What is oppositional defiant disorder (ODD)?
Oppositional defiant disorder (ODD) is a childhood behaviour problem.
A child with ODD:
- won't do what people ask
- thinks that what she's being asked to do is unreasonable
- gets angry and aggressive about being asked to do things.
All children are disobedient and cranky sometimes, especially if they're tired, upset or frustrated. But a child with ODD behaves like this a lot, and the ODD behaviour is so severe that the child has trouble doing ordinary, everyday things.
Diagnosing oppositional defiant disorder (ODD)
To be diagnosed with ODD, a child must have constant angry and cranky moods, along with negative, defiant behaviour that upsets other people. A child must also have at least four symptoms from the following list.
- loses his temper
- argues with adults
- actively refuses to do what adults ask and disobeys rules
- often deliberately annoys people
- often blames others for mistakes or challenging behaviour
- is easily annoyed by others
- is often nasty or unkind.
A child with ODD shows the symptoms:
- very often
- in a way that interferes with usual daily activities
- for at least six months.
If you think your child might have ODD, start by speaking with your GP for a referral to a paediatrician, psychiatrist or psychologist. These health professionals can diagnose oppositional defiant disorder (ODD).
Your GP will probably talk with you about a GP Mental Health Treatment Plan for your child. Getting a Plan doesn't always mean your child has a serious problem. But if you have a Plan, you can get Medicare rebates for up to 10 sessions with a psychologist. You can also get Medicare rebates for visits to a paediatrician or psychiatrist.
Behaviour management plans for oppositional defiant disorder (ODD)
Managing oppositional defiant disorder (ODD) in children is about first accepting that your child will behave in challenging ways.
The next step is working with health professionals to develop a behaviour management plan, which can make the behaviour easier to handle - for you and your child.
A good plan will help your child:
- learn how to improve her behaviour and understand how it affects other people
- manage strong emotions like anger and anxiety
- improve the way she solves problems, communicates and gets on with other children.
These things will help your child with making and keeping friends, saying what he thinks without getting angry, accepting no for an answer and playing well with others.
A good behaviour management plan will also help you cope with your child's challenging behaviour by helping you:
- understand the causes of your child's behaviour
- work out how you can increase your child's positive behaviour and manage her challenging behaviour
- support your child in managing strong emotions and improving social skills
- work on strengthening your family relationships.
It's normal to hope that your child will grow out of ODD, but ODD won't go away by itself. Your child needs professional diagnosis and treatment early on. This will help your child develop the skills he needs to make and keep friends, get and keep a job, and build a support network later in life.
Working on oppositional defiant disorder (ODD) at home
Here are some strategies for working on your child's behaviour at home:
- Use praise to encourage positive behaviour.
- Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
- Give short, brief, direct and specific instructions - for example, 'Would you like to do your homework now, or after the next TV show?'
- Try to avoid using negative consequences, but follow up on uncooperative behaviour straight away. So if your child doesn't do what you ask, ask again and say, 'This is the last time I am going to tell you'. If your child still doesn't cooperate, be ready with a consequence like loss of privilege.
Your child needs to know that she's important to you. One of the best ways you can send this message is by spending positive time together doing things your child enjoys. This will help to strengthen your relationship with your child.
Working with your child's school on oppositional defiant disorder (ODD)
You can work with your child's school to improve your child's classroom and playground behaviour. For example, you could talk to staff about:
- classroom behaviour management programs - for example, seating your child at the front of the classroom away from distractions
- structured classroom activities - for example, having a daily planner on the wall that everyone can see and telling children when activities are about to change
- alternative thinking strategies - for example, allowing children to offer their own ideas about ways to solve problems
- emotional regulation programs that teach children how to manage strong emotions like anger and frustration
- resilience, wellbeing and bullying intervention programs
- rewards for good behaviour, so that your child doesn't feel that he's always being punished for unacceptable behaviour.
Looking after yourself when your child has oppositional defiant disorder (ODD)
It can be challenging to balance looking after yourself with looking after your child with oppositional defiant disorder (ODD) and other children in the family.
Here are some tips on how you can care for yourself:
- Make some time every day to be on your own to read a book, watch a TV show or go for a walk. Start with five minutes at the end of the day if that's all you have.
- Ask family, friends or members of your support network to look after your child for a little while so you can have some time to yourself.
- Make time for some physical activity - for example, walking, yoga or swimming. A bit of exercise can give you more energy to work with your child.
- Make some time to do fun activities with your partner. Your child's difficult behaviour can be stressful on your relationship, especially if you and your partner don't agree about how to handle your child's behaviour.
- Seek professional help from a GP or counsellor if you feel you can't cope.
Sharing support, advice and experiences with other parents can be a big help. You could try starting a conversation in an online forum or joining a parent support group.
Risk factors for oppositional defiant disorder (ODD)
It's hard to say why children develop ODD. It's probably not because of any one thing. But there are some risk factors that are linked to ODD:
- temperament - for example, whether children are easygoing or like rules a lot
- the relationship between children and parents - for example, if children and parents haven't been able to bond or respond to each other in consistently loving ways
- low academic performance at school - for example, if children have learning difficulties
- speech and language problems in everyday life
- poor social skills, poor problem-solving skills and memory problems
- parenting and family factors - for example, inconsistent and harsh discipline, and a lot of family stress
- school environmental factors - for example, schools with harsh punishment or unclear rules, expectations and consequences
- community factors - for example, negative influences from peers, neighbourhood violence and a lack of positive things to do with free time.
Children with ODD often have other difficulties like learning disabilities, attention deficit hyperactivity disorder, anxiety disorders, mood disorders or language impairment.