My child, LittleJ, has been diagnosed with Oppositional Defiance Disorder. This was actually his very first diagnosis, given to him by the child psychologist we saw when he was 4, as a screening visit before we went to the child psychiatrist who would then diagnose him with ADHD.
She said she thought he had ODD because, as he readily demonstrated in her office, HE WOULD NOT DO A SINGLE THING I ASKED HIM TO DO without saying NO, having a fit, calling me a name, and usually all 3. And yes I meant to type in all caps. The way I feel about my son’s oppositional behavior warrants all caps.
Let’s get this straight: all kids say no. This is a developmental stage that kids go through around 2 or 3. It shows that they’re developing independence and a sense of self and it’s nothing to be worried about. Oppositionality shows they’re moving past babyhood and toddlerhood into young kid-hood. But when the NO persists and persists and persists through age 5 and 6 and 7…this may be a sign of what some people call Oppositional Defiant Disorder, or O.D.D.
I say some people, because it’s actually a slightly controversial diagnosis. But more on that in a bit.
Anyway, the child psychologist told me she thought LittleJ had ODD and ADHD and then she proceeded to ask me how I was doing in a very kind voice at which point I burst into tears. Because parenting a child who is not only hyperactive, highly impulsive to the point of being a danger to himself, sensory seeking (another, different diagnosis but consisted of hurling himself against all surfaces in the hopes of getting proprioceptive input) AND who consistently did the opposite of what he was asked to do gets to be very, very, very, very exhausting. And depressing. And lonely. And she knew all of this because LittleJ’s behaviors were so obvious that she moved right on past asking me about my parenting techniques and right into assuring me that my child would get all services their practice could provide. Including medication. And by the way, did I need some too? If we had been at book club I swear that psychologist would’ve pulled out a bottle of wine.
Openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family and academic life.
In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning. Symptoms of ODD may include:
- Frequent temper tantrums
- Excessive arguing with adults
- Often questioning rules
- Active defiance and refusal to comply with adult requests and rules
- Deliberate attempts to annoy or upset people
- Blaming others for his or her mistakes or misbehavior
- Often being touchy or easily annoyed by others
- Frequent anger and resentment
- Mean and hateful talking when upset
- Spiteful attitude and revenge seeking
I seem to remember one website saying that a child had ODD if he/she exhibited these behaviors more than 3-4 times a week. HA!HA!HA! My child exhibited (and still exhibits) some of these behaviors 3-4 time a day.
Subsequent psychologists and psychiatrists (we’re with our 3rd practice now) have mentioned ODD in passing, but it’s no longer a diagnosis. It’s not that things have gotten better, mind you. In some ways things are a little worse as LittleJ has moved on from calling me a stinkerhead to swear words, and what was a developmental delay of a year or two has now morphed into a permanent part of his personality. A personality that needs to be managed, as opposed to enjoyed. The lack of an ODD diagnosis, therefore, doesn’t mean that it’s gone away. What it means is that it’s not actually a useful description of his behaviors.
Yes, he’s oppositional.
Yes, he says no to everything.
Yes, he picks fights.
Yes, he is purposefully provocative.
Yes, he takes pleasure in getting people upset.
But there is a real reason for all of this – and it’s not because he is just plain oppositional. It’s behavior that’s manifested itself because of all his other issues. And these need to be dealt with in order to make the oppositionality go away.
This is actually why ODD is a controversial diagnosis. People who don’t think it’s appropriate are acknowledging that it’s more a description of behaviors that are symptomatic of something else, as opposed to a single, discrete, and treatable situation. ODD actually has no real treatment, at least not in the medical sense. There’s no medication you can give children with ODD to make them better. You can treat other stuff that may be making the oppositional – depression, for example, or mood disorder, or ADHD (or other medical diagnoses that are linked with neurological function), but the ODD itself is not considered treatable. That’s because it’s a description of behavior and doesn’t get to the root of WHY the behavior is happening. I’m going to go out on a limb here and propose this: that ODD is always co-morbid with something else (even if that something else is parenting techniques), and if your child’s doctor is telling you otherwise it’s time to get a new doctor. If your child has ADHD and also seems like he/she has ODD, the best way to manage it is to treat the ADHD. The ODD will follow.
In LittleJ’s case it seems his oppositionality is a combination of early language delay (frustration) combined with his ADHD (impulsivity and frustration) and executive functioning deficit (again, impulsivity and frustration) plus a burgeoning mood disorder (anger, explosiveness) AND possible fetal alcohol exposure (more anger, explosiveness and frustration) plus probable attachment issues (mood, anger, depression) plus not-right-for-LittleJ parenting techniques (you name it we’ve done it) and family patterns (mom + dad both working full time jobs / no experience with special needs kids) have all managed to keep the beast alive.
Yes, I said it. I have helped create the monster.
Which is not to say it’s my fault or my husband’s fault. It’s not. But I have found that if I parent very intentionally I can manage the situation. And the only way to do this is to manage myself. I must remain calm at all times. Calm. Ohhhhhm. Nothing can hurt me. Nothing bothers me. You hate dinner? Oh well, don’t eat. You hate me? I know. No biggie. You ripped your homework to shreds? So sad, I’ll just write a note to the teacher. You want to stab your brother? Uh oh. Inappropriate. Guess you’ll have to go to your room now until you can be with your family again. You chopped all the flowers off the rose bushes? Bummer. Now you’ll have to use your birthday money to buy me some new roses.
La la la. I’m like Snow White with little birds flying around me, helping me be a calm and peaceful mama to my little Grumpy-Rude-Nasty-Button-Pushing No-sayer of a boy.
Now, I have not always been like this. Yesterday was a good day, but the day before that stunk. I have my freak-outs, to be sure. But if there’s one thing I’ve learned through parenting LittleJ it’s that freaking out gives him exactly what he wants and he will do ANYTHING to keep it going once it starts. I truly believe that in his head he wants peace and quiet and love, but the urge to get the big screaming, frustrating response that means he’s important and warrants that level of attention wins out every time. In order to combat that we need to give him the opposite of that many, many more times so a calm, loving, happy way of being becomes what he craves.
If your child has ODD, or you suspect ODD, I have a couple of suggestions for you. First, look into the Love+Logic method of parenting. This has helped us immensely! There are books, seminars, etc. that you can look into, but there are also a series of videos through MonkeySee by a Love+Logic trainer named Julie Greenlee that are wonderful. And short, so if your kid is making you nuts and you need a quick pep-talk you can watch for a minute or 2 and feel like you have tools at your disposal.
The Explosive Child, by Ross Greene, is a book many people swear by. Here’s Dr. Greene’s website, if you’re interested in his overall outlook on parent/child interaction. Personally, I found the techniques in Dr.Greene’s book to be a little too complicated for our situation. Too much talk, discussion, and negotiation for us. Maybe not for you. At the very least this book includes some very important information about why children can be inflexible and explosive and how best to manage them.
So – are your parenting an ODDball? If yes, I’m SO SORRY! It stinks, doesn’t it! Share your tales of woe as well as your successes. What has worked for you?
Related posts: adhd behavior problems, ADHD medication, Adrienne Bashista, behavior modification, CO-MORBIDITIES, feature, ODD, treatment