Oppositional Defiant Disorder (ODD)

Even the most well-behaved children may be difficult and challenging at times. In fact, at certain developmental stages, it would be unusual if they do not throw any tantrums or meltdowns. Oftentimes, small amounts of this constitute a healthy and essential part of growing up. However, if there is a frequent and persistent pattern of anger, irritability, arguing, defiance, or vindictiveness towards parents or other authority figures which is age-inappropriate, this may indicate oppositional defiant disorder (ODD). 

 

Signs of ODD

  • Angry and irritable mood 

  • Deliberately defies adults or people in authority 
  • Blames others for their mistakes or misbehaviour
  • Spiteful or vindictive 

 

Severity of ODD

  • Mild: symptoms only occur in one setting 
  • Moderate: some symptoms occur in at least 2 settings 
  • Severe: some symptoms occur in 3 or more settings

 

Many children and adolescents with ODD also have other mental disorders like Attention-deficit/hyperactivity disorder (ADHD), conduct disorder, depression, anxiety, and learning disorders. It is important to address these other conditions as treating them may improve ODD symptoms. 

 

Risk factors

  • Temperament that includes difficulty regulating emotions, such as being highly emotionally reactive to situations or having trouble tolerating frustration
  • Parenting issues where a child experiences abuse, harsh or inconsistent discipline, or neglect
  • Environmental factors such as peers or poor discipline from authority figures and parents may reinforce oppositional and defiant behaviours 

 

Treatment 

  • Ideally, intervention should involve therapy for both the child and the parent or family. Parents and family members play a key role in a child’s development and teaching parents how to manage their child could be extremely helpful. 
    • Parent Management Training (PMT) to equip parents with skills to improve parent-child interaction and parenting behaviours. This includes ways to better monitor a child's behaviour, communicate instructions clearly and effectively, and use rewards and punishments. 
    • Parent-Child Interaction Therapy (PCIT) are more appropriate for parents with younger children (ie. preschool and early school-aged children). PCIT integrates play therapy and operant behavioural therapy approaches to improve parent-child relationships and address behavioural problems. 
    • Problem-Solving Skills Training (PSST) is a form of cognitive-behavioural therapy (CBT) as it focuses on correcting cognitive distortions to more helpful patterns of thinking. 

If your child exhibits signs that may indicate ODD, seek help from a mental health professional with expertise in disruptive behavior problems. Please remember that you do not have to experience this alone. Moreover, early intervention can help improve your child’s behaviours and prevent the situation from worsening. Treatment can effectively restore your child’s self-esteem and rebuild positive parent-child relationships. 

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