ODD: What to Do

There is no known cause for oppositional defiant disorder, although there are various theories.

One theory claims that as a result of negative interactions with authority figures, children develop incorrect behavior and reactions. That is, having not grown out of it, they become stuck in the terrible two's stage of defiance.

Toddlers are defiant due to difficulty communicating which in turn leads to frustration. But in oppositional defiance is more from resentment of authority than it is from poor communication skills. 

Diagnosing ODD

Oppositional defiant disorder is very difficult to diagnose. Often it is confused with other disorders such as learning difficulties, attention deficit disorder (ADD) or attention deficit hyperactive disorder (ADHD).

Over half of children with oppositional defiant disorder also have ADD or ADHD. Just over a third have some kind of affective disorder. Two out of ten have a mood disorder, such as depression, and slightly fewer have a personality disorder.

Because of the similarities in symptoms, it is vital to have your child professionally diagnosed and identify any other disorders they might have.

Studies have shown that half of all children diagnosed with ODD grow out of it by age 8. But, only a quarter of the older children with the disorder will grow out of it.

In most cases, a child with ODD will develop other conditions such as ADHD by the time they are 8. In fact, 95% of defiant children will have developed an additional condition by the time they are 8.
 
In 10-15% of cases the oppositional defiant disorder will develop into something else.

Treating ODD

There is currently no medical treatment for oppositional defiant disorder, though there has been very little research on the subject.

Two studies with the drug Strattera were inconclusive. One study showed it work and the other that it did not.

Another study showed that adding omega-3 oils and vitamin E to the child's diet helped reduce the defiant behavior to a degree. This research is in its very early stages and there is no strong evidence that medication helps children with opposition defiant disorder.
 
The research on ODD in conjunction with ADHD has been more encouraging. Some studies show that when Ritalin was used to treat children with both ODD and ADHD, 90% of the children showed no more signs of ODD by the end of the study.

Out of the children who did not complete the treatment, 75% still showed signs of ODD. For this reason it is important that all children with oppositional defiant disorder be tested for ADHD. Since it is common for a child to have ADHD and ODD simultaneously, treatment for ADHD will in many cases also reduce or eliminate ODD.
 
Medications such as Ritalin have been shown to have to be effective with ADHD and may help your child's behavior if they also have this condition. However, there are side effects of ADHD medication.

Parent training is the best and most effective way treat ODD. Some parents do this privately, though it is expensive and its availability limited. Recent studies have shown that a good child behavior program administered by the parents at home as just as effective as using a therapist, and the are much more affordable. Therefore, the current recommendation for treating ODD is to enroll in a home study style parent training program.

It is important to choose a program that is specifically designed for ODD and is right for you child's age. Avoid programs that deal with children of all ages. Teens with ODD are different than younger children with ODD. Your approach must be different and specifically designed for each age group.