The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing Oppositional Defiant Disorder (ODD). The DSM-5 criteria include emotional and behavioral symptoms that last at least six months.
Angry and irritable mood:
- Often and easily loses temper
- Is frequently touchy and easily annoyed by others
- Is often angry and resentful
Argumentative and defiant behavior:
- Often argues with adults or people in authority
- Often actively defies or refuses to comply with adults' requests or rules
- Often deliberately annoys or upsets people
- Often blames others for his or her mistakes or misbehavior
- Is often spiteful or vindictive
- Has shown spiteful or vindictive behavior at least twice in the past six months
These symptoms can occur in just one setting or across multiple settings like home, school and in the community.
ODD can sound like a very scary diagnosis to parents. It can make a parent feel like they aren’t good parents or they did something wrong. Or it can feel like something is wrong with their child. The truth is that there is no known single cause of ODD. However, there are lots of different treatment options for parents and their child.
First, it’s important to get properly diagnosed. A lot of times, the child may have some signs and symptoms of ODD but don’t meet the specific criteria. Also, there are times that the child has another disorder that needs to be treated too, like ADHD, learning disabilities, depression or anxiety disorders. Without knowing the full picture, it will be hard to treat the ODD effectively. If your child doesn’t meet the criteria, the type of treatment might be a little different depending on the areas of need.
Once properly diagnosed, the parent needs to look for specific treatment that treats ODD. Not every type of therapy is effective with ODD. The following are more effective treatment:
- Parent Management Training - this helps the parent and others learn how to manage the child’s behaviors. Parent-Child Interaction Therapy (PCIT) is a great type of parent management training that works with kids ages 2-10.
- Individual Psychotherapy - this can help the child learn more effective anger management techniques.
- Family Psychotherapy - this can improve communication and mutual understanding between the family.
- Social Skills training - this increases flexibility and improves social skills to help increase frustration tolerance with peers.
- Medication - this can help control some of the more distressing symptoms and treat any coexisting conditions.
In addition to the above, there are several things that the parents and others can do to help the child.
- Catch the child being good. Praise the child every time you see them doing a behavior that you want to increase. Be specific about what you like when talking to younger children. That lets the child know what you like and what they need to do next time.
- Avoid arguing. A child with ODD will argue if you engage with them. So pick your battles. If you can give options, then do that. Otherwise, pick your battles.
- Take a break if you think you’re about to get elevated. This is a great way to model for the child to take a break. Also, allow them to take a break if they want one.
- Set limits that are age appropriate and reasonable. Be consistent with the consequences and make sure they can be enforced. No empty threats.
- Manage your own stress so that you can stay calm during those challenging moments.
A child with ODD can be challenging but it is treatable. With treatment, the child can have a very successful and fulfilling life.