In every Australian classroom, two children are likely to have developmental language disorder (DLD). October…
All children behave in challenging and difficult ways. But if your child has persistent and frequent behaviours such as anger, arguing, defiance or vindictiveness towards you and other authority figures that impacts their daily functioning they may meet the criteria for oppositional defiant disorder (ODD).
The good news is that if your child has ODD symptoms, help is available. ODD can be managed with support to build positive family interactions and improved ways of dealing with challenging behaviours.
What is oppositional defiant disorder?
Oppositional defiant disorder (ODD) is a childhood behavioural problem. Children with ODD are frequently disobedient and hostile towards their peers, family members and authority figures such as teachers. A child with ODD believes that what they are being asked to do is unreasonable, and therefore may get angry and aggressive when asked to do things.
For children with ODD, their behaviour impacts everyday life, such as their ability to participate at home and school and to make friends.
How common is ODD in children?
The exact number of children with ODD is unknown. However, according to the Victorian Government’s Better Health Channel, approximately one in 10 children under the age of 12 years are thought to have ODD. Boys outnumber girls by two to one.
Other estimates suggest that between 2 and 16 percent of children and teens have ODD. For younger children, ODD is more common in boys than girls. In older children, occurrence is equal in girls and boys.
Signs of ODD often begin in the pre-school years, and almost always by the age of eight.
Signs and symptoms of ODD
ODD symptoms are characterised by frequent anger and defiant behaviours that negatively impact daily life and relationships.
A child with ODD may:
- argue with adults and other authority figures (such as teachers)
- actively disobey rules and refuse to do what they’re asked
- blame other people for their behaviour
- deliberately annoy people and get easily annoyed by others
- lose their temper and throw tantrums
- be nasty, unkind or spiteful to others
- swear or use offensive language
- become easily frustrated.
Who can diagnose ODD in children?
A psychologist, psychiatrist or paediatrician who specialises in children’s behavioural problems can diagnose ODD.
When considering an ODD diagnosis, the health professional will talk to you and your child (if they’re old enough) and compare your child’s behaviour against a checklist for ODD in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association (DSM-5). The health professional may also want to discuss difficulties with teachers and educators to further assess your child.
ODD symptoms can overlap those of other problems, such as ADHD (Attention deficit hyperactivity disorder), so it’s important to get the right diagnosis. To help distinguish between ODD and ADHD, for example, the professional will ask questions like when and where the behaviours occur, how often, and how they impact daily life.
They will also need to know about your child’s general health, your family situation, and any strategies that have been helpful for managing challenging behaviours.
If you suspect your child has ODD, seeing your GP is a good place to start. They can refer you to see a health professional who can diagnose ODD (eg a psychologist, psychiatrist or paediatrician). They can also give you a Mental Health Treatment Plan.
This can offset treatment costs by providing Medicare rebates for up to 10 sessions with a psychologist. You may also be able to use funding from an NDIS plan if you are eligible.
The psychologists at Growing Early Minds can diagnose children with ODD by assessing whether they meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Treatment strategies for ODD
Support is available for families of a child with ODD. Treatment for ODD revolves around training caregivers to better interact with their child and learn techniques to manage their behaviour. An important aspect is providing consistency of care and of responses to behavioural concerns.
To effectively manage ODD, your health professional will work with you to develop a behaviour management plan, also sometimes called a behaviour support plan.
A behaviour management plan helps you to:
- understand the triggers and functions of your child’s behaviour
- put strategies in place to manage your child’s challenging behaviours and reinforce positive ones
- support your child to manage powerful emotions and understand how their behaviour affects others
- help your child develop better communication and social skills
- understand what causes your child’s behaviour
- support your child to get along with others, and
- build stronger family relationships.
At Growing Early Minds, both our psychologists and behaviour support practitioners can provide behaviour support plans and behaviour management strategies. They will work with you and your child to develop a plan that suits your family’s needs and put it into place.
More ODD treatment strategies
Positive parenting training
This involves training parents to interact with their children in a way that builds close, supportive relationships that foster positive behaviour.
Values and skills training
This is about teaching children important life skills, such as empathy, problem-solving, expressing feelings appropriately and taking responsibility for their behaviour.
Caregivers of children with ODD may feel overwhelmed by the child’s behaviour and lack confidence in their skills to manage their child’s behaviour. They may need support to build confidence in their ability to manage their child’s behaviour and put effective strategies in place, such as setting clear rules and consequences.
Behaviour management strategies
This includes techniques such as establishing boundaries for appropriate behaviour, providing clear instructions, and using rewards and consequences to reinforce positive behaviours while reducing challenging ones. Children with ODD can have a strong need to control other people and their environment. It helps to keep house rules simple and framed positively, such as “We speak respectfully to each other”, rather than “Don’t be rude or mean”.
Ensuring good teamwork
Management of ODD will be most effective when everyone involved is on the same page, including caregivers, health professionals, teachers, and anyone else providing support. Good communication and consistency are key to success.
Self-care for caregivers
Supporting a child with ODD is often stressful and exhausting. However, children are usually calmer and more responsive to discipline when their caregivers are also calm. Caregivers may require support for their own physical or mental health to enable them to best support their child.
Other at-home tips and advice for managing ODD behaviour
1. Stay calm when dealing with your child’s behaviour
While your first instinct might be to fight back, this is exactly the response a child with ODD is looking for! Instead of engaging in a heated battle of wills, try to respond to your child’s behaviour in a cool, controlled manner. Use a calm voice and few words to explain your position or request, then stop the discussion.
2. Be consistent with house rules
Children with ODD often feel like they are victims, so ensure you apply house rules and consequences to everyone – yourself included! Be a good role model by admitting when you’ve broken the rules and being prepared to apologise.
Create a positive environment
Children who are physically and mentally well are better able to regulate their emotions and manage stressful situations. Good nutrition and adequate sleep and physical activity will support your child’s physical and emotional health, and their behaviour.
Every small win is a step towards the goal of more positive behaviour. Celebrate each success, such as longer periods without angry outbursts or signs your child is better managing their emotions. A great way to do this is spending time together doing something your child enjoys, such as a bike ride or trip to the beach or park. That way, you’ll be reinforcing positive behaviour as well as connecting with your child.
To find out more about how our psychologists and behaviour support practitioners can help your child with ODD or other behavioural concerns, get in touch with Growing Early Minds on 02 9622 8500 or contact us here