers and principals about the child’s school behavior.
  • Establish a policy at both home and school not to rely exclusively on information your child gives you about what others have done.
  • Sit down with all caregivers (including baby sitters, grandparents, aunt, uncles) to make sure they understand ODD and that they follow the above policy.
  • Do not include the child in these discussions with other caregivers.
  • Have a plan and try not to show any emotion when reacting to the child’s behavior.
  • If you react too emotionally, you may make big mistakes in dealing with the child. Everyone needs to agree in advance on what to do when the child engages in certain behaviors– and then be prepared to follow through calmly.
  • Behavior modification strategies have been used successfully in the therapeutic treatment of ODD, and can also be used effectively in the home. The central premise of behavior modification (or behavior therapy) is that behavior is maintained by its consequences. It suggests that old behaviors resist change unless new behaviors are followed by more rewarding consequences. Many therapists suggest that for the most part, focusing on the positive behaviors and not reacting emotionally to the negative behaviors is the key to getting behaviors to change.

For behavior modification to work, the program must involve certain components:

  • Target only a few important behaviors, rather than trying to fix everything. For example, you may wish to focus on eliminating highly objectionable behaviors such as hitting others, stealing, or swearing.
  • Be very concrete about the expected behavior. Instead of saying, “listen when I am talking,” say, “Sit down and make eye contact with me when we are talking.”
  • Be consistent — no bending of the rules under any circumstances!
  • Rewards for good behavior should not be money or things that are bought. Rather, grant rewards that involve activities that the child enjoys.
  • Rules should be simple and straightforward so as to be easily understood. If your child can read, write the rules and consequences (both negative and positive) into a contract and have the child sign it.
  • Decide which behaviors you are going to ignore.
  • Most children and adolescents with ODD are doing too many things you dislike to include all of them in a behavior management plan. The key caregivers have to decide ahead of time which behaviors will be targeted for change, and which will simply be ignored.

Too naughty child: ODD oppositional defiant disorder

​

Sometimes even the most well-behaved child rebels, or refuses to comply with the most harmless request. However, almost half of all parents of children with ADHD face serious behavioral and discipline problems on an almost daily basis.

This is because approximately 40% of children with ADHD develop oppositional defiant disorder (ODD). This condition is expressed by chronic aggression, frequent outbursts of anger and a tendency to argue, ignore demands and bother.


This material will help you understand your naughty child:

How far can this go? Consider real examples from the lives of children diagnosed with ADHD accompanied by ODD:

  • A 4-year-old girl who happily annoys her parents by turning up the TV volume as soon as she wakes up.

  • A 7-year-old boy who yells "No" to every demand and swears at his parents.

  • An 11-year-old boy who punches a hole in a wall and then physically assaults his mother.

"I call them little terrorists," says Douglas Riley, PhD, author of The Defiant Child and child psychologist in Newport News, Virginia. “These kids are most comfortable when they are in the middle of a conflict. Once you start arguing with them, you are on their territory. made a mistake."

​

The stress of a child with ODD affects the whole family. This can seriously affect marital relationships. This is partly because friends and family tend to condemn the child's behavior as bad parenting. An inconsistent disciplinary approach may play a role in the development of RIA, but it is rarely the only reason. Unfortunately, the reality is that discipline strategies that work with normal children simply don't work with children with ODD. Fortunately, psychologists have developed effective behavioral therapies to keep even the most rebellious child in check. This is not always easy, but it is possible with the help of specialized psychotherapy.

​

Causes


No one knows why oppositional behavior is so common in children with ADHD. However, in many cases associated with impulsivity, oppositional behavior turns out to be a manifestation of ADHD.

"Many children with ADHD who are diagnosed with ODD do exhibit an oppositional trait, such as non-compliance," says Houston-based child psychologist Carol Brady. "They are outrageous not because they are deliberately oppositional, but because they cannot control their impulses."
Another point of view is that oppositional behavior is a way to cope with feelings of irritation and psycho-emotional pain associated with the presence of ADHD.

