What are the Symptoms of ODD?
According to the diagnostic criteria outlined in the Diagnosis and Statistical Manual - 5 (DSM-5), ODD is characterized by a repeating pattern of defiant, disobedient, hostile and negative behavior towards adults. Children show 4 of the following behaviors, which exhibit clinically significant impairment in social, academic, or occupational functioning:
- Often loses temper
- Often argues with adults
- Often actively defies or refuses to comply with requests or rules
- Often deliberately annoys people
- Often blames others for his/her mistakes
- Is often touchy or easily annoyed by others
- Is often angry and resentful
- Is often spiteful and vindictive
Symptoms typically are observed both in home and at school. In school, these children are described as typically challenging class rules, swearing, refusing to do assignments, arguing with other students, and being socially exploitive. The manipulation, testing the limits and constant arguing between the student and the teacher, and / or the student and his peers creates a stressful environment.
Children with ODD thrive on anger, conflict and aggression. They are quick to notice how others respond to negativity, and use these responses to their advantage in social interactions.
What causes ODD?
The exact causes of ODD are unknown, however, experts agree that there are a number of biological, genetic and environmental factors.
Children can be diagnosed as young as preschool age. During puberty, more boys than girls are diagnosed; at post-pubescent ages, the diagnosis tends to be about the same between the genders.
ODD has high co-morbidity rates with a number of other psychological disorders. 50-65% of children with ODD are also diagnosed with Attention Deficit Hyperactivity Disorder (ADHD); 35% also have a mood disorder, such as Major Depressive Disorder or Bipolar Disorder; and 15% also have a personality disorder. Learning disabilities, Conduct Disorder, Tourette’s Syndrome, and Obsessive-Compulsive Disorder are also common in children with ODD. Experts agree that many of the symptoms of these disorders must share common, underlying neurobiological mechanisms.
How do children with ODD think?
As mentioned above, children with ODD thrive on conflict and negativity. They typically are winners in escalating arguments, as they will not back down. They believe that they should be respected and that they can defeat authority figures. They fail to learn from experiences, and have a persistent drive to feel “tough” or seek revenge. Lastly, they blame others for their misbehavior.
What interventions should be used with children with ODD?
Children with ODD typically have poor relationships with peers and adults. Anything that can be done to improve these relationships and create more positive interpersonal interactions is a good first step.
Other helpful strategies include:
- Give Choices Children with ODD like to feel as though they are in control. Given them a choice between two options (would you prefer chicken or vegetables for dinner?) allows them to maintain the feeling that they are in a position of authority.
- Don’t use the word “no” Again, children with ODD thrive on negativity and will not shy away from an argument. Being told “no” will automatically make them defensive, because they will interpret it as not being in control. Common reactions to feeling not in control include verbal and behavioral outbursts. Parents and educators should try to use words such as “avoid,” “escape,” and “redirect.” Similarly, avoid power struggles and raising your voice. Try to react and respond calmly.
- Figure out the purpose of the defiant behavior Does the child need anger management? Social skills training? Anxiety coping techniques? Determining what is driving the negative behavior and correcting for it can lead to positive emotional and behavioral changes. A mental health professional can help with many of these skillsets.
- Avoid punishment when appropriate This sounds counterintuitive. Research shows that children respond more to being rewarded for compliant behavior rather than punished for defiant behavior. Obviously, any behaviors that are dangerous or inappropriate should be punished. However, negative behaviors that can be ignored, should be, and positive behaviors should instead be reinforced. So for example, ignore curse words but reward the child when he uses a slang, yet appropriate word instead.
Lastly, a mental health professional can help teach you and your child behavioral management techniques to help manage and improve defiant behavior.
Pierangelo, R. & Giuliani, G. (2008). Classroom Management for Students with Emotional and Behavioral Disorders. Corwin Press: Thousand Oaks, CA.