ODD or Oppositional Defiant Disorder is a disorder presenting in children who have difficulties controlling both their emotions and behaviour. ODD is characterised by challenging behaviour, particularly towards adults and those in authority. Children with this diagnosis may:
Be easily annoyed, become angry quickly or seem irritable
Have frequent temper tantrums
Argue with adults (particularly with those who are most familiar, such as parents)
Refuse to follow rules
Appear to annoy or aggravate others on purpose
Have a low tolerance for frustration
Blame other people for their mistakes
Of course, many of these behaviours common amongst children of all ages, however, children who display these behaviours persistently and to a degree which significantly interferes with how they function both individually and with others, may meet the diagnostic criteria for ODD. To help determine the difference between typical childhood behaviour and that which is problematic enough for a child to be diagnosed with ODD, a psychologist, psychiatrist or paediatrician specialising in emotional and behavioural disorders can carry out a detailed assessment. A specialist will also aide in clarifying symptomatology and ensuring defiance and disobedience in a child is not related to any other significant issue, such as an inability to concentrate or language impairment.
How would my child be assessed for ODD?
A diagnostic assessment will usually look at how closely a child’s presenting pattern of behaviours match with those specified in the ‘diagnostic criteria’ set out by the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), published by the American Psychiatric Association.
According to the DSM-V, an individual must display a significant pattern of angry or irritable mood, argumentative or defiant behaviour or vindictiveness for at least six months and these behaviours must be pervasive (that is, not only occur within a sibling relationship, for example).
Often a child’s symptoms will be most pronounced in familiar settings around familiar people, and, as such, may not appear significant in a psychologist or paediatrician’s office. For this reason detailed interviews and reports from others involved with the child (eg. teacher) are necessary to consider. Comprehensive assessment tools, such as validated questionnaires, may also be given to parents and teachers to help in making a formal diagnosis.
How common is ODD and what are the causes?
While prevalence rates vary within the literature, the DSM-V reports that on average, around 3.3% of the population experience clinically significant ODD. Problem behaviours are usually first noted before the age of eight and generally no later than adolescence.
There is no single factor that has been identified as causing ODD. Rather, the research suggests that there are a number of factors in the environment, family and child that may place a child at greater risk of developing ODD. Family factors, such as inconsistent, harsh and neglectful parenting as well as child factors, such as being difficult to soothe and being very active, appear to play a role in the development of ODD in children. Overall, it is typically a combination of factors that appears to be important.
Intervention for ODD in Children
Intervention typically involves a team approach and usually includes a psychologist and/or psychiatrist, GP, paediatrician and the family. Intervention typically starts with the GP and/or Paediatrician, to ensure no underlying medical condition/s are impacting on the child and their emotional and behavioural responses. Other aspects of intervention typically include parental support (eg. supporting parents to improve positive parenting skills and communication skills), individual child treatment (eg. developing coping and communication skills), family support (eg. counselling to help families manage stress within the home environment and develop positive family interactions) as well as support for the school (eg. developing behaviour management plans with the teacher, supporting social skills training in the school environment). Intervention also aims to address any co-occurring factors such as any attentional or learning difficulties which may be affecting a child. The efficacy of pharmacological treatment of ODD remains largely unknown at present and a team-based, family focused intervention remains to be the most effective form of treatment for ODD in children.
If you have concerns for your child, there is support available and the best place to start is with the family GP. Your GP will conduct initial assessments and help put you in contact with specialists who can help your family, such as a Psychologist specialising in child behaviour.
Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) – American Psychiatric Association.
Oppositional Defiant Disorder. Anne Fraser & John Wray – Australian Family Physician (FRACP)
Some girls are feisty from the get go, from fussy babies to tantruming toddlers. The pre teen or “tween” years though, can be the time which parents find most confounding. At this time parents can struggle with everything from girls (and boys) becoming increasingly defiant to the ‘sexualisation’ of young girls and navigating increasingly complicated relationships with peers.