"Under stress, a certain percentage of children become depressed for whatever reason, whether they have ADHD or divorced parents," says Larry Silver, MD, a psychiatrist at Georgetown University School of Medicine in Washington, "In others are blamed for everything, the child does not take responsibility for what goes wrong.

Dr. Douglas Riley agrees: "Children with ADHD know from a young age that they are different from other children," he says. “They see themselves as a big problem child. In some cases, the reason may be due to severe learning difficulties (often despite being above average intelligence). So, instead of feeling stupid, their defensive reaction is to feel cool. They're honing their opposition stance."

About half of all preschoolers diagnosed with ODD outgrow the problem by age 8. Older children are less likely to outgrow ODD. If left untreated, oppositional behavior can develop into disorders with even more serious behavioral problems such as physical abuse, theft, running away from home, arson, and other extremely destructive and often illegal behavior.

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Treatment

Any child with ADHD who exhibits signs of oppositional behavior requires appropriate treatment. The first step is to make sure the child's ADHD is under control. Since oppositional behavior is often associated with stress, you should address the source of stress, ADHD symptoms, before moving on to behavioral problems.

Dr. Douglas Riley says: "If a child is so impulsive or distracted that he cannot focus on the therapy we use to treat oppositional behavior, he will not get very far. And for many children with ADHD and ODD, stimulant medications are kind of miraculous. Most of the time, the bad behavior just disappears."

But drug treatment is rarely enough to control OVR. If ODD is mild or infrequent in a child, self-administered behavior change procedures may be a good option. But if the oppositional behavior is severe enough to interfere with life at home or at school, then it is best to consult a family psychologist who specializes in child behavioral problems.

​

Create harmony

A therapist/specialist must protect your child from anxiety, depression and bipolar disorder. All of these phenomena can lead to oppositional behavior and each needs its own form of treatment. The therapist may also recommend cognitive therapy for the child to help them deal effectively with difficult situations.

​

​

Practice mindfulness

The purpose of teaching mindfulness to our children is to give them the skills to develop their awareness of their inner and outer experiences; to teach them to determine whether their thoughts are "fair thoughts"; understand how emotions appear; notice when they lose attention; learn to control impulses.

​

Carrot and stick


In most cases, one of the points of therapy for OVR is teaching parents to manage their child's behavior. A family therapist teaches parents how to change the way their child's behavior is influenced. Between weekly sessions, parents practice what they have learned and report their progress to the therapist.

"The carrot and stick rule is becoming a parenting skill," says Carol Brady, child psychologist. "Gingerbread - your job is to encourage and reward the child for cooperation. Whip - you apply the indicated punishment for bad behavior - as a rule, it means temporary suspension of the naughty child from the activity (time out) or deprivation of the reward."
Teaching parents to manage behavior is very effective, in four out of five cases the child's behavior improves dramatically. Parents who receive training tend to see an improvement in the situation in the family, including improved behavior in their other children.

At the same time, some parents are reluctant to understand that they need training. “They need to learn how to stop at the right time and not get into the battlefield with the child, not descend to the level of squabbles,” says Dr. Larry Silver. assert its authority by creating well-defined rewards and punishments, and then implementing them consistently and impartially.0009 The most important rule is that parents do not take oppositional behavior personally, remain calm and friendly. Oppositional children have a radar for adult hostility. If they feel your anger, they will resist it.
A "two open requirements" approach is recommended. The first time you ask your child to do something, give him two minutes to respond. If he doesn't listen, calmly tell him, "Now I'm asking you for the second time to hang up your coat. Do you understand what I'm asking you to do and what the consequences are if you don't? Please make a smart decision." . If you have to repeat the request a third time, then the predetermined consequences should immediately take effect - the TV is turned off for an hour or video games are taken away.

