Years ago, a speaker taught a class on parenting difficult kids. At the time, I worked on a psychiatric adolescent unit. Many of the teenagers who came to the unit were angry and defiant. They wanted nothing to do with their parents. And the parents were often frustrated, worn out, and burnt out.
I heard parents say, “I’m burnt out. There’s no love left in our [parent-child] relationship. Nothing works. You don’t live with this child.”
The constant fighting, like Chinese water torture, wore away at the fabric of the family.
There is hope! I’m convinced that, whether you are a child, teenager, or parent, you can better understand what ODD is, and how to turn things around in your lives.
ODD is oppositional defiant disorder. The following ODD facts will help you understand what ODD (Oppositional Defiant Disorder) is, and how to turn things around for yourself and/or your family.
1. Here are the diagnostic criteria for Oppositional Defiant Disorder –
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months, as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.
1. Often loses temper
2. Is often touchy or easily annoyed
3. Is often angry and resentful
4. Often argues with authority figures or, for children and adolescents, with adults
5. Often actively defies and refuses to comply with requests from authority figures or with rules
6. Often deliberately annoys others
7. Often blames others for his or her mistakes or misbehavior.
8. Has been spiteful or vindictive at least twice within the last 6 months
B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (example, family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.
C. The behaviors cannot only occur during the course of a psychotic, substance use, depressive, or bipolar disorder.
In other words, a person can have angry/irritable mood, argumentative/defiant behavior, and vindictiveness if s/he has psychotic, substance use, depressive, or bipolar disorder. In that case, those conditions would better describe what is going on.
2. The child must demonstrated these signs and symptoms longer than 6 months, and beyond what is normal for most children his/her age in terms of child development, gender, and culture.
For children younger than 5 years old, at least four symptoms from any of the above categories would need to occur almost daily (with the exception of vindictiveness, which would be twice in six months).
3. These signs and symptoms must cause significant disruption in family relationships, at school, and with friends.
4. The causes of oppositional defiant disorder are unknown.
One study  posits that children of alcoholics or parents with legal problems have an 18% chance of developing oppositional defiant disorder. According to DSM-5, “oppositional defiant disorder is more common in families in which childcare is disrupted by a succession of different caregivers, or in families in which harsh, inconsistent, or neglectful child-rearing practices are common.”
5. Oppositional defiant disorder may be accompanied by the following co-morbid conditions:
ADHD, Conduct Disorder, chemical dependence, depression, Bipolar Disorder, or Learning Disorders. I’d personally be cautious about diagnosing a person with Aspergers disorder with oppositional defiant disorder before first exploring Why the person is being “oppositional”. A person with Aspergers may struggle with the nuances of language and words, or with quick transitions, or understanding the rationale behind rules. Sensory or noise difficulties can overwhelm a person, triggering a meltdown. In those cases, it would be more helpful for a parent or clinician to address those underlying issues instead of labeling the person oppositional defiant.
7. You and your child/teenager can get help. Here are some resources to start with:
- Read information from Dr. Ross Green, author of The Explosive Child. Here are his background and qualifications (via Lost at School), Ross W. Greene is Associate Clinical Professor in the Department of Psychiatry at Harvard Medical School and originator of the Collaborative Problem Solving (CPS) approach, which was first articulated in his acclaimed book, The Explosive Child. He is the founder and director of the non-profit, Lives in the Balance, which provides vast free resources on his model and advocates for behaviorally challenging kids and their parents, teachers, and other caregivers.
- Read my article – Little Known Ways to Understand (Explosive) Children. I talk about Dr. Greene’s strategies in this article.
- Check out articles about oppositional defiant disorder at My Aspergers Child. Mark Hutten has written extensively about oppositional defiant disorder. Read through some of his articles for tips and strategies to better understand What ODD is, and how to best work with it. Mark has also written a very popular e-book, My Out of Control Child, Click Here!
8. Take your child or adolescent to a physician for a complete physical exam to rule out organic factors (e.g, brain damage, tumor, elevated testosterone levels) that may be causing poor anger control.
9. Complete psychological testing for yourself or for your child.
Psychological testing can help you better understand exactly what specific conditions you or your child may be struggling with. It identifies strengths and weaknesses. If there is another condition occurring, such as depression, or bipolar disorder, or attention deficit disorder, for example, you will then better know how to approach each condition. If you have healthcare insurance, turn your card over and call the number on the back for mental health/behavioral health, and ask about your coverage for psychological testing. The process can be expensive, but it can also save you and your treatment team time in figuring out the causes and treatment strategies for your or your child’s condition/s.
10. Connect with other parents online. Mark Hutten’s online parent support program provides a lot of support and a parent forum.
Scott Sells, author of Parenting Your Out of Control Teenager, went through a difficult time in high school. He became increasingly angry and rebellious at home, refusing to speak to his father or mother. His father started a mandatory outing with his son every Saturday: a game of tennis. Scott was furious, but he went anyway. On the court, he hit more than a few balls out of anger at his father and into the net. He ignored his father, and continued to refuse to speak to him.
But over time, his father’s persistence and unconditional love, got to him. One day, he told us (at a continuing education seminar I attended), he just broke down and started crying in front of his father. He told his father about all the frustrations with friends and school underlying his anger and misbehavior.
Today, Dr. Sells teaches hundreds and thousands of families how to overcome oppositional defiant disorder.
As a parent, you can turn your child’s life around from frustration and discord to competence and harmony. It’ll take time, counseling, coaching, and support. But you can do it! I hope this article has given you hope.
What are some of your experiences with oppositional defiant disorder? Please share in the comments!
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