Parenting a Child with ODD

Understand the ODD diagnosis, what to do and access resources

Oppositional Defiant Disorder, also known as ODD, is a “pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months.” The difference between ODD and Conduct Disorder is that children with ODD are not aggressive towards people, property or animals and they do not show a proclivity towards theft or deceit. The diagnosis of ODD is invalid if the individual is diagnosed with Reactive Attachment Disorder (RAD).

How do I know if my child has Oppositional Defiant Disorder?

The following criteria is established to determine if a child has Oppositional Defiant Disorder.

Oppositional Defiant Disorder

1. A Disruptive, Impulsive-Control, and Conduct Disorder marked by a negativistic, hostile, and defiant behavior toward authority figures persisting for at least six months
2. Developmental progression to Conduct Disorder; it often co-occurs or precedes a diagnosis of Conduct Disorder, but many ODD never develop Conduct Disorder
3. ODD often manifests through excessive stubbornness, revenge-seeking, oppositionality, and blaming of others for wrongdoing
4. Verbal aggression and outbursts are common, but do not include aggression toward people or animals, or destruction of property
5. Symptoms begin round preschool years and most often present around family members
6. Wide estimates of prevalence rates (1 to 11 percent). In childhood, boys more likely than girls to have an ODD diagnosis; gender disparity diminishes by adolescence
7. Linked to inconsistent, neglectful, or overly harsh parenting, temperament. Possibly neurobiological markers.
8. High comorbidity with Attention-Deficit/Hyperactivity Disorder
9. Increased risk for anxiety, depression, antisocial behavior, and substance use disorders.

In order to receive the ODD diagnosis, there must be markable distress for the family and it must interfere with academic and social functioning. Children with ODD can escalate if they also suffer from ADHD and depression. A mental health professional can help determine if additional issues are present in your child.

ODD Diagnosis confirmed. Now How to Parent a Child with ODD?

Take a breath and get ready. When it comes to how to parent a child with ODD, it will take patience and consistency in order to see changes happen. The good news is that many of the recommended approaches include family participation. Learn more about the disorder and techniques that help intervene. The lessons and classes on Smarter Parenting are ideal for ODD. These have derived from the Family-Teaching Model which was created by adults and parents working with children who were referred by the juvenile court system. When parenting a child with ODD, these skills work.

Treatment options when parenting a child with ODD include family interventions and behavior skills

The following therapeutic approaches are recommended for children who have been diagnosed with Oppositional Defiant Disorder:

• Behavioral parent management training
• Cognitive-behavioral therapy related to anger management
• Social skills training (though contagion can occur in group treatments)

There are no primary medication to treat ODD. Stimulant medications can reduce defiance and impulsive or retaliatory aggression however it does not cure ODD. The focus of treatment is on learning new behavioral skills.

Probable causes

Some experts believe that ODD may derive from various developmental inconsistencies beginning with ineffective parenting practices. This is followed by problems with authority figures and poor social skills. As a child grows older these behaviors escalate and eventually become a pattern. Early detection and intervention addressing negative behaviors in a positive manner as well as positive social interactions can improve the overall functioning of the child and diminish their opposition. There are no definitive causes of ODD however the focus of treatment on skills, behavior modification and communication indicate that there exists a need for the child to learn strategies to function. The lack of medication treatment for ODD also indicates there are no physiological issues. Those who get proactive when parenting a child with ODD can make a major positive impact.

Tips for parents using this concept after an ODD diagnosis:

• Be sure your child understands the concept that behaviors are preceded by thoughts or actions. This concept is very important.
• Discuss with your child the “Antecendents” to their behaviors. What causes them? Help them define these and write them on a piece of paper for later review.
• Explore options for other behaviors to occur when those “Antecedents” occur.

Customizing Correcting Behaviors to ODD

A child with an ODD diagnosis will often need to be corrected. Watch the video first.

Tips for parents using Correcting Behaviors for ODD:

• Be patient. You will more than likely have to do what the mother in the video did with her son. You will address the behavior but may need to return later to practice the new behavior when things are calm. This is ok.
• Be sure they practice the new behavior (whatever you decide it to be) more than 3 times. The more practice, the more likely the new behavior will be ingrained, and they will adopt it as a “new normal” behavior.

Modifying Decision Making for ODD

When parenting a child with ODD, help your child find their own alternatives to negative behaviors using this method. By predetermining what course of action to take, your child will have a better chance at behaving appropriately in difficult situations.

Tips for parents using Decision Making for ODD:

• Let your child do as much of this method on their own as possible. Let them determine their own options.
• Have them write it down on paper and post it somewhere visible for easy reference.
• Practice the chosen option as much as possible. Practice more than three times. The more practice the better.
• Continue to use this method for any situation where your child struggles.

There are more tips, ideas, suggestions and activities to help you teach these lessons in an engaging way to your child on this website. Visit each of these lessons pages for more information.

The following resources may be helpful when parenting a child with ODD.

John Hopkins provides additional information on Oppositional Defiant Disorder.

The Mayo Clinic also has information on an ODD diagnosis.