Positive side

Rewarding good behavior or punishing bad behavior is not a revolutionary concept, but with oppositional children this is easier said than done. Parents need to control their urge to yell or spank, and learn to replace negative punishments with things like time out or loss of privileges.
Many parents of children with ODD are so focused on the negative that they have stopped encouraging positive behavior. However, encouraging positive behavior is the heart and soul of the parenting process.
"Invariably, parents come to treatment with the idea of ​​suppressing, eliminating, or reducing a behavioral problem," writes Alan Kazdin, Ph.D., in Parent Management Training (Physician's Handbook). Instead, parent education emphasizes the concept of "positives". "For example, parents ask what to do if they want their child to stop screaming, slamming doors loudly, or breaking things. The objection to such behavior would be to insist on speaking quietly, gently closing the door behind you, handling things carefully. "
Dr. Alan Kazdin states that helping parents learn to praise good behavior is one of the most difficult tasks facing the therapist. He says that parents are often “hesitant to praise or encourage the behavior mainly because they believe the behavior should not require any intervention. “My child knows how to clean his room, he just refuses to do it” – typical parent comment.

Delight


When parents express praise, they should be enthusiastic. "An unenthusiastic 'Well Done' statement is unlikely to change a child's behavior," says Alan Kazdin, Ph.D. Praise should give a special character to praiseworthy behavior, ideally include some kind of non-verbal gesture. For example, you can say, "That's great, you played so quietly while I was on the phone!" and then kiss the baby.

Appropriate rewards and punishments vary from child to child. The more creatively you tailor the program to your child's specific abilities and needs, the better. But, as Russell Barkley, Ph.D., professor of psychiatry at the Medical University of South Carolina at Charleston, writes in Your Defiant Child:

"Creativity is the key to raising children, but it is no match for consistency. Consistency is how you approach your child - you set rules and express expectations, pay attention, encourage good behavior and apply punishment for bad behavior is the key to normalize your child's actions."

​

Never lose sight of the fact that usually oppositional children show many abilities once their behavior is under control. "Opposition kids are also often quite interesting and colorful," says child psychologist Douglas Riley. "They tend to be optimistic, strong personalities with their own way of looking at the world. After you deal with their defiance, you will find many pleasant discoveries.

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Rebellious Children and Oppositional Defiant Disorder

Quite often we find that a child is not ready to blindly obey parental instructions or orders. Sometimes, as he grows older, he begins not only to refuse, declaring “I don’t want to”, but also objects, citing arguments in favor of his refusal. In other words, the child has his own opinion, and he is ready to be guided by his own accumulated knowledge and experience. This experience is still small, not sufficient for independent decisions, and often contradicts social norms and rules.

All this, for the time being, is absolutely normal for a developing personality. But what to do if such behavior is not episodic, but turns into systematic behavior? Often or constantly the child gets angry, is in a state of constant irritation when communicating with parents, and sometimes teachers, easily loses his temper, takes offense himself and offends others, gets angry and is ready to quarrel with everyone around.

In this case, parents should have questions about the mental (psychological) well-being of their son or daughter.

If, in addition to the above, the child behaves defiantly, does not recognize authorities, argues with elders and is insolent to them; refuses to comply with the rules or requirements established by adults, deliberately causing irritation of others and anger is evident in his behavior, it's time to think about the fact that such symptoms most closely fit the definition of Oppositional Defiant Disorder (ODD).

If the disorder occurs only at home or only at school, it is considered moderate. If in three or more communication groups - serious.

WHEN TO SEE YOUR DOCTOR

Symptoms of ODD usually begin in the preschool years. Your child is unlikely to recognize his own behavior as a problem. Instead, he is likely to complain about unreasonable demands or blame others for his problems. If your child is showing signs that may indicate ODD or other disruptive behavior, or you are concerned about a parent's ability to challenge a child, seek the help of a child psychologist with experience in behavioral problems. Behavioral treatment for ODD includes learning skills to help create positive family interactions and manage problem behaviors. Additional therapy and possibly medication may be needed to treat the disorders associated with this disorder.

