Showing posts from February, 2012

What should I do if I think my child has Oppositional Defiant Disorder?

Mothers and fathers who are concerned that their youngster may have Oppositional Defiant Disorder should seek a professional evaluation. This is important as a first step in breaking the cycle of ineffective parenting of the "problem child.”  During the evaluation process, the parent may come to appreciate the interactive aspect of this disorder and look for ways to improve his/her management of the youngster. Books and parenting workshops given under the auspices of churches, schools, and community agencies may also help moms and dads respond better to the needs of their kids. Once Oppositional Defiant Disorder has been diagnosed, the psychiatrist or other professional may recommend a combination of therapies. Among the options your clinician may recommend are following: 1. Cognitive Behavioral Therapy: Behavioral therapy can help kids control their aggression and modulate their social behavior. Kids are rewarded and encouraged for proper behaviors. Cognitive therapy

Does bad parenting cause Oppositional Defiant Disorder?

Re: Does bad parenting cause Oppositional Defiant Disorder? I don’t think there is a causal relationship (i.e., one causes the other) between bad parenting and Oppositional Defiant Disorder – but there certainly is a correlation (i.e., one contributes to the other) between lack of appropriate parenting skills (i.e., skills needed specifically for raising an oppositional child) and this disorder. Oppositional Defiant Disorder does seem to arise out of a circular family dynamic. The infant, who is by nature more difficult, fussy and colicky, may be harder to soothe. The mom or dad may feel frustrated and unsuccessful at parenting such a child. If parents perceive their youngster as unresponsive or "bad," they may begin to anticipate that the youngster will be unresponsive or noncompliant. They may then become unresponsive or unreliable in return, adding to the youngster's feelings of helplessness, neediness, and frustration. As moms and dads attempt to asser

What should be done about a child who abuses animals?

Question My 11 yr old granddaughter that has lived with me since she was 2 has been hurting my animals. I show dogs and this is a business so it isn't as simple as re-homing a pet. A year ago she dislocated a dog’s ankle requiring 2 surgeries to repair when in anger she stomped on its foot. I made her tell the vet who talked to her, as did I about the inappropriateness of her actions. I found she's still hitting them but not as severely this past week and took her to the police station. They explained to her this is a felony and she could go to jail for 5 yrs and gave me a few options available in our county including institutionalizing her or some juvenile jail time or a program for troubled youth where she would live at home. We did a lot of therapy years ago, but it didn't seem to improve anything and now it's a mess and I am overwhelmed and don't even know where to begin. I really think each time she does something like this and she's talked to and rea

What are the identifying signs of Oppositional Defiant Disorder?

I think my child may have ODD. How would I know for sure? Distinguishing Oppositional Defiant Disorder from age appropriate normal defiant behavior isn't easy. Symptoms of the disorder tend to mirror (in exaggerated form) child rearing problems common in all families. In addition, different families have various levels of tolerance for defiant behavior. In some, a minor infraction of the house rules produces major consequences, while in more liberal homes, defiant behaviors are largely ignored until they cause major problems. In kids with Oppositional Defiant Disorder, there is a pattern of uncooperative, defiant, and hostile behavior toward adults that seriously interferes with the youngster’s day-to-day functioning. Regularly, they lose their temper, argue with adults, actively defy adult rules, refuse adult requests, and deliberately annoy others. The symptoms are seen in multiple settings (e.g., home, school, in the neighborhood, etc.) and are not simply the result of

How does a therapist diagnose Oppositional Defiant Disorder versus Conduct Disorder?

There is a large overlap between Conduct Disorder and Oppositional Defiant Disorder, with similarities in both disorders that include: anger bullying of peers and siblings defiance disobedience rebellion against authority resentment school problems In order to differentiate between the two, one of the things a therapist will generally look at is how the adolescent treats animals. Is he or she mean or cruel to the family pets or kind to them? Another area that is looked at is whether or not there have been legal problems, what those legal problems were, and if they are recurring or one-time events. For example, many adolescents experiment with shoplifting and end up getting caught, but this does not mean they have either a Conduct Disorder or Oppositional Defiant Disorder. However, if they keep shoplifting, or their activities turn to more serious stealing behavior, it is probably safe to assume that there is a more serious behavior problem going on. In addition

Is there a connection between ADHD and Conduct Disorder?

