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The Defiant Child

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  As children grow up, they begin to test the boundaries that parents set for them. They crave independence and break the rules often to figure out how far they can go and what they can get away with. This is a frustrating time, for both parents and children. Although this is a regular part of the emotional and mental development of a child, there are a few who show a tendency to be defiant to every rule and authority figure and this constantly oppositional behavior, does create problems in family dynamics and school environments, in relationships with teachers and friends. 

If a child shows repetitive patterns of anger and irritation with a tendency to argue and throw tantrums, and is vindictive towards parents and people in authority, the child could have Oppositional Defiance Disorder. (ODD)

ODD is a behavioral disorder that affects children and can be seen from primary school children to adolescents. It may be confused with children who naturally act out during the “terrible twos” or the pre-teen years and family members may consider it a “phase” that they will grow out of. However, persistent and aggressive oppositional behavior should be evaluated by mental health professionals to rule out ODD. 

It is usually accompanied with other mental health issues an may lead to Conduct Disorders, which are more severe destructive anti-social disorders. There is also an increased incidence of ODD in children with:

  • learning disabilities
  • mood disorders 
  • anxiety disorders 
ODD is recognized by the tendency of the child to be 
  • Defiant and argumentative 
  • Vindictive and hostile 
  • Negative and spiteful 
  • Questions the rules 
  • Refuses to comply with requests 
  • Deliberately annoys or upsets others and is also easily annoyed 
  • Involved with bullying
  • Blames others for their own mistakes

As per the DSM5 (Diagnostic and Statistical Manual 5) by the American Psychiatric Association, these symptoms should be present for a period of at least six months Causes of ODD Although there are no known definitive causes of ODD, research suggests that various factors may be responsible, including biological (genetic), psychological and social factors. 

  1. Biological Factors: A child may be more susceptible to ODD, if a parent also has ADHD, mood disorders or problems with alcohol or drug abuse. Poor nutrition, exposure to toxins or a brain-chemical imbalance have also been implicated. 

  2. Social Factors: A chaotic home environment, absent parents, inconsistent discipline abuse or neglect have been seen 

  3. Psychological Factors: a poor relationship with parents or family and an inability to understand social cues or navigate relationships is common 
Diagnosis for ODD is usually done when parents or schools approach health professionals about the child’s behavior. A mental health professional like a child psychologist or a child psychiatrist can conduct evaluations through detailed history taking and questionnaires, to determine if the child is exhibiting signs of ODD. 

Treatments for ODD involve therapy for both the child and the family. The family is taught to cope with the child’s unique disposition, in order to make relationships functional.

Approaches that are often used are:

  1. Parent Management Training programs and family therapy 
  2. Cognitive Problem-solving training for the child 
  3. Social skills programs 
  4. Medications: may be needed to treat co-existing conditions like ADHD, anxiety and mood disorders as the symptoms of ODD often improve when these conditions are controlled. 

Disclaimer: The above information is for awareness and education purposes only and cannot be used for diagnosis or treatment of any condition. Please consult with a physician for any concerns or questions
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Dr C P Ravikumar

Aster CMI Hospital, Bangalore

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