odd presentation

OPPOSITIONAL DEFIANT DISORDER (ODD)

BY CHRISTINE SCHMITT

What is Oppositional Defiant Disorder?

Oppositional Defiant Disorder is a relatively new diagnosis.

It is classified as a disruptive behavior disorder and is defined as a pattern of negative, disobedient, defiant or hostile behavior directed toward authority.

ODD Definition Continued

Periods of difficult behavior are normal.

Toddlers and teens go through periods of difficult behavior as they strive for autonomy and independence.

ODD children display negative or defiant behavior over time that is more often or worse than normal for their age.

Diagnosing ODD

Diagnosis for Oppositional Defiant Disorder must meet certain criteria specified in the Diagnostic and Statistical Manual of Mental Disorders.

A physical exam is performed. A mental health professional can then

determine whether a child or adolescent has ODD.

Symptoms and Signs of ODD

Often loses temper/ temper tantrums

Symptoms Continued

Argumentativeness with adults Refuses to comply with adults’ rules Deliberately annoys other people Often blames others for his/her

misbehavior or mistakes Is touchy or easily annoyed Often angry or resentful May be spiteful or vindictive

Symptoms Continued

Anthony Kane, MD believes there are a few key questions whose answers may be indicative of ODD.

Oppositional Defiant Disorder usually appears by age 8, and usually not later than early adolescence.

Who Has ODD?

Oppositional Defiant Disorder in younger children is more common among boys.

Who? Continued

Among school aged children and adolescents, ODD occurs almost equally in boys and girls.

Who? Continued

1% to as high as 6% of children and adolescents have oppositional defiant disorder to some degree.

Who? Continued

ODD affects all types of families, but it seems to occur more in lower socioeconomic families.

Causes of ODD

DEVELOPMENTAL THEORY LEARNING THEORY

There may be limitations or delays in a child’s ability to process thoughts or feelings.

This suggests that ODD is the result of negative experiences.

Causes Continued

Temperament Theory Many children who are in therapy have higher

maintenance temperaments. Dr. David Rice worked for non-profit

organization…The Preventive Ounce

Temperament Traits Affecting ODD

Adaptability: not being able to quit an activity or be flexible

Persistence: because frustration tolerance is low, the child or adolescent wants problems solved for him/her

Temperament Continued

Mood: reacts to the world negatively

Additional Causes

Inconsistent or harsh discipline Abuse or neglect Lack of supervision Chemical imbalance, i.e. serotonin

Related Disorders

ADD, ADHD: found in 50 to 65% of ODD children

Affective Disorders: 35% (of the above) Personality Disorders: 15% (of the above) Learning Disorders

Risk factors

A parent with a history of a disorder or abuse

Brain impairment Exposure to toxins Poor relationship with parent(s) Neglectful or absent parent(s) Poverty Instability at home

Treatment for ODD

Therapy is the usual treatment for individuals and families.

Therapy

Cognitive problem solving training

Therapy Continued

Parent training: a therapist helps parents develop skills for more positive and less frustration outcomes, especially in regard to temperament

Medication

Ritalin: if ODD co-exists with ADHD

Strattera Risperdal Divalproex Vitamins and

Supplements

Medication alone is not a recommended treatment for ODD

In Schools

For teachers: remember that the ODD student has deficits when it comes to dealing with frustration.

Teachers need to help identify frustrating activities and help develop coping skills.

Clearly state behavioral goals.

Prognosis: What becomes of children and adolescents with ODD?

With treatment, some will outgrow their ODD.

Prognosis Continued

In older children, 75% will retain ODD traits.

Prognosis Continued

The ODD may become something else. The child or adolescent may develop a

conduct disorder. In very few cases, the child may continue

to have only ODD.

Alternate Treatment

Boot camps Clinics Ranches

Prevention

Good parenting

Early intervention

Conclusion

Early diagnosis and treatment are very important.

For those who receive treatment, many can become symptom free and can lead rewarding, happy lives.

Ruth Wells, MS Director of Youth Change

“If you work with kids, but you are not a mental health professional, maybe it’s time to at least learn some of the basics about children’s mental health. And, no matter what your role with children, please consider it your obligation to train your kids to be peaceful. That may be the most important contribution you could make in a world that so thoroughly ensures that every child knows so much about extreme violence, and so little about anything peaceful.”