Do you feel like all of your parenting attempts are met with resistance? Does your child ignore you, or worse, lash out at you when you try to discipline? Does your child blame everyone else for the things he or she has done wrong? If you answered yes to any of these questions, it is possible that your child is suffering from Oppositional Defiance Disorder (ODD), a psychiatric condition characterized by antagonistic, hostile, defiant, and vindictive behaviors (1).
Some of the symptoms of ODD include:
The active defiance of rules or requests imposed by adults - the child refuses to clean his room when prompted, for example, or continuously fails to make curfew.
The frequent loss of temper - the child is unable to control surges of anger. This could include threatening behaviors, name-calling, shouting, and even violence.
The blame of others for the child's own wrongdoings - the child refuses to acknowledge his or her own accountability. Often, children with ODD will blame others for their own actions. "I only hit you because you said I couldn't have it. It's your fault", for example.
If you have observed any of these symptoms of Oppositional Defiance Disorder, then the first step is obtaining accurate and objective diagnosis. Keep a journal documenting your child's temper, defiance, violence, or hostility and take it with you to the diagnostic meeting.
To obtain a diagnosis, there are a variety of resources available. If your child is suffering academically, one potentially free resource is to request Special Education services for your child. One of the requirements for services is academic and psycho-social testing by a licensed psychologist who is trained to diagnose children with any disorder that may impact the child's academic performance.
If school is not an issue, a diagnosis can be obtained from requesting a psychological evaluation from any licensed child psychologist. This type of diagnosis is expensive, but it provides a thorough investigation into your child's life and is more likely to provide a comprehensive diagnosis with treatment recommendations than any other diagnosis option.
Psychiatrists differ from psychologists in that they also medical doctors. A psychiatric evaluation, or medication monitoring initial visit lasts just a few hours and diagnosis can happen as early as the first visit. In addition to psychiatrists, Licensed Clinical Social Workers (LCSW)and Professional Counselors (LCPC) are also licensed to provide a diagnosis under therapy.
Medications to treat ODD vary, but some research suggests it can be treated with the same medications prescribed for ADHD. Ritalin, Strattera, and Divalproex seem to have an effect on improving explosive behaviors in children with ODD (2). In addition, Risperdal is anti-psychotic medication sometimes described to decrease violence in children. One study even suggests Omega 3 Fatty Acids and Vitamin E can improve the behavior of a child with ODD (2).
Other treatment options include: children's case management, a program that links children with much-needed services across the state in which they reside, including everything from park passes to psychiatric hospitalization; family therapy or home-based counseling, programs that emphasize therapeutic strategies that take place in the home, which typically where the majority of problem behaviors take place; Multi-systemic therapy, another home-based counseling program which includes case management and family therapy - this program is typically reserved for children at risk for hospitalization; individual counseling; and psychiatric medication monitoring. In extreme cases, children can be placed in short-term, therapeutic living programs that provide 24-hour therapeutic services to children, and intermittent family therapy on a regimented basis.
1. DSM IV, criteria for DX 313.81 ODD, at: http://www.behavenet.com/capsules/disorders/odd.htm, retrieved: May 27, 2008.
2. Kane, Anthony. "Oppositional Defiance Disorder Treatment", at: http://addadhdadvances.com/ODD.html, retrieved: May 27, 2008.