Between the ages of 8 and 13, children are expected to push the boundaries and this is a part of becoming more independent. You can therefore expect girls at this age to disagree with you, show a bit of ‘attitude’, take risks and want to be more like their friends. Remember, “this too shall pass”. In the meantime, you can support your child by guiding her behaviour with clear rules, warm relationships and an understanding of why teenagers behave the way they do.
For example, their brain are still developing: the ability to control our impulses does not fully mature until 25! Pre teens and teens, therefore, are more likely to make decisions based on emotion and have poor foresight. They are also often sensitive, moody and unpredictable. This poor ability to foresee consequences and make informed decisions can be offset by helping to build a pre teen’s confidence so that she can avoid bad situations, bad relationships and be able to say no.
Just because they are getting older doesn’t mean your girls don’t need rules and boundaries. Instead of imposing these on them, set agreed limits that teach independence, responsibility and problem solving. This will lead them to develop their own standards for what is appropriate and how others should be treated. Praise and encouragement, of course, is still important at this age so let her know what she is doing right. Also, although rude and disrespectful behaviour is common at this age that doesn’t mean it should be acceptable. Collaborate with your child on rules about this type of behaviour and then model what you would like to see youself. In the moment, stay calm and wait for the right time to talk about it. When the situation has cooled and can be talked about, let her know how you feel e.g. “I feel hurt when you speak to me like that.” Fighting between siblings is also common at this time and is a normal part of growing up which teaches us life skills like conflict resolution.
The pre teen years are a time when girls are dealing with peer pressure, possibly bullying or cyberbullying and the need to begin taking risks. An increasingly important role for parents and other adults at this time is to help girls to develop a positive self image. It is difficult for them to ignore the messages from TV, music, movies, the web and clothing stores which sometimes encourage girls to be “sexy” and base their self worth on how they look at a time when they are not physically or emotionally ready. The belief held by young girls that they must dress a certain way to fit in is part of growing up. They feel pressure to conform because dress is part of their social code. As parents we can tune in to media that is targeting our girls and then talk to them about it.
Talk about the qualities they value in their friends and how important these are versus physical attractiveness.
Have conversations about TV shows, dolls and outfits that you don’t like instead of giving a blanket “no” and encourage activities where she excels that take the focus off looks and being cool.
Most importantly, don’t lecture! Ask for your girls’ opinion and try to listen more than you speak. At this time it is also important to not avoid sex education but rather find out what the school is teaching so you can follow up at home. This goes beyond “where babies come from” and is about choices, behaviour and relationships. Ask your daughter’s opinion about these things, she is probably just as conservative as you are! Overall, be a healthy role model and avoid talking about feeling “fat”, “ugly” or going on diets around your daughter.
The pre teen years are a time when we expect girls to get a little feistier but some will show this more than others. Disruptive behaviour is known to pass through generations so if you were a feisty young girl there is a good chance your daughter will be too. You can buffer against this by fostering a warm relationship and setting firm but fair boundaries. Remember to talk to your girls so you can support them through what can be a tough time. You may sometimes get a ‘brick wall’ but meet them where they are by setting aside special time and being available when they come to you.
Helping girls develop a positive self image. Australian Psychological Society (website)
Molen et. al., (2011). Maternal Characteristics Predicting Young Girls’ Disruptive Behaviour. Journal of Clinical Child and Adolescent Psychology. 40 (2), 179 – 190
Pre-teens behaviour: in a nutshell. Raising Children Network (website)
This post was produced by Quirky Kid and first published at the Essential Kids website Gratitude is a positive way of thinking and viewing the world. Raising a grateful child is a hard thing to accomplish in a culture that wants everything now and is quick to move onto the next best thing but gratitude is an important life skill. By learning gratitude, children learn to become sensitive to the feelings of others, developing empathy and other life skills such as the ability to view situations positively. Grateful children begin to learn to look outside their one-person world. When a child does not learn gratitude, there is a risk that the child may end up feeling entitled and perpetually disappointed.
