Defying ODD: what it is, and ways to manage.

Defying ODD: what it is, and ways to manage.

Not only is ODD exhausting, but parents must find the energy and doggedness to be consistent, and the compassion and forgiveness to be nurturing.

ODD is caused by abnormal electrical activity in the brain, it is not in the character or ‘soul’ of your child or teen, and not something they can control.  If your child could do better on their own, they would.  You are the one who can make the most difference.

If you think your child or teen’s defiance is oppositional defiant disorder, you have practical ways to manage your child’s exasperating condition.  This information comes from psychiatric, psychological, and child behavior resources– information to help you work effectively with mental health providers or teachers.  You’ll need to ask them focused questions to learn everything they know about ODD.  Professionals pay better attention to knowledgeable parents (which shouldn’t be the case, all parents deserve attention).  Go in armed with knowledge.

This is what ODD looks like.  The pinkish curving region in the center of the 3-D brain image below represents hyper-charged electrical activity in a 13-year-old boy with severe oppositional defiant disorder.  This feature is typical of ODD, but also typical in individuals with obsessive compulsive disorder (OCD), “Road Rage,” pathological gambling, chronic pain, and severe PMS.

The name of this region is anterior cingulate gyrus (ACG), and scientists believe this area is responsible for enabling a person to shift attention and think flexibly, traits which are deficient in ODD kids.  It is also the brain region known to regulate emotions.  Children with a hyper-charged ACG have “a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which 4 or more of the following are present:

  • Often loses temper
  • Often argues with adults.
  • Often actively defies or refuses to comply with adults’ requests or rules.
  • Often deliberately annoys people.
  • Often blames others for his or her mistakes or misbehavior.
  • Is often touchy or easily annoyed by others.
  • Is often angry and resentful.
  • Is often spiteful and vindictive.” 

–From the “Diagnostic and Statistical Manual of Mental Disorders, 4th Edition,” published by the American Psychiatric Association, 2000.

There are two different medication approaches to ODD:

  • treat it as a form of attention deficit disorder;
  • treat it as form of depression and obsessive-compulsive disorder.

The attention deficit approach may use Straterra (chemical name is atomoxetine), Ritalin (methylphenidate), Risperdal or risperidone (for patients with low IQ), and Depakote or divalproex (a mood stabilizer).  This is not a complete list because new compounds may come into the market.

The depression & obsessive-compulsive approach may use serotonin-based antidepressants such as Prozac (fluoxetine), and Anafranil or clomipramine (used to treat OCD).  Again, this is not a complete list.

Oppositional defiant disorder often includes symptoms from other disorders, so you may be coping with more than defiance.  Below are common disorders that combine with ODD:

  • 50-65% of these children also have ADD or ADHD
  • 35% of these children develop some form of depressive disorder
  • 20% have some form of mood disorder, such as bipolar disorder or anxiety
  • 15% develop some form of personality disorder
  • Many of these children have learning disorders

Anthony Kane, MD 

Other medical conditions that can cause disruptive behavior like ODD:

  1. Neurological disorders from brain injuries, left temporal lobe seizures (these do not cause convulsions, no one can tell these are happening), tumors, and vascular abnormalities
  2. Endocrine system problems such as a hyperactive thyroid
  3. Infections such as encephalitis and post-encephalitis syndromes
  4. Inability to regulate sugar, rapid increases and decreases of blood sugar
  5. Systemic lupus erythematosus, Wilson’s disease
  6. Side-effects of prescription medications:  Corticosteroids (anti-inflammatory and arthritis drugs such as Prednisone);  Beta-agonists (asthma drugs such as Advair and Symbicort)

–From Peters and Josephson.  Psychiatric Times, 2009.

ODD is a disability.  It isn’t easy to manage, but you can do it.  Your child may need multiple medications and a large variety of approaches to therapy and behavior modification.  You will need patience as his or her teachers, doctors, or specialists try different approaches until they discover one that improves your child’s behavior, so hang in there!

