Managing Kids with Oppositional Defiant Disorder

Learn about these coping strategies for parents of children with ODD: Managing oppositional defiant disorder at home and treatments you can try.

It’s not unusual for a child to have a temper tantrum. If your child is tired, hungry, or wants something he can’t have, he may act out. Oppositional defiant disorder (ODD) has been described by many parents as “temper tantrums on steroids.”

“This is not to belittle temper tantrums,” said Becky Theroux, a mom whose child has ODD and attention deficit disorder (ADD). “My friends kids may yell, cry, or say mean things to their parents. Children with ODD take that a step further. They can totally withdraw or even run away.”

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What is oppositional defiant disorder?

A child having a tantrum will eventually stop when he either gets what he wants or realizes that the tantrum will get him nothing. Children having an ODD meltdown stop when they run out of steam. “I’ve seen it with my own child and it’s exhausting,” Theroux said.

Douglas Riley, PhD, child psychologist, and author of "The Defiant Child: A Parent’s Guide to Oppositional Defiance Disorder," calls these meltdowns, “tiny terrors.” “These children are most comfortable when they’re in the middle of a conflict,” Riley said. “As soon as you begin arguing with them, you’re on their turf. They keep throwing out the bait, and their parents keep taking it.”

Theroux’s friends and family have offered her lots of advice. “They think that the regular meltdown rules apply and they don’t,” she said. “I’ve learned that my son doesn’t misbehave on purpose. He misbehaves because he can’t control his impulses.”

Oppositional defiant disorder treatment

Managing ODD takes a different approach than stopping a tantrum. Nagging, using logic, and spanking won’t work for most children with oppositional defiant disorder. What’s necessary is stopping ODD as soon as it’s spotted. “Left untreated,” Riley said, “it can evolve into more serious behavioral problems such as physical violence, stealing, running away, and other illegal behaviors.”

Riley tells parents of children with ODD to treat the whole child. Many children with oppositional defiance disorder can also have ADD, attention hyperactivity deficit disorder (ADHD), autism, or other mental challenges. “If a kid is so impulsive that he can’t focus on the therapies we use to treat ODD, he isn’t going to get far,” he said.

That child may need medication for his ADD or ADHD symptoms. “We address the source of the stress before treating the behavioral issues,” he explained.

A strong support system

When the ODD is so severe that it carries over to school, it’s important to have a family therapist and a therapist at school. Theroux pulled her child out of the public school system and put him in a school for children with special needs. Her child’s behavior is addressed there, and the school therapist talks to the family therapist.

Having a strong support system works. “It’s good that the counselors at school and our family counselor all share information with each other and with us,” she said. “In addition to my son’s therapy outside of school is that my child’s therapist works with us, too. And the therapist at school hosts a monthly support group for parents at the school.”

Parents with children with ODD should first have their child screened for anxiety, depression, and other mental health disorders. Once a diagnosis is made, parents should do the following:

• Take an ODD management training session from a therapist. In this type of therapy, parents learn how to change the ways the react to disobedient behaviors.
  
• Learn to praise positive behaviors instead of harping on the negative ones.
  
• Parents have to learn to stop entering the arena when your child wants to pick a fight. According to Theroux, that’s a hard one. “My immediate reaction is to point out the bad behaviors and fight back,” she said. “That only makes it worse.”
  
• Parents managing kids with ODD have to learn not to take any of this personally. “Oppositional kids have radar for adult hostility,” Riley said.
  
• When a child is asked to do a chore and doesn’t comply, Riley recommends asking a second time to do the chore. Ask them to “please make a smart decision and empty the dishwasher,” he said. “If they don’t, tell them that the TV goes off or they lose an hour of video game time.”
  
• Use time-outs or loss of privileges. Don’t raise your voice.
  
• Reward positive behaviors with a trip to the bookstore or by spending time together doing something your child enjoys.
  
• Don’t do it alone. Work as a team with your partner, therapist, and school counselors.
  
  

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