Data collected in numerous studies indicates that about 50% of kids with ADHD will also develop Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) at some point during their development. An interesting finding has been that although "pure" ADHD (i.e., without either Oppositional Defiant Disorder or Conduct Disorder) is quite common in kids, the reverse is less likely. In other words, it appears that most kids under age 12 who meet criteria for Oppositional Defiant Disorder or Conduct Disorder will also be diagnosed with ADHD. In these cases, it appears that the impulsivity and over activity that is characteristic of ADHD kids, and the ensuing difficulties this creates in parent-child, teacher-child, and peer relationships, increases the risk for the kind of problematic interactions that promote the develop of these other disruptive behavior disorders. The long term outcomes of kids with pure ADHD - and with ADHD plus Conduct Disorder - are very diffe

What is Conduct Disorder?

Conduct Disorder (CD) is a more severe type of behavioral disorder than Oppositional Defiant Disorder (ODD) and is more likely to develop in kids with ADHD. According to the publication of the American Psychiatric Association that provides current diagnostic criteria for all recognized psychiatric disorders, the essential feature of Conduct Disorder is "...a repetitive and persistent pattern of behavior in which the basic rights of others or age appropriate social norms or rules are violated." These behaviors fall into 4 main groupings: Serious violation of rules (e.g., truancy from school; running away from home; staying out at night prior to age 13) Non-aggressive conduct that causes property loss or damage (e.g., fire setting with intent to cause damage; deliberate destruction of property) Deceitfulness or theft (e.g., shoplifting; breaking into someone's house; frequent lying to obtain goods or avoid obligations) Aggressive behavior that causes or threatens t

What is the best way to work with oppositional defiant high school students?

The first thing to keep in mind is this 10 letter word: PREVENTION. Once an ODD student has it out for you (i.e., you’re on his/her hit list), then it is nearly impossible to re-establish a positive relationship with that child. It is helpful to understand how ODD children think when trying to come up with prevention methods. How does a student with ODD think? “Because I know how much you want me to change, I will be very stubborn about changing behaviors.” “I am equal to those in authority.” “In spite of experiencing your intended punishments and/or rewards, if I change, it will be on my time and for me.” “My greatest sense of control comes from how I make others feel.” “No one has the right to tell me what to do.” “When you punish or reward me, I feel that you are trying to control or manipulate me.” “Yes, I sometimes do the wrong thing, but it is usually your fault.” Now let’s look at the prevention methods that work best with ODD students: 1. Act, don’t dis

Parenting Children with Oppositional Defiant Disorder

==> Help for Parents with Oppositional Defiant Children and Teens

Oppositional Defiant Disorder: What Parents Need To Know

Oppositional Defiant Disorder (ODD) is defined by the Diagnostic and Statistical Manual of Mental Disorders as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months and is not due to a mood or psychotic disorder. To fulfill the diagnosis, the person must have 4 of the following: Often actively defies or refuses to comply with adult requests Often angry or resentful Often argues with adults Often blames others for his or her mistakes or poor behavior Often deliberately annoys others Often loses temper Often spiteful or vindictive Often touchy or easily annoyed Symptoms are almost always present at home and may or may not be present in the community and at school.   Treatment & Management— Children with Oppositional Defiant Disorder need to be assessed for the presence of Attention-Deficit/Hyperactivity Disorder and learning disorders, given the high co-morbidity. If Atten