Some good news, if your child has these traits, it will be easier to improve or overcome ODD behaviors:

  • A normal IQ
  • A first-born child
  • An affectionate temperament
  • Positive interactions with friends their age
  • Nurturing parents who can consistently set clear behavioral limits

–From the Journal of American Academic Child and Adolescent Psychiatry, 2002.  Author J.D. Burke.

People’s natural instincts of parenting do not work with an ODD kid.  They need completely different techniques than normal children. 

How to reduce ODD behaviors

Shield yourself.

First get a shield, then prepare yourself for the intensity of parenting a defiant kid because you are about to run a marathon.  Get enough sleep, maintain your other important relationships (spouse or partner, children, friends), schedule breaks or getaways, and guard your physical and emotional health.  Don’t expect quick results with these techniques; it may take weeks or months… years.

Tips from professionals that may work for you:

Parent Management Training – PMT refers to intensive educational programs that are “evidenced based,” proven to help parents gain the skills they need for extremely difficult children, especially those with ODD.  These programs are intensive, but substantiated interventions in child mental health.  PMTs help parents assert consistency and predictability, and promote pro-social behavior in their child.  A good explanation can be found at the Encyclopedia of Mental Disorders.  Examples include:  the Total Transformation and the Incredible Years.

Find something positive to do together.  Your child has normal needs for closeness and appreciation and joy.  Ask your child about their interests, and if their ideas don’t work for you, try new activities until one brings about a good chemistry between you and your child.

Praise is one of the most powerful tools for managing disruptive behavior.  Make an effort to inject as much positive energy into your relationship with your child or teen.  It’s likely that this relationship has been close to 100% negative, yes?   Caution: don’t expect thanks or joy from your child once they’re praised; it’s not about you.

Set limits – “Consistent limit setting and predictable responses from parents help give children a sense of stability and security.  Children and teens who feel a sense of security regarding the limits of their environment have less need to constantly test it.”  (Webster-Stratton and Hancock)

Active ignoring – This works for best with children between the ages of 2 and 12.  It involves purposefully withdrawing your attention away from your child when they are misbehaving, such as in a temper tantrum, or when whining or sulking, or when making continuous demands or loud complaints, etc.  Pretend you don’t care and even turn your back if possible.  Give attention only after the behavior is over.

Make the behavior uncomfortable for the child/teen.

  • Example:  If your kid swears, test them, “C’mon, you can do better than that, be creative, I’ve heard all those things before.”  They can get frustrated when they aren’t getting the reaction they want from you, and give up.
  • Another example:  Your teen refuses to get out of bed for school.  Don’t nag or repeat, repeat, repeat.  Remove the bed covers and set them far enough away that your child has to get out of bed to retrieve them.  (“Managing Resistance,” John W. Maag, jmaag1@unl.edu)

Give multiple instructions at once, where at least one of the instructions is what they want to do, and one is what you want them to do.  “Close the door while you’re yelling at your sister and don’t forget the light.”  Your child will be overloaded as they try to figure out which thing they’re supposed to defy.  Kids tend to get flustered by the mental effort and comply without knowing they’re doing it. (from “Managing Resistance,” see above)

Reverse psychology:  Yes, this works, and it’s OK when important.  Example:  your child is bouncing on the furniture.  You turn on music and say “hey, try this, see if you can bounce to the beat, it’s harder to do on the floor.”  This is a good kind of manipulation.

Unexpected rewards – Occasionally reward appropriate behavior with something they like.  They are more likely to do a desired behavior if they expect something they want and aren’t sure when it will be offered.

“Why should I have to do this when it’s my kid’s responsibility to behave?”

It’s your responsibility as a parent to do what you can to help your child be successful.  ODD is a genuine disability that negatively affects their life and future.  I’ve seen highly intelligent ODD kids experience academic failure or enough suspensions and expulsions to hold them back a grade.  This is a can’t-win-for-losing path sucks, doesn’t it?

