Oppositional Defiant Disorder: What It Is And How It's Dealt With

Anger, temper tantrums defiance, and challenging authority figures are all normal parts of growing up. So, perhaps, are feeling the need to seek revenge and the temptation to purposely do things that make others angry. (Before you dismiss those feelings as "psychopatic", think back to your own childhood and remember the arguments you had with your siblings or classmates!) But when these behaviors go well beyond normative childhood defiance, a child may have Oppositional Defiant Disorder.

Living With ODD: An Overview Of Symptoms

“I knew something was 'off' very early on with my youngest son. He was angry all the time, had a hard time complying with anyone or anything, and would freak out completely if something unexpected showed up on the family schedule.

He had trouble at school too, but he went to a village school without many resources and simply got labeled as a difficult kid, rather than referred for counseling or diagnosis. When I got divorced, they blamed that for my son's behavior. I sought help from social services several times but was never taken seriously.”

This is the start of Ellie's story. Ellie has three children, who are all teenagers now. The son she describes has now formally been diagnosed with Oppositional Defiant Disorder. The description above doesn't sound so bad, does it? You may think this is just a normal kid, going through a normal kid angry phase.

It's actual examples of his behavior that make you realize the true extent of the ODD symptoms. He has hit his mom while she was driving, sold illegal fireworks, and started trying to hurt his younger sister by throwing objects at her when he was only a year old — and he's never stopped since. 

Oppositional Defiant Disorder (ODD) is a childhood disorder that the Diagnostic and Statistical Manual of Mental Disorders, the DSM, describes as a pattern of anger-guided disobedience, hostility, and defiant behavior toward authority figures that goes beyond the normal bounds of childhood behavior. Ellie stresses that her child lacks empathy and does not seem to comprehend that his actions have consequences.

Excessive, frequent anger and tempter tantrums are common in kids with ODD. Children who have the disorder purposely provoke hostility in others, while always shifting the blame onto others. They are disrupted easily and prefer revenge or hostility over communication as a “problem-solving approach”.

The diagnostic criteria listed by the DSM 5, the Diagnostic and Statistical Manual of Mental Disorders (which guide psychologists and psychiatrists in making diagnoses) must exist for a minimum of six months and should be considered to be beyond normal childhood behavior.

Four of these eight signs must be present for an ODD diagnosis to occur:

• The child actively refuses to comply with requests and rules, even those supported by a majority or agreed upon through consensus.

• The child purposely annoys others through his actions.

• Frequent anger and resentment of others are on open display.

• The child frequently gets into arguments.

• Children with ODD blame other people for their mistakes or wrongdoings.

• Kids with ODD frequently lose their temper.

• These children are spiteful and favor revenge.

• Children with Oppositional Defiant Disorder are easily annoyed — they have a “short fuse”.

It is not currently clear what causes ODD, but Ellie is very sure there is a strong genetic component — both her husband and his father displayed similar symptoms. Mental health professionals agree with her, but also list possible environmental risk factors. They include alcoholic parents, abuse or neglect, a delayed cognitive development (Ellie's son has an IQ score of 80), and inconsistent parental supervision or discipline.

Beyond The ODD Diagnosis

Ellie's son was diagnosed with Oppositional Defiant Disorder in high school. By the time he received the label, he already had a long and impressive career of trouble behind him in every sphere of life. His mom knew something wasn't right and attempted to seek help without much of a result many times, and the school simply described him as a problem child — who was probably being parented badly.

Ellie and her kids live in Europe, and the diagnosis eventually came from a developmental psychologist at her son's high school. The delay was due, in part, to the fact that Ellie's country requires a minimum of two people to come to the same diagnostic conclusion, and nobody paid much attention to her plight.

What can you do if you have a child who displays symptoms that you believe point to Oppositional Defiant Disorder? Many parents of children with mental disorders and learning difficulties share a similar experience, that of not “being heard” when they seek help. As parents, you get the most complete picture of your child's behavior. I suggest keeping a journal detailing the child's behavior, and filming him in action if at all possible.

Ellie feels that she didn't receive the help she needed with her son even after the ODD diagnosis — the respite care she was offered gave her a break, but not the necessary skills to make her a more successful parent. Yet such assistance is crucial for the sanity of parents and siblings of ODD children, as well as the rest of the community. Help is available in several forms on well-organized jurisdictions, and a treatment plan for Oppositional Defiant Disorder often consists of:

• Social skills and problem-solving training for the child. If successful, this can help the child learn to behave in an acceptable manner and deal with sudden life changes better.

• Ongoing therapy for the child.

• Parent-child interaction therapy and parent therapy. This aims to preserve the parents' sanity and help them parent their child in a way that is less frustrating for all parties.

Medications can also offer some relief, particularly in cases where the child has dual or multiple diagnoses, such as ADHD as well as ODD.

Children with ODD have a strong need for clear boundaries and a rigid routine. Power struggles that could stir the child's natural tendency to be oppositional and to seek revenge need to be avoided as much as possible. Strong, consistent discipline is necessary, and parents should be especially careful to choose consequences that can always be enforced — but beware, pick consequences that are temporary in nature, so the child can be rewarded for good behavior as well.

Above all, it is important to realize that parenting a child with ODD is simply hard. Nothing is going to take that fact away. Parents who realize that they are facing immense challenges may feel like less of a failure, thereby also giving them the strength to continue.