Oppositional defiant disorder (ODD) is one of a group of behavioral disorders called disruptive behavior disorders (DBD).
Even the best-behaved children can be uncooperative and hostile at times, particularly adolescents, but those with ODD show a constant pattern of angry and verbally aggressive behaviors, usually aimed at parents and other authority figures.
The most common behaviors are; defiance, spitefulness,negativity, hostility and verbal aggression. Approximately between one and 16 percent of children and adolescents have ODD.
Listen in as Melissa Breslin, MA discusses ODD, its symptoms and treatments, so as a parent, you don't have to go it alone in trying to manage a child with ODD.
Selected Podcast
Child/Teen Oppositional Defiant Disorder
Featured Speaker:
Melissa Breslin, MA, MSW, LCSW, ACT
Melissa Breslin, MA, MSW, LCSW, ACT has expertise in individual therapy for children, adolescents, and adults. She focuses on depression, anxiety, obsessive compulsive disorder (OCD), phobias, anger management, and stress management. Mrs. Breslin treats families using an approach that includes parental guidance to help address attention deficit hyperactivity disorder (ADHD) and behavioral issues. Transcription:
Child/Teen Oppositional Defiant Disorder
Melanie Cole (Host): Even the best-behaved children can be difficult and challenging at times. But if you have a child or a teen that has frequent and persistent pattern of anger, irritability, arguing, defiance toward you or other authority figures or even towards their friends, he or she may have oppositional defiance disorder. And as a parent, you do not have to go it alone in trying to manage a child with ODD. My guest today is Melissa Breslin. She’s a licensed clinical social worker and a therapist for children, adolescents, and adults at Summit Medical Group. Welcome to the show, Melissa. What is ODD or oppositional defiance disorder?
Melissa Breslin (Guest): Thank you, Melanie. Oppositional defiance disorder can be defined as a pattern of negative behaviors that children are typically displaying during the preschool year. Sometimes they develop later, but typically before the early teenage years. Oftentimes, these behaviors will cause significant impairment, whether it’s within the family dynamics, during social activities, or at school, and sometimes under all three domains.Like you mentioned, the behaviors are typically including emotional and behavioral symptoms, such as anger and irritability. Children are often very argumentative with their parents and other authority figures. Often, you’ll see vindictiveness or kind of annoying type behaviors towards others. Again, they don’t need to be across all environments but typically will start in one environment and then carry on over the years into others if not addressed properly.
Melanie: Well, because kids normally get defiant at some points in their life, and even little kids, we hear about the terrible two’s and the nightmare four’s, and then of course, teenagers are aliens we know anyway. How do you know that it’s really something that needs counseling so that a parent -- because, Melissa, as a parent—and I have two teenaged children—it gets very frustrating when a child is defiant or argumentative. When do we know that this is more than that?
Melissa: I’m typically coaching parents to look at all the environments the child is in and getting feedback from teachers, coaches, other people that are also with their children. And even if the behaviors are just occurring at home, I typically will tell parents to get help, whether it be for themselves, for parenting sessions, or their child. If it’s too much, then the relationships are being strained. Sometimes, we’re looking at a child temperament even before it develops into oppositional defiance disorder, but if parents can work out some behavioral strategies to address this and everyone’s dynamic can be more pleasant, it’s easier as they’re getting into the older grades. The other thing I speak about often is when it is affecting school and other activities in a child’s life and you’re getting reports from either teachers or coaches or babysitters, then I would really suggest that a family gets their child in treatment so that the behaviors can be regulated with behavior modification.
Melanie: Tell us about the behavior modification that’s involved. If we were to come see you with this child and maybe the child is resistant to come seeing you anyway, once we get them there, what do you do to help them?
Melissa: What I suggest is for behavioral issues that we’re discussing today, that a child is seen for an initial evaluation and that parents are usually following up for parental guidance sessions without the child present unless the child behaviors are not regulating with that approach. Because typically when we’re speaking about behaviors like this, if a child is sitting one on one with a therapist, behaviors aren’t really going to change very much. It’s very effective if parents are sitting with the therapist and looking at the patterns of behavior, the function of the behavior, why it’s occurring, and ways that they can respond differently. Typically, it’s one on one with the parents or whomever can come, the caregivers that are involved. A child is often brought in if there’s 66 symptoms that need to be addressed such as anger outburst or some mood changes, and then the child will be working one on one with the therapist to identify triggers to their anger, to identify the thoughts that come before some of their behaviors, and work on techniques to calm their bodies down in these moments.
Melanie: What about parent and child interaction? It’s great when they’re in therapy together and working on these things, as you say, but what about when they’re at home? Do you teach parents how to set limits or pick their battles or praise children? What do you at home?