Warning, once you start consistent enforcement, things get worse at first – Defiant behavior will increase once your family system is changing.  This as a good sign—you are regaining your authority!  Your child’s backlash is a common human psychological response, and it’s called an “extinction burst,”  see diagram below.  As parents change their approach to handling inappropriate behavior, the child becomes more defiant to test their resolve.  View this as predictable and plan ahead.  It won’t last, and they will eventually comply with this one rule.  They then find another rule to defy and ramp up their defiance.  As you enforce it, they back off again, and the pattern continues until it’s just not worth it to defy these particular rules anymore.

 

–From “Behavioral Interventions for Children with ADHD,” by Daniel T. Moore, Ph.D., © 2001, http://www.yourfamilyclinic.com/shareware/addbehavior.html .  The author requests a $2 donation through PayPal to distribute his article or receive printed copies.


Tips for effective parenting of an ODD child through adulthood

Don’t treat your home like a democracy, where everything must be fair and equal.  You must be the supreme ruler, the benevolent dictator.  Your child does not have an equal say in how things are done.  Parents must keep their authority and rightful power in the household, and tell their ODD child that they make the important decisions, plus, the decisions may not always seem fair. Tell them you’ll listen to what they have to say but make no promises. Once you’ve made a decision, avoid explaining your reasons when they challenge you. This helps you keep their power, and it limits endless arguments and accusations. As your child ages into adulthood, you must still hang on to your power. The adult child will continue to require limits, and limits will still need enforcement. To a parent, it will feel as if you’re treating your adult offspring as a child. YOU ARE and you should be, and this is the interesting part: they won’t notice.

Don’t blame or belittle your child-–this goes for all children–but a difficult child can bring out the worst in an exhausted parent. It’s easy to think they’re being bad on purpose because they’ll act like it, and show amusement when they’re bad or belittle you. Keep in mind that ODD is no one’s fault, and your child would not choose to have ODD if they understood what it meant.

Don’t ignore your child’s unique needs that have nothing to do with ODD.  They may face bullying at school, lack of sleep, stress from a chaotic home, or other challenges like any other child.

Always enforce rule breaking as immediately after the fact as possible.  Why:  If enforcement comes later or only occasionally, the child does not connect the broken rule with the punishment. Or, they believe they can still get away with breaking a rule and then talk their way out of consequences later.

Don’t let your stress turn into anger directed at your child.

  • They can use this against you by teasing or baiting to get you angry again!
  • You’ll be modeling that anger is an OK response to stress.

Take care of your emotional wellbeing. Check in with yourself if you feel you are losing control. All parents with troubled children need to work extra hard at maintaining a level head. It’s a good skill to have anyway.

Avoid justifying your rules or offering explanations. Children with ODD are not able to reason when they turn defiant. They will only resist harder and use your words to argue more with you. Even if they can understanding your reasoning in a calm moment, this will vanish once they become defiant again.  (What’s interesting is I’ve observed parents trying to reason with young children(4 or 5), too young to be reasonable in the first place, or with young adults (early 20’s) who have a long track record of being unreasonable.

Don’t interpret everything as ODD-defiance.  Some rebelliousness is normal for children, especially if parents are over controlling.

Don’t keep trying the same things that still don’t work.  Like making excuses; like screaming.  (Don’t be embarrassed; we’ve all done this.)

Don’t jump to conclusions that demonize the child.  It hurts you as much as it hurts them. I often hear parents say:  “Why does he keep doing this?, or, “Why doesn’t she stop after I’ve told her not to, over and over again.”  Then they answer their own questions:  “It’s because he always wants his way,” or, “She’s doing this to get back at me.”  As they tell their story, I hear them taking things personally:  “He does this just to make me mad;” “She manipulates the situation because she wants more (something) and I won’t give it to her.”

Good luck with your defiant ODD child.   Hang in there.  I WISH YOU THE BEST!

–Margaret

How am I doing?  Please comment.


