Difficult or Defiant: Understanding Oppositional Defiant Disorder

By Rick Shaffer

As any parent can tell you, from the “terrible twos” through to the “rebellious teens,” dealing with the many emotional and intellectual changes every child must go through before reaching adulthood can be difficult. Yet, most parents can take solace in the knowledge that each change is “just a stage” that likely will soon pass.

In some cases, however, a child’s emotional or behavioral difficulties may be the result of a deeper-seated problem or disorder. One often overlooked or undetected condition is oppositional defiant disorder, or ODD. Estimates vary, but some researchers suggest that as many as 16 percent of children and adolescents, mostly boys, have ODD.

What Is ODD?

ODD is a behavioral disorder characterized by the repeated display of negative, angry, defiant behavior. But there’s a twist. Compared with children with other behavioral disorders, children with ODD tend not to violate the rights of others. They do know the difference between right and wrong, and they feel guilty if and when they do something that is seriously wrong.

Is Defiance Normal?

Some defiant behavior in children is absolutely normal, points out Dr. Claudio Toppelberg, a child psychiatrist and researcher at Harvard Medical School and Boston’s Children’s Hospital. “Similar to aggressive behavior, oppositional and defiant behavior is common in the first years of life and decreases subsequently in most children,” Dr. Toppelberg explains. “Children who suffer from ODD, however, tend to display negative behavior much more often, for longer periods of time and with greater intensity than is typical in other children of a similar age."

What Causes ODD?

Unfortunately, the exact cause of ODD is not known. However, there are several theories regarding the cause of the disorder. Researchers believe that the disorder may be related to:

• A child’s temperament and the family’s response to it

• A child’s social skills

• A child’s ability to communicate through language

• How parents discipline and understand the child

• The way a child’s body adjusts to arousal and stimulation

• Having parents who are overly concerned with power and control

• Disrupted childcare – involving, for example, multiple caregivers

• An inherited disposition to the disorder, possibly both environmental as well as genetic

• Neurological damage (such as a head injury)

• Prenatal and perinatal factors.