Melissa: Exactly that. The first thing I recommend are clear, consistent boundaries and consequences. Also, using positive rewards instead of negative rewards. It’s very effective with children with this temperament. I always coach parents to catch the alternate behaviors you’re looking to increase. For example, if we’re speaking about the negative behavior, being disrespectful verbally to the parent, I recommend praising the alternate behavior of not being disrespectful. So when you catch your child speaking respectfully, you use verbal praise, or even something tangible for a younger child, like a sticker or a stamp or a small piece of candy. It’s very important to pick battles, which is when I speak about expectations and shifting the expectations for the child who is going to be defiant. Essentially, I coach parents to set up situations so that they’re giving them less opportunity to say no. Also, speaking about how you phrase requests when you’re speaking to a child who tends to be defiant.
Melanie: How do you phrase requests? That’s a really important point, I think, Melissa. And as a parent, you always think to yourself, “How do I ask this child to bring up the laundry? How do I ask this child to mow the lawn?” What would be a really good way that parents can take right now on the way to phrase a request that the child would be more likely to think about it and decide if this is something they can help out with?
Melissa: Great question. Typically, I find when I’m figuring out what’s getting in the way and why the child is not following through, that parents are often demanding that something be done right when they ask. Especially for the older, middle-school to teenage age group, I often will coach parents to give them more control over the request. For example, “By 7:00 this evening, the garbage needs to be out at the curb, and if I don’t see it out closer to that time, I’ll remind you.” Instead of saying, “Put down the video game; you need to do it now,” which then tends to increase the defiance and the noncompliance, giving them more wiggle room with when they can complete the chore is important.
Melanie: Great advice. I’m going to try that advice tonight, for sure. What happens when you get that defiance, the challenges? How is a parent supposed to control their own anger and emotion when these children are acting out?
Melissa: If we go with this situation we just spoke about, when you’re asking a child to do something and they flat out refuse, my suggestion is that you don’t start the tug of war. Because they are in control. You cannot make a child physically stand up, go get the garbage cans, and bring it to the curb. So I speak about an adult time out, meaning the adult will walk away from the situation and say to the child, “I see that right now you’re not listening to what I’m asking you to do. I’m gonna be back in a few minutes,” or, “Is there a way for us to work this out so that we don’t start to argue?” Again, this is for the older children, more the teenagers. Adult timeout first, coming back, and reconvening so that you can figure out how you’re best going to solve the problem that just came up when the child was defiant. Another piece is that I think you have to really see the pattern. And if you have an idea of when your child will be triggered, we have to shift again the expectations for this child. We may not ask them to do certain things for a while, or you may communicate with them differently, like writing a list or even sending teenagers a text message to request something so that verbal argument doesn’t happen.
Melanie: It’s all such great and usable advice. In just the last minute, Melissa, if you would, give parents listening your best advice for dealing with oppositional defiance disorder in their children, recognizing those symptoms, and getting some treatment and help for both of you.
Melissa: I would say that if you’re noticing that your child’s behavior is persistent over four months or more and it’s starting to affect other areas of their life and your relationship, then it’s time to get a third party involved, whether it be for parental guidance sessions or some individual therapy for your child, depending on the symptoms that they’re displaying. I think the first thing before getting treatment is to really look at the expectations for that child and recognize that they are behaving that way for a reason and it’s not necessarily just to annoy the parent, but there could be something else going on that needs to be addressed.
Melanie: Thank you so much. It’s great information. You are listening to SMGRadio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Child/Teen Oppositional Defiant Disorder
Melanie Cole (Host): Even the best-behaved children can be difficult and challenging at times. But if you have a child or a teen that has frequent and persistent pattern of anger, irritability, arguing, defiance toward you or other authority figures or even towards their friends, he or she may have oppositional defiance disorder. And as a parent, you do not have to go it alone in trying to manage a child with ODD. My guest today is Melissa Breslin. She’s a licensed clinical social worker and a therapist for children, adolescents, and adults at Summit Medical Group. Welcome to the show, Melissa. What is ODD or oppositional defiance disorder?
Melissa Breslin (Guest): Thank you, Melanie. Oppositional defiance disorder can be defined as a pattern of negative behaviors that children are typically displaying during the preschool year. Sometimes they develop later, but typically before the early teenage years. Oftentimes, these behaviors will cause significant impairment, whether it’s within the family dynamics, during social activities, or at school, and sometimes under all three domains.Like you mentioned, the behaviors are typically including emotional and behavioral symptoms, such as anger and irritability. Children are often very argumentative with their parents and other authority figures. Often, you’ll see vindictiveness or kind of annoying type behaviors towards others. Again, they don’t need to be across all environments but typically will start in one environment and then carry on over the years into others if not addressed properly.
Melanie: Well, because kids normally get defiant at some points in their life, and even little kids, we hear about the terrible two’s and the nightmare four’s, and then of course, teenagers are aliens we know anyway. How do you know that it’s really something that needs counseling so that a parent -- because, Melissa, as a parent—and I have two teenaged children—it gets very frustrating when a child is defiant or argumentative. When do we know that this is more than that?
