A few months ago I met with a well-known child and youth psychiatrist in the community. We have several shared clients and it seemed like a good idea to start creating a relationship so we can provide our clients with the best service possible. During our meeting, I was able to learn a little bit more about one of his areas of specialization, oppositional defiant disorder or ODD.
ODD is a childhood and youth disorder with symptoms usually starting to present in preschool years and almost always present before the teenage years. It is characterized by persistent patterns of irritability, anger, vindictiveness, and defiance towards parents and sometimes other authority figures. To clarify, it is completely normal for just about all kids to go through difficult stages and stages of defiance. ODD is characterized by longstanding patterns and the symptoms are severe enough that they interfere with daily life. Children and youth with ODD are at risk of having issues with school performance, impulse control, social skills and substance use and abuse.
According to the DSM-V (the bible of mental health) there needs to be a least four symptoms present from different categories. The symptoms can’t be related to another mental health diagnosis, the symptoms must be present with at least one individual who is not a sibling, and the symptoms cause significant impairment at work, school or home. Criteria for diagnosing ODD include both emotional and behavioral symptoms and the disorder can vary in severity. For mild ODD symptoms are displayed in only one setting (ie home), moderate ODD is diagnosed if symptoms are displayed in two settings (ie school and home), and for severe ODD symptoms are displayed in three or more settings (ie home, school, with friends).
Treatment of ODD usually does not include medication, unless there are other disorders present as well. Treatment typically includes parent skills training, individual and family therapy, and social skills training. It can be really challenging to parent a child with ODD but with some work and consistency, behaviors and relationships can greatly improve. If you have questions or concerns about someone in your life who may have ODD, touch base with your doctor and they can get you connected to the right resources.