 

14 Replies to “Defying ODD: what it is, and ways to manage.”

  1. Hi, I’m in the U.K. but hope you can offer some clarity on the article. My daughter is nearly 14 and just missed a diagnosis when she was about 5 or 6, she can be very clever and even at that age behaved on the day of the hospital appointment and charmed the consultant! Please can you clarify the ‘don’t try these at home’ section – some then say Don’t do this or that – should I be doing those things or not?! I have tried so many strategies that I am confused about what might work or not! As someone who works with children, and a mum of two others as well, I am not without experience – but none of it has been much use!

    1. Hello Sandy,
      Thank you for writing. I just reread the article and agree this section is inconsistent. I see how it can be confusing. I’m going to rewrite it thanks to your comment. The original intent was to show parents that commonsense, healthy parenting techniques do not work with a child with ODD, and can actually make things worse. Starting with the first one, this is for clarification:

      “Don’t treat your child like another adult” – For a parent to keep their authority and rightful power in the household, don’t allow the ODD child to share in important decisions, or modify rules to fit their preferences, or expect everything to be fair. Tell them you’ll listen to what they have to say but make no promises about your decision. Once you’ve made a decision, avoid reasoning with them. This helps parents keep their power and limits endless arguments and accusations. As they age into adulthood, you must continue to hang on to your power and authority. The child will still require limits as adults, and limits will still need enforcing. To a parent, it may feel like you’re treating your defiant adult offspring as a child. YOU ARE and you should be, and this is the interesting part: they won’t notice.

      (Rewrite) “Don’t find fault with your child…” For the child’s benefit and self-esteem, don’t blame or diminish or belittle them–this goes for all children! But a difficult child can bring out the worst in an exhausted parent. It’s easy to blame the child and think they’re being bad on purpose. A parent should keep in mind that ODD is no one’s fault, nor would the child choose to have ODD if they understood what it meant.

      “Don’t ignore your child’s unique needs…” ODD may not be the reason for difficult behavior, they can be unruly for many other legitimate reasons.

      (Rewrite) “Always enforce rule breaking as immediately after the fact as possible.” Why: If enforcement comes later or only occasionally, the child does not connect the broken rule with the punishment. Or, they believe they can still get away with breaking a rule and then talk their way out of consequences later.

      (Rewrite) “Don’t let your stress turn into anger directed at your child.” Take care of your emotional wellbeing. Check in with yourself if you feel you are losing control. All parents with troubled children need to work extra hard at maintaining a level head. It’s a good skill to have anyway.

      (Rewrite) “Avoid justifying your rules or offering explanations.” Children with ODD are not able to reason when they turn defiant. They will only resist harder and use your words to argue with you incessantly. Even if they can understanding logical reasoning in a calm moment, this will vanish once they become defiant again.

      (Rewrite) “Don’t fall into a pattern that’s not working.” It’s easy to keep trying the same things over and over and hoping your child will change. Try new parenting approaches to managing your child’s behavior.

      “Don’t jump to conclusions that demonize the child.” ODD can be so relentless and exasperating that even the best parents can fall into the trap of thinking ODD is in charge of the child. A parent starts to expect defiance when there isn’t any.

      Sandy, if you have any more questions please don’t hesitate to respond. And if you’ve discovered something that helps with your daughter, please feel free to share it here for others. This article is among the top ones read on this blog, so you may be able to help other struggling parents.

      Take care, Margaret

      1. Hi Margaret,

        I can’t tell you how much I appreciate your reply!

        As someone who believes children should have a voice and be part of decisions that affect them, I can see this does not work for my daughter as it has for her sisters! Similarly, I do explain my decisions, and expect her to begin to see reason, but it very rarely works. Our relationship HAS been damaged, because it has been almost relentless daily battles since she was about a year old.

