Oppositional Defiant Disorder by Anthony Kane, MD

ODD is the most common psychiatric diagnosis in children and it usually persists into adulthood. One would think a lot of

research would be done on this condition. That is not the case. While there are hundreds of research studies on ADHD and

childhood mood disorders, there is very little research on ODD.

Co-morbidity

ODD is frequently goes along with other disorders. 50-65% of ODD children also have ADHD. 35% of these children develop some form of affective disorder. 20% have some form of mood disorder, such as depression or anxiety. 15% develop some form of personality disorder. These children frequently have learning disorders and academic difficulties.

If your child has ODD it is important to know there are other co-existing problems. These other problems usually must be

addressed before you can begin to help your child with ODD.

Prognosis

So what happens to these children? There are four possible paths.

1.Some will grow out of it. Half of the preschoolers that are labeled ODD are normal by the age of 8. However, in older ODD children, 75% will still fulfill the diagnostic criteria later in life.

2.The ODD may turn into something else. 5-10 % of preschoolers with ODD have their diagnosis changed from ODD to

ADHD. In some children, the defiant behavior gets worse and these children eventually are diagnosed with Conduct Disorder.

This progression usually happens fairly early. If a child has ODD for 3-4 years and he hasn't developed Conduct Disorder, then he won’t ever develop it.

3.The child may continue to have ODD without any thing else. This is unusual. By the time preschoolers with ODD are

8 years old, only 5% have ODD and nothing else.

4.The child develops other disorders in addition to ODD. This is very common.

Treatment

Most of these children have some other disorder along with their ODD. Treating this other disorder is the key to proper ODD

management. This frequently means giving medication. Although this type of medical intervention does not make the children

"normal", it can make a big difference. It often allows other non-medical interventions to work much better.

For example, if a child has both ODD and ADHD, then giving the child Ritalin may have a significant effect on his ODD, also.

This positive effect does not seem to be related to the severity of the ADHD. That means even if the child has mild ADHD and

could do without Ritalin, if he is treated medically, you might see an improvement in his ODD.

Once the other problems are under control, the best treatment for ODD is parent training. In a study published in 1998,

eighty-two research studies were evaluated were examined for efficacy. Approaches focusing on parent training were the most

affective techniques.

The main point is that some parent-training program is essential in addressing ODD. This is not going to work for everyone, but it is the best treatment that we have available for ODD.

Advice to Parents

That is with regard to your child. If your child has ODD you need to take care of yourself, also. No child needs a martyr as a parent.

Here are some of the things you can do:

·Maintain interests other than your child with ODD. You have to be a person.

·Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.

·Take time to work on your relationship with your spouse. Raising these children is very difficult and can put a strain on the best of marriages.

·Manage your own stress with exercise and relaxation.

·Take frequent vacations. This is a must.

Conclusion

It is tough to live with children who have ODD. What is worse is that there does not seem to be any cure. However, if you make sure that your child has his other problems addressed and you improve your parenting skills by enrolling in a parent training program, you can do a great deal to improve your child’s condition and your own.

Anthony Kane, MD

ADD ADHD Advances

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BIO:

Anthony Kane, MD is a physician and international lecturer.
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