Oppositional defiant disorder (ODD) is not and should not be such an easy condition to diagnose. Young children, especially as they develop and learn, will at many times exhibit problematic behaviors. They will fight with, yell at, and maybe even hit family members when things don’t go their way and it is just part of growing up. What sets these typical childhood behaviors apart from symptoms of ODD is persistence and severity of the behaviors as well as the negative impact such behaviors have on other family members or relevant relationships.
According to the Child Mind Institute (2018), children with ODD will display some of or all of the following symptoms that will occur for six consecutive months and longer:
- Being unusually angry and irritable
- Frequently losing their temper
- Being easily annoyed
- Arguing with authority figures
- Refusing to follow rules
- Deliberately annoying people
- Blaming others for mistakes
- Being vindictive (https://childmind.org/article/what-is-odd-oppositional-defiant-disorder/)
These behaviors tear at families and make schooling and community interactions incredibly difficult. A few examples may include continuous fights and principal’s office visits at school, horrible tantrums at the store or other public setting, and poor adherence to house rules such as chores and treating family members with respect. More often than not, children with ODD may find themselves in legal trouble as they get older and are at risk for their condition morphing into other disorders such as conduct disorder.
So, where does OT’s role come into play with children with ODD? Psychotherapy and medication management (for when the child has other coexisting disorders such as ADD, anxiety, or depression) are not within the OT’s realm of practice, but are common approaches for ODD through other disciplines (Mayo Clinic, 2018). With that in mind, it is essential for parents to embrace a multi-disciplinary approach and to consult with various professionals. Pediatric OT may introduce and apply some of the following intervention approaches when working with children with ODD:
- In-depth initial evaluation: An OT can’t diagnose a child with ODD, nor can they provide additional diagnoses like a psychiatrist or medical doctors. OT evaluations sift out functional problems and patterns. In other words, they zero in on the activities in which the child has trouble with due to difficult behaviors. As a result, OTs may be able to provide a more holistic picture for the parents and possible causations for escalating behavior.
- Social Skills Training: Pediatric OTs often provide social skills training for children with difficult behaviors who have trouble with making and keeping friends. Furthermore, social skills training teaches a child to reciprocate healthy conversations with friends and family by teaching them how to appropriately react in social scenarios.
- Cognitive/Problem Solving Training Techniques: ODD is considered to be a neurological disorder, or a condition of the brain in which the cause is unknown. Therefore, it would make sense to use cognitive approaches. OT can teach the child specific problem-solving techniques where they have to work with difficult situations that may cause them to lash out inappropriately. Enhanced problem-solving skills are used to reduce negative behavior in order for the child to participate in daily tasks successfully.
- Family-based interventions and education: OTs can also help target challenging interactions between children and their parents/caregivers. By doing so, the OT may use interventions that heavily involve positive communication between parents and the child. Improving interactions will reduce the child’s capacity to test and push parents’ authority through tantrums and manipulation.
There is no cure for ODD, thus a parent’s influence and approach is a daily process. At times, some of the best parents will start to question themselves and their parenting skills when raising a child with ODD. This is heart-breaking, but normal. Like any child with unique needs, a parent who has a child with ODD will be using different styles that best work for them and their family. Do not hesitate to consult with professionals as soon as possible. No parent is ever expected to know everything about raising a child, so expand your knowledge and get the help now.