Of late there is a change in the child's behavior, making
hue and cry of even petty issues. The child seems to be in a defiant mood
always - A strict 'no' to anything and everything, certain amount of physical
violence too. The ballet teacher, sports coach, schoolteacher - have all shared
their individual opinion.
Looking at it intently, you can notice that the
child's behavior is unusually different with those in authority. The aftermath
is becoming contagious. Certain amount of strain is seeping into relationships.
What is happening to your child? Should you understand these tantrums as mere
signs of growing up? Will things smoothen in due course of time?
Feeling hopeless and helpless
can in no way ease the situation. If empowered with information you are well
equipped to take proactive steps. Find clues to early detection and understand
causes. Check who to approach for help and how to choose suitable treatment
options to bring back the child on the road to normalcy.
Oppositional defiance disorder
Children at a tender age of two, teens and adolescents can
have oppositional defiance disorder. In younger children, oppositional defiance
disorder is more common in boys than in girls. But as the children age, the
possibility is almost equal in boys and in girls. Oppositional defiance
disorder is the toughest behavior disorder.
Those with oppositional defiance
disorder usually have other behavioral problems such as
attention-deficit/hyperactivity disorder, learning disabilities, mood disorder
(depression) and anxiety disorders. More critical cases may lead to developing
a serious behavior disorder called conduct disorder.
Almost all children have their moments. Most of the time
they detest being told what to do or ought to do. During these times, depending
on their age, they exhibit their unwillingness differently. Some argue or talk
back, some cry, some throw tantrums, some shy away - different forms of showing
defiance. However, if the child seems to show defiance always, it could be a
A defiant attitude, uncooperative and hostile behavior for
more than six months towards any authority figure signals presence of a problem;
more so if the behavior has an effect on the child's family, social and
academic life. Understanding oppositional defiance disorder holds the key to
prompt evaluation and diagnosis.
Oppositional defiance disorder causes
Medical experts are yet to zero in on a single cause for
oppositional defiance disorder. Extensive research on the subject has revealed
that it can be a combination of biological, genetic and environmental factors.
Biological factor: Alterations in the neurotransmitter
activity of the brain are linked to oppositional defiance disorder.
Neurotransmitters are made from amino acids, which in turn are obtained from
protein in food. Neurotransmitters are brain chemicals. The chemicals
facilitate nerve cells in the brain to communicate with each other.
High or low results in shift in moods and
changes the way we think. Messages may not make it through the brain. The
afflicted individuals may continue to argue, there may be nil fear for
punishment, comprehension power may diminish, may shy away from socialization
etc. Thus it can lead to psychiatric conditions and mental health problems.
Genetic factor: There is enough data that suggests that oppositional defiance
disorder may run in families. In many cases, both children and teens diagnosed
with oppositional defiance disorder have had close family members suffering from
mental illnesses. Mental health professionals opine that the vulnerability to
develop oppositional defiance disorder is high in such cases.
Environmental factor: Home or school, the
environment plays a pivotal role in development of oppositional defiance
disorder. A child or teen with an imbalance in neurotransmitter levels or who
is vulnerable to develop due to genetic reasons is at a high risk of developing
oppositional defiance disorder if the environment is not conducive enough. Few
environmental factors that contribute are poor parenting skills, domestic
violence, physical abuse, sexual abuse, uncaring parents, poverty or low
standard of living, substance abuse by parents.
The three factors apart, a group of medical experts have
pin pointed two theories as possible causes for oppositional defiance disorder.
Developmental theory: If these children with
oppositional defiance disorder are persistent or adamant, it is due to
incomplete development. The children do not outgrow their toddler years. Stuck
in the 2-3 year old stage they exhibit the same child defiance and are unable
to comprehend or be receptive to reasoning.
Learning theory: According to this theory, the
child develops the disorder in response to ineffective parenting skills. Right
from the formative years the child is exposed to negative techniques, for
example harsh or inconsistent discipline. As a result, the child may learn and
develop a disobedient behavior.