Research suggests that gratitude is something that many adults have not yet developed and find difficult to practice. Children who are encouraged to be grateful throughout childhood, will typically be more appreciative later in life. A 2003 study at the University of California in Davis, showed that grateful people report higher levels of kindness, happiness and optimism. A little sacrifice causes us to miss things that we take for granted …
Strategies to Develop Gratitude
The research tells us that ‘gratitude’ is not an inherent natural behaviour, rather it is a learned behaviour. It is also important to remember that each developmental stage impacts on the capacity the child has to think ‘outside themselves’ and consider others.
We can begin to teach our children gratitude from a young age through modelling. Parents have to model behavior they hope their children adopt as their own. A simple, sincere expression of gratitude when your child does something they were asked to do is always appropriate. On the contrary, demanding ‘thanks’ from your children does not assist nurture the growth and development of gratitude.
We can begin to teach our children, and ourselves, how to think gratefully, by practising the following skills;
Teach our children to focus on the positive and find gratitude. This can be done by creating a gratitude journal and can be done as a family. Reflect together on the best parts of the day. This teaches children to pause and think about the good things in their day. Also, redirecting children’s attention to all that they currently have, rather than ‘what they want’.
Celebrate the ‘small’ things. Help your child focus on the things they have achieved, whether big or small. Sharing successes with family members and friends, keep a special folder or box and collate ‘keepsakes’ which help the child remember what they have achieved, the positives in their lives and the happy experiences and memories.
Teach through example. If you notice a lack of the gratitude attitude, consider teaching through example. Responding in a grateful way, and labelling this ‘gratitude’ behaviour will assist your child learn the ‘how to’ of gratitude.
Establish family rituals. By having family rituals which centre around gratitude, children learn to express thanks. Examples of family rituals include, each family member listing one thing they were grateful for during their day, or, writing thank you notes to each other once a week.
Try going without. From time to time, consider a family project that involves going without something important. For example, try making bread for a week rather than buying it, or try walking in your local area, rather than using a car. A little sacrifice causes us to miss things that we take for granted and helps us be a more humble and grateful when the thing is restored.
The impact of a person’s birth order is often underestimated as a significant factor in identity formation. The environment at home impacts on child development and birth order can influence how a child is treated by parents and siblings.
Our birth order impacts how we are perceived by our families and can relate to the amount of responsibility, independence and support we are given as children.
Birth order can also change the way parents raise their children. In most cases parents develop skills over time. The first-born child may be raised in an environment of anxiety if parents are unsure of their new role. This can result in more anxious first-born children. As parents become increasingly comfortable with raising children, they will typically given their second or third born child more freedom to explore etc.”
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“Ideally, children should be raised as individuals. Parents should do their best not to discriminate between children. Making comparisons between siblings is dangerous as this can promote competition” says Kimberley O’Brien, Child Psychologist at the Quirky Kid Clinic.
However, the effects of birth order on a child’s personality may diminish over time. “As we mature we are less affected by the behaviour of our parents and our initial family unit” says Kimberley. While parenting effects diminish as children progress into adulthood, maternal bonds may differ according to birth order. One study of 426 mothers relationships’ with their adult children revealed a deeper emotional connection with their youngest child, yet they would be more likely to contact their oldest-born child when facing personal crises. (Suitor & Pillemer, 2007).
In general, first-born children are typically independent, trailblazers, with the propensity to be anxious or dominant. They have also been shown to be higher achievers, more conscientious and more patient. Second-born siblings are more open to new experiences and demonstrate more rebellious tendencies (Healey & Ellis, 2007).
The ‘middle child syndrome’ is popularly characterised by children who might be lacking in identity, trying to please others with no defined goals or vying for attention from their older and younger siblings. However there is little truth to this idiom, in Kimberley’s opinion. “Middle children can be influenced by their elder siblings, and have increased social opportunities with younger and elder peers.” One study of 794 adult middle-borns revealed no reduction in relationship quality with their family members. They did not preference friendships over family relationships any more than other birth orders (Pollet & Nettle, 2009).
Children born last in line typically gain more attention within the family, however they may display more immature and dependent characteristics than their elder siblings. On a positive note, they have been shown to be more agreeable and warm (Saroglou & Flasse, 2003). Interestingly, one study of 700 brothers found the younger brothers were 1.48 times more likely to participate in high-risk activities (Sulloway & Zweigenhaft, 2010). Another study revealed an interesting dissociation: boys with older siblings were more likely to engage in sports like football, whilst girls with older siblings were less likely to participate in extracurricular activities such as community service and school bands (Rees et al., 2008).