Recommended Reading for Clinicians Working with ODD Clients

1. American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR). Washington, DC: American Psychiatric Press. 2. Angold A, Costello EJ, Erkanli A (1999), Co-morbidity. J Child Psychol Psychiatry 3. Burke JD, Loeber R, Birmaher B (2002), Oppositional defiant and conduct disorder: a review of the past 10 years, part II. J Am Acad Child Adolesc Psychiatry 4. Collett BR, Ohan JL, Myers KM (2003), Ten-year review of rating scales. VI: Scales assessing externalizing behaviors. J Am Acad Child Adolesc Psychiatry 5. Connor DF (2002), Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment. New York: The Guilford Press. 6. Loeber R, Burke JD, Lahey BB, Winters A, Zera M (2000), Oppositional defiant and conduct disorder: a review of the past 10 years, part I. J Am Acad Child Adolesc Psychiatry 7. Olweus D (1994), Bullying at schools: basic facts and effects of a school based intervention progr

Facts About ODD, CD and Personality Disorder

Some important statistics about Oppositional Defiant Disorder, Conduct Disorder, and Personality Disorder: 15% of oppositional defiant children develop some form of personality disorder later in life. 20% of children with Oppositional Defiant Disorder have some form of mood disorder (e.g., Bipolar Disorder or anxiety). 35% of these children develop some type of affective disorder. 50-65% of Oppositional Defiant Disorder children also have ADD or ADHD. 75% of children with Oppositional Defiant Disorder above the age of eight will still be defiant later in life. About 30% of Conduct Disorder kids continue with similar problems in adulthood. About 50-70% of ten-year-olds with Conduct Disorder will be abusing substances four years later. Cigarette smoking is also very high. Children with Conduct Disorder and Oppositional Defiant Disorder are at high risk for criminality and antisocial personality disorders in adulthood. Girls with Conduct Disorder more often end up having moo

What does the future hold for a child with Oppositional Defiant Disorder?

Re: What does the future hold for a child with Oppositional Defiant Disorder? The short answer is this: It depends on whether or not the child gets help. It was once thought that most kids would outgrow Oppositional Defiant Disorder (ODD) by adulthood. We now know this is not always true. While some of the symptoms of Oppositional Defiant Disorder can go away over time, and while some kids do outgrow the disorder, many kids with Oppositional Defiant Disorder will continue to experience the consequences of this condition during their later years. For those who do not receive treatment, Oppositional Defiant Disorder can develop into Conduct Disorder, a more serious behavioral disorder. Of those with Conduct Disorder, almost 40% will develop Antisocial Personality Disorder in adulthood. If your youngster is showing signs of Oppositional Defiant Disorder, it is very important that you seek help from a qualified professional immediately. Without treatment, kids with Opposi

What therapies are ineffective in treating Oppositional Defiant Disorder?

Experts agree that therapies given in a one-time, short-lived approach (e.g., boot camps, tough-love camps, scared straight programs, and brat camps) are not effective for kids and teens with Oppositional Defiant Disorder. In fact, these approaches may do more harm than good. Trying to scare or forcibly coerce kids and teens into behaving only reinforces aggressive behavior. These children may comply while under duress, but will learn from the scare tactics that were used on them – and use those same tactics on others at a later date. Kids respond best to treatment that rewards positive behavior and teaches them skills to manage negative behavior. Before you send a troubled child or teen with Oppositional Defiant Disorder to a boot camp, it's important that you understand what these boot camps are and how effective (or not) they are in transforming angry, unhappy, struggling kids. The theory behind most boot camps is that “if you scream enough at kids and discipline t

Does oppositional defiant behavior improve as the child gets older?

Some lucky kids will outgrow Oppositional Defiant Disorder. About 50% of kids who have this disorder as preschoolers will have no psychiatric problems at all by age 8. Follow-up studies have found that approximately 67% of kids diagnosed with Oppositional Defiant Disorder who received treatment will be symptom-free after three years. However, studies also show that approximately 30% of kids who were diagnosed with Oppositional Defiant Disorder will go on to develop Conduct Disorder. Other studies show that when the behavioral symptoms of Oppositional Defiant Disorder begin in early life (i.e., preschool or earlier), the youngster or teen will have less chance of being symptom-free later in life. Also, the risk of developing Conduct Disorder is three times greater for kids who were initially diagnosed in preschool. In addition, preschool kids with Oppositional Defiant Disorder are more likely to have coexisting conditions (e.g., ADHD, anxiety disorders, mood disorders, depressio

How Is Oppositional Defiant Disorder Treated?