No single clear cause of ODD has been found, but possible causes may be a combination of inherited and environmental factors, including:

Genetics - a child's natural inclination or temperament and possibly neurobiological differences in nervous system and brain function.

Environment - problems with parenting, such as lack of proper attention or overprotection, inconsistency in demands, harsh discipline, parental abuse or neglect.

RISK FACTORS

Temperament - the child's temperament has difficulty managing emotions, such as reacting emotionally to situations or having trouble coping with any disappointment.

Parenting problems - a child who experiences abuse or neglect, harsh or inconsistent discipline, or lack of parental attention.

Other family problems - A child who lives in a troubled or broken home or has a parent with a mental illness or substance use disorder.

Environment - oppositional and defiant behavior can be provoked and reinforced by peer attention and inconsistent demands for discipline from other authority figures such as teachers.

To determine if your child has oppositional defiant disorder, a child psychologist or psychotherapist will likely perform a comprehensive psychological assessment. Because ODD often occurs along with other behavioral or mental problems, the symptoms of ODD may be difficult to distinguish from those associated with other problems.

Be prepared to give the specialist the following information about your child:

  • General health.
  • Frequency and intensity of oppositional behavior.
  • Emotions and behavior in different situations and relationships. Family situation and relationships of family members.
  • Strategies that have been helpful—or not helpful—in managing problem behaviors
  • Presence of other disorders of the mental plane, learning or communication.

TREATMENT

Treatment for oppositional defiant disorder is primarily family-based and family-based interventions, but it may include various types of psychotherapy and education for your child as well as for the parents. Treatment often lasts several months or longer. It is important to consider any problems that arise, such as conduct or learning disorders, as they can create or worsen symptoms of ODD if left untreated.

No medication is used to treat ODD unless your child has another mental disorder. If your child has coexisting disorders such as ADHD, anxiety, or depression, medications can help manage them.

KEYSTONES OF AVR TREATMENT GENERALLY INCLUDE:

PARENT TRAINING.

A therapist or child psychologist with experience in ODD can help you develop parenting skills that are more consistent, positive, and less frustrating for you and your child. In some cases, your child may be involved in this learning with you, so everyone in your family develops common goals for problem solving. Involving other authority figures, such as teachers, in teaching can be an important part of the treatment.

PARENTAL THERAPY.

During parent-healing therapy, a therapist or child psychologist coaches parents as they interact with their child. For example, as an option, it guides parents on strategies that reinforce their child's positive behavior. As a result, parents learn more effective parenting techniques, improve the quality of the parent-child relationship, and reduce interaction problems.

INDIVIDUAL AND FAMILY THERAPY.

Individual therapy for your child can help him or her learn to manage anger and express feelings in a healthier way. Family therapy can help improve your communication and relationships and help your family members learn how to work together.

COGNITIVE PROBLEM TRAINING.

This type of therapy is designed to help your child identify and change thought patterns that lead to behavioral problems. Collaborative problem solving, in which you and your child work together to come up with solutions that work for both of you, can help solve RAD-related problems.

SOCIAL SKILLS TRAINING.

Your child may also receive therapy to help him or her be more flexible and learn to interact more positively and effectively with peers.

As part of parent education, you can learn how to manage your child's behavior:

  • Provide clear instructions and follow up with appropriate consequences if needed.
  • Recognizing and praising your child's good behavior and positive characteristics to promote the desired behavior.

While some parenting techniques may seem obvious, learning to use them consistently in the face of opposition is not easy, especially if there are other stressors at home. Learning these skills will require routine practice and patience.

The most important thing in a successful fight against an illness is to show sincere love and care for your own child, accept him as he is, and gently but firmly lead him through a rather difficult process for the majority to recovery.

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