Only children can be easily dismissed as spoilt or lacking social skills, however their access to more resources and more parental attention certainly benefit their development.
The literature is divided as to whether birth order significantly impacts a child’s IQ, however one recent study revealed there are approximately 3 IQ points, or, a fifth of a standard deviation between first-borns and second-borns (Black et al., 2011). The discrepancy is not biologically determined, but more a result of birth endowments, allocated resources and the independent personality traits commonly associated with eldest children. These birth order effects are slightly more pronounced for girls (Kristensen & Bjerkedal, 2010). The same effects were found in a study of 2,500 adolescents in a child and adolescent psychiatry clinic (Kirkcaldy, Furnham & Siefen, 2009).
There have been theories that birth order can influence your choice of potential romantic partners. “Couples may be able to more easily relate to each other if they have the same birth order, such as two first borns may be comfortable with independence and increased responsibility. They may also have experience caring for younger siblings,” says Kimberley.
While there are documented effects of birth order on factors such as personality, risk-taking and academic performance, parents would do well to ensure each child is given equal attention, nurture and resources.
Black, S. E., Devereux, P. J., Salvanes, K. G. (2011). Older and wiser? Birth order and IQ of young men. CESifo Economic Studies, 57(1), 103-120.
Healey, M. D. & Ellis, B. J. (2007). Birth order, conscientiousness and openness to experience: Tests of the family-niche model of personality using a within-family methodology. Evolution and Human Behaviour, 28(1), 55-59.
Kirkcaldy, B., Furnham, A. & Siefen, G. (2009). Intelligence and birth order among children and adolescents in psychiatric care. School Psychology International, 30(1), 43-55.
Kristensen, P. & Bjerkedal, T. (2010). Educational attainment of 25 year old Norweigans according to birth order and gender. Intelligence, 38(1), 123-136.
Pollet, T. V. & Nettle, D. (2009). Birth order and adult family relationships: Firstborns have better sibling relationships than laterborns. Journal of Social and Personal Relationships. 26(8). 1029-1046.
Rees, D I., Lopez, E., Averett, S. L., Argys, L. M. (2008). Birth order and participation in school sports and other extracurricular activities. Economics of Education Review, 27(3), 354-362.
Saroglou, V. & Flasse, L. (2003). Birth order, personality and religion: a study among young adults from a three-sibling family. Personality and Individual Differences, 35(1), 19-29.
Sulloway, F. J. & Zweigenhaft, R. L. (2010). Birth order and risk taking in athletics: a meta-analysis and study of major league baseball. Personality and Social Psychology Review, 14(4), 402-416.
Suitor, J. J. & Pillemer, K. (2007). Mother’s favouritism in later life: The role of children’s birth order. Research on Aging, 29(1), 32-55.
We are proud to announce the publication of Kimberley O’Brien and Jane Mosco’s book chapter on Positive Parent-Child Relationships by Springer press. The book, Positive Relationships, was compiled by Dr. Sue Roffey.
Kimberley is our Principal Child Psychologist.
This highly accessible book takes a positive psychology approach to explore why healthy relationships are important for resilience, mental health and peaceful communities, how people learn relationships and what helps in developing the positive.
The abstract is as follow:
Practitioners working in child and family psychology typically hear about the challenges of problematic parent–child relationships. A positive psychology approach, however, identifies what is effective in fostering family resilience and facilitating optimal parent–child relationships (Suldo SM, Parent-Child Relationships. In Gilman R, Huebner ES, and Furlong MJ (eds) Handbook of positive psychology in schools. Routledge, New York, 2009).
Drawing on this perspective, this chapter summarises the literature, exploring different parenting styles and effective parenting strategies. We also outline changes in the parent–child relationship from birth through infancy, childhood, adolescence and early adulthood. We also consider the impact of alternative carers and cultural diversity with reference to mutually rewarding parent–child connections and increased child well-being.