Oppositional defiance disorder symptoms
It is indeed a challenging task to discriminate between a
strong-willed child or teen and one with oppositional defiance disorder. Gone
are the days when children and teens respected and regarded words of parents,
teachers or elders sans questioning. Children today like to reason out and
voice out their individual thoughts on any given subject. The thin line lies in
the degree and frequency of aggressive, adamant, defiant, relentless behavior.
Compare the child with children of same age group and
gender. Check if there is a disturbance in behavior and how often it occurs.
Look if it interferes with family, social and academic or organizational
functioning. If it persists for at least 6 months, and if a minimum of four of
the following are present, it signals the presence of oppositional defiance
Loses temper too often
Develops an aggressive behavior
Argues with adults or people in authority
Inconsiderate towards requests from adults
Plays blame game for his or her behavior
Resorts to deliberately annoying people
A touch me not or lacks sportive spirit
Often angry and feels agitated
Refuses to obey rules
Exhibits temper tantrums often
Finds hard to maintain healthy friendships
Faces academic or occupational problems
Before long, acknowledge the necessity to seek help from
experts. Aim for early detection and save time. Earlier the diagnosis, better
are the chances of reversing its effects. Unlike other health conditions, there
are no blood tests done for diagnosing the disorder. Even your child's
pediatrician can provide a referral and direct you to concerned health
specialists. Psychiatrists, mental health professionals, child psychologists or
child behavioral expert are all equipped to undertake a systematic diagnostic
At this stage, health professionals look for other
disorders, which may be present such as attention-deficit hyperactive disorder,
learning disabilities, mood disorders and anxiety disorders. Proper treatment
of oppositional defiance disorder may not be possible without treating the
other disorders. Talk to the health care provider to understand the factor that
has influenced the disorder.
Well before seeking an appointment, do some extensive
homework. Equip with detailed information on the subject. Try and speak to
parents who have treated their children. Before fixing an appointment with the
health care provider, gather information about the person you are supposed to
meet. Check their expertise level on the subject and know career profile.
to your child. It is necessary to keep them informed of the steps being taken.
Talk to other family members in order to ensure that the child gets good family
support. These can make you feel absolutely confident that indeed it is the
right path to restore your child's self-esteem.
Tackling oppositional defiance disorder
Varied treatment options are available. There is no single
treatment that can work well for all those affected. Treatment is case
specific. It is individualized after considering the family background,
environmental factors, biological factors, health condition, available
resources, and the degree of the problem, gender, and age.
Therapy combined with medications show significant
improvement. The aim is to reduce, decrease or eliminate all that which signals
a defiant behavior, in order of severity. At the end of a successful treatment
the individual should be able to tread the normal path of life like others of
their age and gender.
Counseling: Individual counseling and family
counseling are integral part of treatment. Parents are taught specific
parenting skills and techniques that positively contribute to managing the child
or teen. Health professionals encourage and often stress the importance of
strengthening the parent-child bonding.
They counsel parents to make them
realize how a slight lethargic attitude can negatively contribute to the issue.
Likewise, periodical assessment of the child or teen is shared with parents.
Parents are informed about the intended future course of treatment and the role
to be played by the parents.
Psychosocial treatment: The parents are taught
specific techniques to handle the child's defiance.
Parent management training: The aim of the training
is to change the way parents and child have been interacting. Parents are
encouraged to appreciate the child's positive behavior and subject the child to
mild negative consequences for negative behavior. Certain modifications in
lifestyle, eating habits, handling o sensitive issues that impact the child are
Psychotherapy: Psychotherapy involves alleviating
psychological distress through talking rather than through medications. The child,
teen or adult is taught cognitive-behavioral approaches. It improves their
problem solving skills, communication skills, control impulsive behavior and
better manage anger.
How to help?
It could be your child, niece or nephew, friend or
neighbor who is affected with oppositional defiance disorder. If you wish to
contribute to speedy recovery, here are some useful easy-to practice tips.
Check if medications are taken regularly.
Appointments with experts are kept.
Checklists, advice of health professionals are
Check if the child or teen gets enough
Be courteous with the child.
Never criticize, ill-treat or look down.
Discuss advantages of obeying rules.
Talk why listening to authority figures are
Play with the child or spend quality time with
Engage in activities that make him/her happy