        As well as ODD, she also has recognised autistic traits, which have improved, such as she has never coped well with any changes and at about a year old she moved bedrooms and this seemed to trigger everything off, with sleeping issues that lasted until she was about 9 years; lining her toys up; watching the same tv programmes over and over; some sensory issues etc. Although some of these have improved more recently. She is a persistent liar, usually to avoid getting in trouble, and has some addictive traits, particularly around watching tv/youtube and food , food in particular is an issue as she is intolerant to gluten and diary, but regularly sneaks food. hides food and over eats.

        She has a diagnosis of dyslexia and this affects her auditory processing as well. She constantly picks at things, rips or tears things, she chews tv remote controls, and used to eat her clothing!

        Despite all this, she does fairly well at school and is quite ambitious. Over the years her behaviour has improved in some areas, mainly due to maturity; but has deteriorated in other areas – she is extremely confrontational, manipulative and bounces between being paranoid (thinking everyone is against her, or that she has been followed) and taking risks.

        Life with her is like riding a rollercoaster. There are days I am so proud of what she has achieved and feel hopeful for her future; and other days I am in despair, wondering how she will cope in life! It is like living with two different people, and on those different days, she convincingly says things that entirely conflict with what she said the day before. No story is without embellishment to prove she has had the ‘best day ever’ or the ‘worst day ever’ – even if it is on the same day!

        I no longer collect her from school in the afternoon, as on the short ride home, she is usually yelling at me by the time we get back. A few weeks ago she told me she couldn’t wait to have a daughter so she could show me what a real mother/daughter relationships looks like. Where once she would physically attack me, now the blows are verbal, but just as painful.

        On school holidays she is difficult to motivate, while she likes seeing friends and going out with them, she is easily tired, and spends a lot of time on her bed, or having pyjama days in front of the tv. Gone are the days when I could physically get her up and out, as she is now taller and heavier than me.

        She has the face of an angel, and can be very kind and caring, mostly polite (to others), but has challenged me in numerous and frequent ways – but proof that a mother’s love is unconditional!

        Many thanks again for clarifying the article!

        1. Hello again Sandy,

          I was heartened to hear you found something useful in my reply. Your question made me rewrite a lot of this article and it’s better for it. It also inspired me to write another one on parental authority and rights–how parents lose them and how they regain they rightful leadership of the household.

          Your daughter seems to have an extraordinary diverse combination of symptoms, and some are worrisome. They embody more than mental illness or psychiatric illness per se, and include neurological, sensory processing, and autoimmune disorders. However, a lot of the difficult behavior you describe can be attributed to ‘normal’ troubled teenagers, and it can be hard to tell what needs genuine mental health treatment and what she’ll mature out of as she enters adulthood. It might help to look at another article here: “Is my teen ‘normal’ crazy or seriously troubled?” and see what areas she might need help with so she can grow into a functional/safe adult with a life of wellbeing. This might help tease out what’s most important to address, things like safety: 1. safe from harm to self or others; 2. safe from being a victim or perpetrator of abuse; 3. safe from addictions; and 4. safe from bad life choices.

          Other behaviors you describe sound like borderline personality disorder (or BPD for short). There is a special therapy for this that is extremely helpful, and it is called Dialectical Behavior Therapy or DBT. You can find out more on Wikipedia and in my article “Brace yourself for Borderlines.” Knowing the symptoms of BPD may help you emotionally; you’ll ride a slower, mellower roller coaster. There is a pattern ing BPD behaviors, and knowing her pattern can help you anticipate difficult symptoms and not be knocked down by her painful episodes.

          I wish you the very best,

          Margaret

  2. Hello Margaret
    I am in the same situation like K. But the only change is that part my husband is the same trouble like her mother. He has the same problem like our 12 years old son – ODD with ADD but he does not think so. But the true is he always make a drama. I really do not know What to do. Both still Fight and usually husband starts screaming about nothing on him. My son does not have chance to change himself. Do you have some advice for me? Thank you. Michaela

  3. I have a question: My gifted/almost certainly ODD son went incorrectly-diagnosed for at least 4 years- he is now ten- and a significant problem right now is that my mother, who lives with us, always reacts very negatively to his defiance. She more or less mirrors his anger back at him, and I am constantly in the middle of battles. What is the healthiest manner in which to defuse an argument of this kind? I need to return to school and the working world, so I have to begin figuring this out before they spend a lot of time together without me ready to calm things down. Its a relief to finally recognize what I have been seeing for what it probably is, but the information is very new.

