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 can teach kids with Oppositional Defiant Disorder self control, self guidance, and more thoughtful and efficient problem solving strategies.

2. Family Therapy: Problems with family interactions are addressed in family therapy. Family structure, strategies for handling difficulties, and the ways moms and dads inadvertently reward noncompliance are explored and modified through this therapy. This approach can also address the family stress normally generated by living with Oppositional Defiant Disorder. Sometimes in the course of treatment, a mother or father is also found to have a psychiatric disorder. Treatment of that parent may be helpful since the adult's behavior can affect how the youngster responds to treatment.

3. Individual Psychotherapy: The therapeutic relationship is the foundation of a successful therapy. It can provide the difficult youngster with a forum to explore his feelings and behaviors. The therapist may be able to help the youngster with more effective anger management, thus decreasing the defiant behavior. 

The therapist may employ techniques of cognitive behavioral therapy to assist the youngster with problem solving skills and in identifying solutions to interactions that seem impossible to the youngster. The support gained through therapy can be invaluable in counterbalancing the frequent messages of failure to which the youngster with Oppositional Defiant Disorder is often exposed.

4. Medication: Medication is only recommended when the symptoms of Oppositional Defiant Disorder occur with other conditions (e.g., ADHD, OCD, anxiety disorder). When stimulants are used to treat ADHD, they also appear to lessen defiant symptoms in the youngster. There is no medication specifically for treating symptoms of Oppositional Defiant Disorder where there is no other emotional disorder.

5. Parent Training Programs: Some moms and dads are helped through formal parent training programs. In these sessions, the parent learns strategies for managing his/her kid's behavior. These are practical approaches to dealing with a youngster with Oppositional Defiant Disorder. The emphasis is on observing the youngster and communicating clearly. Parents are taught negotiating skills, techniques of positive reinforcement, and other means of managing the behavior of the youngster with Oppositional Defiant Disorder.

6. Social Skills Training: When coupled with other therapies, social skills training has been effective in helping kids smooth out their difficult social behaviors that result from their angry, defiant approach to rules. Social skills training incorporates reinforcement strategies and rewards for appropriate behavior to help a youngster learn to generalize positive behavior, that is, apply one set of social rules to other situations. 

Thus, following the rules of a game may be generalized to rules of the classroom; working together on a team may generalize to working with adults rather than against them. Through such training, kids can learn to evaluate social situations and adjust their behavior accordingly. The most successful therapies are those that provide training in the youngster's natural environments - such as the classroom or in social groups as this may help them apply the lessons learned directly to their lives.

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 assert control by insisting on compliance in such areas as eating, toilet training, sleeping, or speaking politely, the youngster may demonstrate resistance by withholding or withdrawing. As a youngster matures, increasing negativism, defiance, and noncompliance become misguided ways of dealing with grown-ups. In this way the disorder may be a tenacious drawing out of the "terrible twos."

The more a youngster reacts in defiant, provocative ways, the more negative feedback is elicited from the mother or father. In an attempt to achieve compliance, the parent and other authority figures remind, lecture, berate, physically punish, and nag the youngster. But far from diminishing defiant behavior, these kinds of responses toward the youngster tend to increase the rate and intensity of non-compliance. Ultimately, it becomes a tug of war and a battle of wills.

When such patterns typify parent-child relationships, discipline is often inconsistent. At times, moms and dads may explode in anger as they attempt to control and discipline their youngster. At other times, they may withhold appropriate consequences which soon become hollow threats. As the youngster continues to provoke and defy, parents lose control. Then, feeling regret and guilt (especially if they’ve become verbally or physically explosive), the parent may become excessively rewarding and gratifying in order to undo what they now perceive to have been excessive discipline or punitive consequences.

When a youngster starts school, this pattern of defiant behavior tends to provoke educators and peers as well. At school, the youngster is met with anger, punitive reactions and criticism. The youngster then argues back, blames others and gets angry.

These kids tend to have difficult adapting at school. Their behavior can cause disruption in the classroom and interfere with social and academic functioning. When their behavior and defiance affects their schoolwork and performance, kids often experience school failure and social isolation. This, coupled with chronic criticism, often leads to low self-esteem. Usually, Oppositional Defiant Disorder kids feel unfairly picked on. In fact, they may believe that their behavior is reasonable and the treatment and criticism they receive unfair.

Oppositional Defiant Disorder coexists with ADHD in many cases. In fact, the impulsivity and hyperactivity of ADHD can greatly amplify the non-compliance and uncontrolled anger of Oppositional Defiant Disorder. Symptoms of Oppositional Defiant Disorder may also occur as part of major depressive disorder, obsessive compulsive disorder, or mania. Some kids with separation anxiety disorder may also have defiant behaviors. Clingy attachment merges into or possibly reflects oppositional behavior. There also seems to be a correlation between Oppositional Defiant Disorder in a youngster and a history of disruptive disorders, substance abuse, or other emotional disorders in the parents(s).

==> Parenting Children with Oppositional Defiant Disorder