Oppositional Defiant Disorder (ODD)

According to the DSM 5, children who demonstrate Oppositional Defiant Disorder (ODD) in less severe cases show oppositional defiant behaviors primarily at home. The more severe the ODD the greater the frequency of the defiant behaviors and the more likely these behaviors are demonstrated outside the home. It is also noted that there are two important factors to consider:

Part of childhood is to be oppositional and defiant. As is seen when the child is learning to separate and form their own identity. As such, these behaviors should not be considered consistent with ODD nor should a distinction be made from what are normal oppositional behaviors and what are atypical.

It is further noted that from the “Perspective of the Child,” the demands being put on the child are viewed by the child as unreasonable and/or unfair.

There does not appear to be a biological basis for this diagnostic category. As such, when implementing a behavior program to address the oppositional and defiant behaviors we have to look at the two considerations above. What are the implications here?

First, when implementing the program, our goal is not to reduce the oppositional behaviors to zero! Why, you might ask? In typical child development, a child needs to be oppositional (if not defiant at times) to assert their feelings and thoughts as they establish their identity. Being oppositional is the beginning to learning to make their own choices in life and, as such, we do not want to compromise those learning opportunities.

Second, we have to look at what the child might be saying. For example, are their demands or expectations unreasonable in reality? If, in fact, the parent or teacher is expecting more from the child than they can deliver, the child’s opposition to the expectations will be appropriate. As such, we need to carefully examine and understand when and why a child becomes oppositional. In this case the intervention has to do more with setting realistic expectations by the parents and/or teachers.

Note: Selected information presented here is taken from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, American Psychiatric Publishing, Washington D.C., London England, 2013.