Oppositional defiant disorder (A complete guide)

All children refuse to comply at sometimes or other. And a lot of children occasionally get involved in the fights.

Also, various children lie at times. Although these behaviors are inappropriate, from clinical point of view they need not be of great concern if they occur infrequently and in an isolated manner.

When however, these behaviors occur in a cluster and repeatedly in a particularly child.

There is a reason to be worried because it may be oppositional defiant disorder.

What is Oppositional Behavior?


Oppositional or non-compliance is a behavior is behavior in which a child resists a caregiver.

A range of oppositional behaviors may be dis concerned, from passive to active form of non-compliance.

Thus children may ignore a parental direction, which is a form of mildly active non-compliance.

In addition children may angrily reject parental commands and prohibitions, which is a form of severe non- compliance or defiant (Mathys, Walter & John, 2011).

Oppositional Defiant Disorder (ODD)
When a child or teen has a frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures, he or she may have oppositional defiant disorder (ODD).

Rules to understand the defiant child


There are following rules that oppositional children follow. These rules can vary from individual to individual.

They could assist in understanding the defiant child.

Rule 1: Oppositional children live in a fantasy in which they are able to defeat all authority figures.
Rule 2: Oppositional children are optimistic.
Rule 3: Oppositional children are fail to learn from experience.
Rule 5: Oppositional children need to fail tough.
Rule 6: Oppositional children seek revenge when angered.
Rule 7: Oppositional children believe that is they ignore you long enough, you will run out of moves.
Rule 8: Oppositional children from middle class homes emulate the behavior of their least successful peers.
Rule 9: Oppositional children teenagers attempt to answer most questions with ‘I don’t know’ (Riley, 1997).

Signs and Symptoms

Most children argue with parents and defy authority from time to time, especially when they are tired, hungry, or upset.

Some of the behaviors associated with ODD also can arise in children who are undergoing a transition, who are under stress, or who are in the midst of a crisis.

This makes the behavioral symptoms of ODD sometimes difficult for parents to distinguish from expectable stress-related behaviors.

5 Children with ODD show an ongoing pattern of extreme negativity, hostility, and defiance that:
• Is constant
• Lasts at least 6 months
• Is excessive compared with what is usual for the child’s age?
• Is disruptive to the family and the school
• Is usually directed toward an authority figure (parents, teachers, principal, coach)

The following behavioral symptoms are associated with ODD:


• Frequent temper tantrums
• Excessive arguments with adults
• Actively refusing to comply with requests and rules
• Often questioning rules
• Deliberately annoying and upsetting others
• Often touchy or annoyed by others
• Blaming others for their mistakes
• Frequent outbursts of anger and resentment
• Spiteful attitude and revenge seeking

Typically, children with ODD do not engage in delinquent behavior.

Also, children whose behavioral symptoms are specifically related to a mood disorder, such as depression or bipolar disorder, are usually not diagnosed with ODD.


Causes of Oppositional Defiant Disorder


The exact cause of ODD is not known, but it is widely believed that a combination of biological and environmental factors work together towards causing a person to develop the symptoms of oppositional defiant disorder.


Biological causes


The defects in or injuries to certain areas of the brain can lead to serious behavioral problems in children.

In addition, ODD has been linked to abnormal functioning of certain types of brain chemicals, or neurotransmitters.

Further, many children and teens with ODD also have other mental illnesses, such as ADHD, learning disorders, depression, or an anxiety disorder, which may contribute to their behavior problems.


Genetic causes


It is common for children who are diagnosed with ODD to have family members who also suffer from various mental illnesses.

Such illnesses can include mood disorders, personality disorders, and anxiety disorders.

This fact suggests that there is most likely a genetic component that leads a person to be more susceptible to developing oppositional defiant disorder, as opposed to a person who has not next been exposed to the same type of genetics.

Child characteristics


The first of these is an emotional dimension consisting of impatience, irritability, quickness to frustrate or be annoyed, anger, and hostility.

A child who has a temperament that includes difficulty regulating emotions, such as being highly emotionally reactive to situations or having trouble tolerating frustration may leads to the symptoms of ODD.


The second dimension of ODD is one of defiant behavior or social conflict.

A propensity for rule-breaking, stubbornness, noncompliance or a direct refusal to obey, ignoring the requests of others, such as parents, hyperactivity, excessive, and even defiant verbal behavior, and physical resistance to the demands of others are present in children with oppositional defiant disorder.


Environmental factors


The environment in which a person is raised can have a significant effect on whether or not he or she may fall in to the symptoms of oppositional defiant disorder.

If a child is surrounded by abusive and violent family environment then, it would not be unreasonable to assume that the child could begin acting out at as a result.

Similarly, if children are exposed to violence or have friends who behave in destructive, reckless manners, those children too are more likely to begin displaying behavioral symptoms that correlate with the onset of oppositional defiant disorder.


Parent’s characteristics


ODD children, especially those with comorbid ADHD, are also more likely to have parents with psychiatric disorders, especially ADHD, depression, and antisocial personality disorder, than are children without these disorders.


Ways to manage Oppositional defiant disordered (ODD)

Behavioral Interventions


Social learning family interventions


Children with odd disorder often engages in that behaviors that violates the rules set by authorities, behavioral interventions involving authorities are most common and more effective for oppositional defiant disorder .

Behavioral plans mostly rely on parents management interventions collectively referred to as social learning family interventions.

Parent Training Program


Patterson (1982) developed a parent training program in which parents learn a step by step approach for managing the child with odd behaviors.

Essentially this behavioral program includes the combination of following steps:


Psychoeducation


Psycho education will be given to the parents about the basic behavioral concepts of odd such as coercion, reinforcement, punishment, rule violation and operationally defined behavior.

