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Diagnosis:
While psychological testing may be needed, the doctor must examine and talk with the child and the
parents, and review the medical history. ODD rarely travels alone. Children with ADHD will also have ODD 50% of the time.
Children with depression/anxiety will have ODD 10-29% of the time. (Because all of the features of this disorder are usually
present in conduct disorder, oppositional defiant disorder is not diagnosed if the criteria are met for conduct disorder.)
A diagnosis of ODD should be considered only if the behaviors occur more frequently and have more serious consequences
than is typically observed in other children of a similar developmental stage. Further, the behavior must lead to significant
impairment in social, school, or work functioning.
TREATMENT:
Treatment of ODD generally consists
of group, individual and/or family therapy, and education. Of all, individual therapy is the most common. Therapy can provide
a consistent daily schedule, support, consistent rules, discipline and limits. It may also help train these children to get
along with others and modify behaviors.
Parent management training focuses on teaching the parents specific and
more effective techniques for handling the child's opposition and defiance. (Research has shown that parent management training
is MORE EFFECTIVE than family therapy.)
Whether in therapy or working on the disorder at home, the child must work
with his/her parents' guidance to make the fullest possible recovery. The following lists what should be done (by the child,
with help):
1 Use self timeouts
2 Identify what increases anxiety
3 Talk about feelings instead
of acting on them
4 Find and use ways to calm themselves
5 Frequently remind themselves of their goals
6
Get involved in tasks and physical activities that provide a healthy outlet for energy
7 Learn how to talk with
others
8 Develop a predictable, consistent, daily schedule of activity
9 Develop ways to obtain pleasure
and feel good
10 Learn how to get along with other people
11 Find ways to limit stimulation
12 Learn to
admit mistakes in a matter-of-fact way
Stimulant medication is used only when oppositional defiant disorder
co-exists with another disorder (i.e. ADHD).
***PARENTS HAVE TO CHANGE FIRST. There are many parental issues
which may interfere with efforts to help these children function better. SO, before using any technique, a serious look within
ourselves is needed. Start by asking several questions, and if there is help needed in any area, address that BEFORE trying
to work on changing your childs behavior:
1. Is your childs need for help your highest priority? There needs to
be time taken EACH DAY to work with your child in order to really improve behavior. Without a substantial investment of time
and energy on the part of the parent, the child will not get better.
2. Is your anger under control?
3.
Are you a role model for your child? (Since children generally respond more to our actions than our words, we need to ensure
we are modeling the behaviors we expect of our children.)
4. Do you have a problem that needs treatment?
5.
Are you optimistic about your childs future? (It is critical that we are hopeful and optimistic regarding our childs ability
to improve!)
6. Do you create too m any conflict points with your child? Need to develop increased tolerance for
some of the minor troubles or tendencies. (This is hard for me because I find myself easily irritated by minor annoyances.)
7. Are you playful with your child? (Your child will want to cooperate with your rules and expectations the more
playful you can be with him/her.)
8. Do you have time for yourself? (If you are chronically worn out and irritable,
you will be less effective. Take time for yourself each day and each week.)
9. Do you know what your child is thinking
and feeling right now? Many ODD children are very sad and worried, beneath the surface of anger and defiance. It is important
to remember that the outer turmoil we experience is different than the inner turmoil these kids are living with.
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