Melissa: I’m typically coaching parents to look at all the environments the child is in and getting feedback from teachers, coaches, other people that are also with their children. And even if the behaviors are just occurring at home, I typically will tell parents to get help, whether it be for themselves, for parenting sessions, or their child. If it’s too much, then the relationships are being strained. Sometimes, we’re looking at a child temperament even before it develops into oppositional defiance disorder, but if parents can work out some behavioral strategies to address this and everyone’s dynamic can be more pleasant, it’s easier as they’re getting into the older grades. The other thing I speak about often is when it is affecting school and other activities in a child’s life and you’re getting reports from either teachers or coaches or babysitters, then I would really suggest that a family gets their child in treatment so that the behaviors can be regulated with behavior modification.
Melanie: Tell us about the behavior modification that’s involved. If we were to come see you with this child and maybe the child is resistant to come seeing you anyway, once we get them there, what do you do to help them?
Melissa: What I suggest is for behavioral issues that we’re discussing today, that a child is seen for an initial evaluation and that parents are usually following up for parental guidance sessions without the child present unless the child behaviors are not regulating with that approach. Because typically when we’re speaking about behaviors like this, if a child is sitting one on one with a therapist, behaviors aren’t really going to change very much. It’s very effective if parents are sitting with the therapist and looking at the patterns of behavior, the function of the behavior, why it’s occurring, and ways that they can respond differently. Typically, it’s one on one with the parents or whomever can come, the caregivers that are involved. A child is often brought in if there’s 66 symptoms that need to be addressed such as anger outburst or some mood changes, and then the child will be working one on one with the therapist to identify triggers to their anger, to identify the thoughts that come before some of their behaviors, and work on techniques to calm their bodies down in these moments.
Melanie: What about parent and child interaction? It’s great when they’re in therapy together and working on these things, as you say, but what about when they’re at home? Do you teach parents how to set limits or pick their battles or praise children? What do you at home?
Melissa: Exactly that. The first thing I recommend are clear, consistent boundaries and consequences. Also, using positive rewards instead of negative rewards. It’s very effective with children with this temperament. I always coach parents to catch the alternate behaviors you’re looking to increase. For example, if we’re speaking about the negative behavior, being disrespectful verbally to the parent, I recommend praising the alternate behavior of not being disrespectful. So when you catch your child speaking respectfully, you use verbal praise, or even something tangible for a younger child, like a sticker or a stamp or a small piece of candy. It’s very important to pick battles, which is when I speak about expectations and shifting the expectations for the child who is going to be defiant. Essentially, I coach parents to set up situations so that they’re giving them less opportunity to say no. Also, speaking about how you phrase requests when you’re speaking to a child who tends to be defiant.
Melanie: How do you phrase requests? That’s a really important point, I think, Melissa. And as a parent, you always think to yourself, “How do I ask this child to bring up the laundry? How do I ask this child to mow the lawn?” What would be a really good way that parents can take right now on the way to phrase a request that the child would be more likely to think about it and decide if this is something they can help out with?
Melissa: Great question. Typically, I find when I’m figuring out what’s getting in the way and why the child is not following through, that parents are often demanding that something be done right when they ask. Especially for the older, middle-school to teenage age group, I often will coach parents to give them more control over the request. For example, “By 7:00 this evening, the garbage needs to be out at the curb, and if I don’t see it out closer to that time, I’ll remind you.” Instead of saying, “Put down the video game; you need to do it now,” which then tends to increase the defiance and the noncompliance, giving them more wiggle room with when they can complete the chore is important.
Melanie: Great advice. I’m going to try that advice tonight, for sure. What happens when you get that defiance, the challenges? How is a parent supposed to control their own anger and emotion when these children are acting out?
Melissa: If we go with this situation we just spoke about, when you’re asking a child to do something and they flat out refuse, my suggestion is that you don’t start the tug of war. Because they are in control. You cannot make a child physically stand up, go get the garbage cans, and bring it to the curb. So I speak about an adult time out, meaning the adult will walk away from the situation and say to the child, “I see that right now you’re not listening to what I’m asking you to do. I’m gonna be back in a few minutes,” or, “Is there a way for us to work this out so that we don’t start to argue?” Again, this is for the older children, more the teenagers. Adult timeout first, coming back, and reconvening so that you can figure out how you’re best going to solve the problem that just came up when the child was defiant. Another piece is that I think you have to really see the pattern. And if you have an idea of when your child will be triggered, we have to shift again the expectations for this child. We may not ask them to do certain things for a while, or you may communicate with them differently, like writing a list or even sending teenagers a text message to request something so that verbal argument doesn’t happen.
Melanie: It’s all such great and usable advice. In just the last minute, Melissa, if you would, give parents listening your best advice for dealing with oppositional defiance disorder in their children, recognizing those symptoms, and getting some treatment and help for both of you.
Melissa: I would say that if you’re noticing that your child’s behavior is persistent over four months or more and it’s starting to affect other areas of their life and your relationship, then it’s time to get a third party involved, whether it be for parental guidance sessions or some individual therapy for your child, depending on the symptoms that they’re displaying. I think the first thing before getting treatment is to really look at the expectations for that child and recognize that they are behaving that way for a reason and it’s not necessarily just to annoy the parent, but there could be something else going on that needs to be addressed.
Melanie: Thank you so much. It’s great information. You are listening to SMGRadio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.