Brad* was a 15-year-old boy in our care. He was very articulate and loved to share his Asian culture. Brad enjoyed cooking, current events and video games. He could often be found talking about the latest news or stock market trends. Brad was most happy when participating in activities that interested him and when he was given choices. When asked to participate in an activity that did not interest him he could become aggressive, defiant and non-compliant. Brad taught us that kids thrive when they have a trusted adult that is willing to advocate for them.
Many children can be defiant once in a while but it can become a concern when the behaviour is frequent and habitual. Oppositional Defiance Disorder (ODD) falls under the category of conduct disorders. Often this presents itself as a behavioural disorder first where the child may be irritable, antisocial and disruptive. Children with ODD can be negative, hostile and defiant often towards adults and often in a persistent, patterned way. They can be argumentative, easily frustrated, vindictive and throw temper tantrums. ODD is sometimes a precursor for other conduct disorders and frequently co-occurs in children who have ADHD. Unlike other conduct disorders, children with ODD are not aggressive towards people or animals, do not destroy property and do not demonstrate a habit of stealing or lying.
In order for a child to be diagnosed with Oppositional Defiance Disorder they must display at least four of the eight signs and symptoms for more than six months. These behaviours would be considered beyond what a typical child would exhibit and must be demonstrated toward at least one individual who is not a sibling.
- The child refuses to comply with requests or rules
- He/she does things to deliberately annoy others
- He/she is often angry and resentful of others
- The child is argumentative
- The child frequently blames others for their own mistakes
- He/she often loses their temper
- The child is spiteful and seeks revenge
- He/she is easily annoyed or irritated
The cause is unknown although there seems to be a link to genetic, psychological and environmental factors. Contributing factors are thought to include: heredity, substance use during pregnancy, brain injury, insecure attachments and low socioeconomic status.
The characteristics of ODD are likely to affect the child’s ability to function well in school and in social situations. Defiance of authority figures can often result in negative reinforcements such as suspension and lead to delinquency.
There is no cure for this developmental disorder although there are many interventions that may help a child to improve and manage the characteristics of ODD. Interventions can include parental training, cognitive behavioural therapy and social skills support.
- Strive to build a positive relationship built on trust and mutual respect, take an interest in the childs likes and dislikes
- Avoid power struggles
- Be consistent in teaching methods and rules, follow through every time
- Allow the child to take “body breaks”
- Use open-ended questioning and actively listen, avoid questions that can be answered with “no”
- Be a calm, relaxed presence, give “soft” reprimands
- Give the child an “out” when presented with confrontation, drop the request for now and engage them in something that interests them
- Have clear expectations where the child can receive positive reinforcement for appropriate behaviour
- Give the child more choices and try to include their interests in the activity whenever possible. This Universal Design for Learning approach allows the student some freedom in choosing their task or assignment.
- Employ the Collaborative Problem Solving model whenever possible. Recommended reading: Lost at School by Ross Greene
comprehensive PDF Article on ODD
A PDF Guide for Families from AACAP
Canadian Mental Health Association
Childrens Mental Health Society
*Names and some details have been changed.
I am fortunate to have a background working with exceptional children and managing a program for children with special needs. I think that it is important to understand that every child is an individual first and should not be defined by their diagnosis. And every family has the right to treat the condition however they see fit. I do believe that the decision on how to treat your child (if at all) should be made after careful consideration, education, implementation of behavioural modification plans and consultation with professionals (teachers, counsellors, Pediatricians etc.).