There is no one-size-fits-all treatment for kids and teens with Oppositional Defiant Disorder. The most effective treatment plans are tailored to the needs and behavioral symptoms of each youngster. Treatment decisions are typically based on a number of different things, including the youngster’s age, the severity of the behaviors, and whether the youngster has a coexisting mental health condition. The goals and circumstances of the moms and dads also are important when forming a treatment plan. In many cases, treatment may last several months or more and requires commitment and follow-through by moms and dads as well as by others involved in the youngster’s care. Treatment usually consists of a combination of: 1. Cognitive Problem-Solving Skills Training to reduce inappropriate behaviors by teaching the youngster positive ways of responding to stressful situations. Kids with Oppositional Defiant Disorder often only know of negative ways of interpreting and responding

Support and Education for Parents with Oppositional Defiant Children and Teens

W hat I s O ppositional D efiant D is a resource for families and medical professionals who deal with the challenges of Oppositional Defiant Disorder [ODD]. Our website provides sources of professional help, recommended reading, moderated support message boards, lists of camps and schools, links to local/national/international support groups, educational resources, conference information, and articles. We strongly believe that all children and teens faced with the challenges of ODD have the right to – and deserve – appropriate education, inclusion, support, and understanding so that they and their families may enjoy the highest possible quality of life.

Mark Hutten, M.A.

Personal: Mark was born in Freemont, Ohio in 1956. He graduated from Anderson High School (Anderson, IN) in 1974.  Educational: Bachelors Degree; Psychology -- Anderson University, Anderson, IN Masters Degree; Counseling Psychology -- Vermont College of Norwich University, Montpelier, VT Current Employment: Madison County Community Justice Center Madison County Correctional Complex Sowers of Seeds Counseling Indiana Juvenile Justice Task Force Mark has worked in the “addictions” field since 1994 and has worked with children who are experiencing emotional and behavioral problems - and their parents - since 1988. He is a Probation Officer as well as a Family Therapist and performs home-based counseling and supervision for families experiencing difficulty with their children's emotional and behavioral problems. His primary mission is to help these families develop much needed coping skills so that they can avoid involving their children in the Juvenile Ju

Why would a child only show oppositional defiant behavior toward his mother?

Question An 8 year old boy was diagnosed with ADHD Combined Type. His mother, a licensed MFT, referred him for the evaluation. He was never referred by teachers or day care providers. They describe him as an active child, minimally disruptive, but not violent. His grades are above average. His parents are divorced with shared custody, every other week. At his mother's house, he is defiant and has violent meltdowns. His mother fears for her safety and the safety of his sister. At the father's home, he does not exhibit these extreme behaviors. There are rules and consequences for not following the rules. The mother accused the father of child abuse because he has spanked him (as a last resort). Charges were investigated and unfounded. The mother wants the boy on medication so she can handle him at her house. The father does not want to medicate him for behavior that occurs only at the mother's house. Again, he is not violent at his father's or at school. Answe

Are there ways to prevent Oppositional Defiant Disorder?

Research shows that early-intervention and school-based programs along with individual psychotherapy can help prevent Oppositional Defiant Disorder. A developmental sequence of experiences occurs in the development of Oppositional Defiant Disorder. This sequence may start with ineffective parenting practices, followed by difficulty with other authority figures and poor peer interactions. As these experiences continue, defiant behaviors develop into a “pattern” of behavior. Early detection and intervention into negative family and social experiences can be very helpful in disrupting the sequence of experiences leading to more defiant behaviors. Early detection and intervention with more effective communication skills, parenting skills, conflict resolution skills, and anger management skills can disrupt the pattern of negative behaviors and decrease the interference of defiant behaviors in interpersonal relationships with grown-ups and peers, and school and social adjustment.