Parents may also receive some detailed information about the disorder such as symptoms, etiology, prevalence and overview of the treatment plan.


Observation and monitoring


Target problematic behaviors are identified and parents are asked to monitor the occurrence of these behaviors and establish a baseline chart to measure the effectiveness of the future intervention.

Ideally behaviors are easily identifiable, discrete and operationally defined that helps in designing intervention plan of therapy.


Reinforcement of prosaically behavior


In third step parents learn reinforcement techniques to focus the child attention from antisocial behavior and onto prosocial goals.


Social rewards consist of praise, hugs and smiles from their caretakers, material rewards may include eatables, token or money that may be used by the child to purchase the tangible things.

Activity rewards may include access to favorite games or allow them to play in playground.

These rewards are combined in this step to encourage the client to engaged in the prosaically behavior identified by the parents and therapist.


Discipline of unacceptable behavior


At this stage of parent training, parents are taught to use the correct use of time out.

Time out is the removal of the child from a reinforcing or stimulating situation or placement in a situation that is free of reinforcement and stimulation.

Time out should occur for a discrete period of time and attempts on the part of the child to escalate behavior and escape time out should be met with further punishment or ignoring.

For example if the child is showing tantrums in his room, the door may be shut and extra 2 minutes added to the time out.

Parents also learn to actively ignore mild attention getting behavior to avoid reinforcing the child negative behavior with attention.


Supervision monitoring


Parents are encouraged to provide close supervision for their child even when the child is away from the home.

This involve such behaviors as knowing where the child is at all times, what the child is doing and when the child will be at home.


Cognitive behavior therapy


Cognitive behavior therapy targets the child thought and behaviors related to three primary overlapping deficits found in odd children: social relationship, problem solving and anger management


Social skill training


Social skill training deals with the children who demonstrate social behavioral deficits.

Social skill training teach the children in play skills, friendship and conversational skills, academic skills and behavior control strategy for example children are taught to question others for information, clarification and invitation they learn to help by giving support and suggestion.

They are encouraged to cooperate and they are reinforced for sharing.


Problem solving


Problem solving interventions combine cognitive and behavioral techniques to teach problem solving such as generating alternative solutions and consequential thinking and taking the perspective of others.

Problem solving is taught using variety of techniques such as, didactic teaching, practise, modelling, role, playing, social reinforcement and therapeutic games such as response cost and token reinforcement are also frequent component of problem solving interventions.

Anger Management


The goal of anger management is to help individuals learn skills to manage anger in a positive manner, improving personal relationships and quality of life.

Children are taught ways to identify the physical signs that indicate anger in themselves and others such as muscle tension and clenched fists so this identification can increase the anticipation and control of anger bursts.

Anger reducers

The goal of this technique is to reduce the anger and to increase the self-control.so these following reducers were introduced in the following program.

Reducer 1: deep breathing can reduce the physical symptoms of anger and increase concentration
Reducer 2: backward counting is used to distract the child from provoking situation and gain time to consider choice
Reducer 3: pleasant imagery is a relaxation technique used to reduce tension.

Increasing personal power by self-control


This technique introduces child the basic concept that anger create problems in the child life.

Admired people who achieved success with self-control are introduced as role models.

Children are taught that they are more powerful when they do not react angrily or respond to provocation.

Using reminders


Children are taught positive self-statements to increase control in pressure situation e.g. slow down, chill out and be relaxed these reminder are introduced to replace internal triggers.

Medication


Medication may have the greatest effect on ODD children with co-occurring attention problem or hyperactivity and especially if theses co-occurring problems are contributing to the oppositional defiant antisocial behavior (conners,1971).

Neuroleptics are sometimes used when agitation and excessively violent behaviors are primary features of ODD furthermore; the side effects of neuroleptics especially with long term use limit their utility with children.

Lithium and anti-depressants has been used with some effectiveness in explosively aggressive ODD children.

Lifestyle and Home Remedies


Mash and wolf (2010) described some strategies related to lifestyle and home remedies for the problematic behaviors of oppositional defiant disorder.

Recognize and praise child’s positive behaviors.

Be as specific as possible, such as, “I really liked the way you helped pick up your toys tonight.”

Model the behavior. Parents have to model the behavior that they want their child to have i.e if his father shows most of the time angry behavior in his home than his father has to overcome his anger and shows polite behavior so his child can easily model his father polite behavior.

Set up a routine


Parents have to set up a routine by developing a consistent daily schedule for your child.

Asking your child to help develop the routine may be beneficial.

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Build in time together


Parents have to build time together with their children by developing a consistent weekly schedule that involves you and your child spending time together.

Be prepared for challenges early on


At first, your child probably won’t be cooperative or appreciate your changed response to his or her behavior.

Expect behavior to temporarily worsen in the face of new expectations. This is called an “extinction burst” by behavior therapists.

Remaining consistent in the face of increasingly challenging behavior is the key to success at this early stage.

Frequently Asked Questions (FAQ)

What causes oppositional defiant disorder?

ODD is caused by a combination of biological, social and psychological factors.

ODD occurs in families with history of substance abuse, mood disorders and ADHD.

Brain imaging studies have also suggested that children with ODD may have subtle differences in the part of the brain responsible for reasoning, judgment and impulse control.


Does ODD get better with time?

Yes, with timely and proper management many children improve over time.

Researches have shown that signs and symptoms of ODD resolve within 3 years in 67 % of cases.

However if remain unmanaged 30 % of children with ODD develop propensity of developing conduct disorder.

Can ODD be prevented?

Yes. There is some evidence of parent management, social skills training, conflict resolution and anger management, cognitive and behavioral therapies to be helpful in preventing Oppositional defiant disorder.

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