    Thank you for this article!

    1. Hello K.,

      Thank you for writing.

      You hit the nail on the head. Your mother is creating a hostile environment where your son can’t improve or learn any new behaviors. She is undermining any treatment he’s receiving, plus your ability to teach him social skills. Her anger problem is toxic; you didn’t go into detail, but it could be flat out abusive. I hate to report that there are no easy ways to defuse the battles because it’s your mother that needs parenting. It’s like she needs to be sent to her room. Your son needs to see that YOU are in charge and that you care how he’s treated.

      Moving your mother out of your home may not be possible, but your son’s future may be more at risk because he’s enduring emotional stress. His teen years are coming, which will magnify any stress. He will not only have school/social challenges due to ODD, but he will have learned from your mother that defiance is part of the family culture. It is a recipe for criminality. A child deserves better.

      This is my personal opinion from experience: your mother needs hard boundaries or therapy. In one of my support groups, a mother brought in her mother because of fights over her troubled son. As we went around the room and heard everyone’s stories and challenges, this grandmother started to understand. She asked questions and got an earful from the other parents. Eventually she started to cry and apologized to her daughter and asked forgiveness. The mom also started crying. Grandmother’s change of heart was beautiful to watch. Is there a support group for parents in your area? Your mother needs to hear the truth from others.

      You may need tons of support for standing up to your mother. It will not be easy. Be strong. You won’t be at fault or a bad daughter for making the rules and demanding that she is responsible for changing her behavior. You will never regret going through a tough mother-challenge to put his needs first. He will notice that you are protecting him. Consider getting your own emotional support too, with a therapist, or minister, or a supportive group of friends or family.

      Do hang in there and good luck. You can do this. It’s worth it.

      Margaret

  4. This article showed my that my child might have been misdiagnosed. I was told that she had ADHD. I was at the end of my rope and I cry often because I love my daughter and don’t know what else to do to make life easier for both of us. After reading this article I believe that my daughter might have ODD. I have also gained valuable tips on how to manage her behaviors. I hope this could be a new day for our family. thank you.

    1. Hello Eileen,

      If your child does indeed have symptoms of ODD, I wish you the best, and I’m glad this article was of help. It is common for children diagnosed with ADHD to also be diagnosed with ODD. In addition to tips in this post, you will have to come up with some techniques of your own that work for your daughter (children are all unique) and within the context of your family. You will also have to ‘experiment’ and try different things to minimize her challenging behaviors. Keep in mind that, like all children, she will grow and change (and wise up) and you’ll have to try other things. Don’t be frustrated by this or interpret it as a setback. All you need to do is be one step ahead. Take good care,

      Margaret

  5. Thank you so much for the information. I’m at my wits end but with this new information maybe things can change. Specially knowing that the defiance gets worse for awhile.

    1. Hi Carla, I’m glad to hear that this article helps. Anytime a parent wants to assert new rules in a home, or new limits on behavior, the child has a reaction or backlash of some kind. This is true for almost all children, but hardest to manage with an ODD child. I wish you the best as you face the backlash(es). Get lots of support for yourself and stay strong. It’s better on the other side of the explosion. Margaret

Leave a Reply to Eileen Cancel reply

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and partners with parents for successfully raising their troubled child, teen, or young adult. She believes parents and families need realistic practical guidance for home and school life, not just information about disorders. Margaret has mentored families for over 20 years. She is an author & speaker, and believes mentally healthy families raise mentally healthy children.

You Can Handle This.

You Can Handle This.

You are not alone. It's no one's fault. Behavior disorders are disabilities! Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
Amazon $14.99, Kindle $5.99

%d bloggers like this: