From Your School Psychologist…

Oppositional Defiant Disorder

Symptoms and Facts

Oppositional Defiant Disorder (ODD) is an ongoing and persistent pattern of uncooperative, defiant, disobedient, and hostile behavior towards authority figures that seriously interferes with the child’s daily functioning. Symptoms of ODD include: losing one’s temper, arguing with adults, defying or refusing adult requests, deliberately annoying others, blaming others for his/her mistakes, frequent anger and resentment, or being spiteful or vindictive. Five to 15% of all school-age children have ODD. While the causes of ODD are unknown, research indicates that biological & environmental factors may play a role.

In order to be accurately diagnosed with ODD, a child must receive a comprehensive evaluation by a psychiatrist or other qualified mental health professional. During this evaluation, it is important to look for other disorders as well since ODD usually occurs in conjunction with other disorders. Common comorbid conditions include ADHD, mood disorders (depression, bipolar disorder), and anxiety disorders. It is important to accurately diagnose and treat these comorbid conditions as it will be difficult to improve the symptoms of ODD without doing so.

Treatment

Medical treatment of ODD may include group, individual, and/or family therapy. It may involve:

  • Parent Management Training Programs to help manage the child’s behavior
  • Individual Psychotherapy to develop more effective anger management strategies
  • Family Psychotherapy to improve communication skills
  • Cognitive-Behavioral Therapy to improve problem-solving and decrease negativity
  • Social Skills Training to increase flexibility, improve social skills, & improve frustration tolerance
  • Medication Management

A child with ODD can be very difficult for parents and teachers as they frequently attempt to provoke reactions in others. Therefore, it is important to plan ahead and react calmly when dealing with these students. The following are behavioral strategies that may be helpful when dealing with students who have ODD:

  • Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want the child to do and decide which behaviors you are going to ignore.
  • Provide consistency, structure and clear consequences for the student’s behavior. Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
  • Always build on the positives. Give the child praise and positive reinforcement for flexibility and cooperation.
  • Take a time-out or break if you are about to make the conflict with the child worse, not better. This is good modeling for the child. Also, support the child when they decide to take a time-out to prevent overreacting.
  • Establish a rapport and build a relationship with the ODD child.
  • Maintain a calm voice. Silence is a better response than arguing.
  • Do not take the defiance personally.
  • Avoid power struggles. Give the child space and position the student away from authority figures.
  • Always listen to the student and address concerns privately.
  • Give choices or options when possible.
  • Systematically teach social skills, anger management, conflict resolution, etc.

Other Resources

About.com: Special Education:

Minnesota Association for Children’s Mental Health

References

American Academy of Child & Adolescent Psychiatry (2011). Facts for Families: Children with Oppositional Defiant

Disorder.(No. 72). Retrieved April 2012 from

The New York Hospital-Cornell Medical Center Department of Psychiatric Nursing.Fact Sheet: Oppositional Defiant

Disorder. Retrieved April 2012 from