Oppositional Defiant Disorder: The War at Home

This diet has helped people with ADHD, Oppositional Defiant Disorder, and Autism

Here is what parents are saying about “The Autism and ADHD Diet“, which many parents have found useful to use as an Oppositional Defiant Disorder Diet as well:

I read this book in a couple of hours. Once I started,is was like a great mystery, I couldn’t wait til the next chapter. Ms. Silberberg has written a touching, funny and realistic guide that anybody can use and understand. Not only does she give you lists of items you can purchase but she also gives you detailed information about where to find these items. And if that isn’t enough, she has even given us recipes.

I wish I hadthis book when we first changed our diet! Barrie does an amazing job of explaining a sometimes complicated subject in understandable terminology. (For example, she walks the reader through the basics of label reading which for most people can be overwhelming in the beginning). I can’t recommend this book enough!

This is a wonderful book if you are starting the diet and don’t know where to begin. That is my family – we have struggled for years with my son’s autism and ADHD and finally committed to the diet. I purchased this book and never looked back. Barrie has listed many great resources and helps “non-cooks” like me navigate this new world. I have several other Autism and Diet books – and this is the one that is dog eared and used the most. Well worth the time and $$$. Barrie – please keep this book updated with frequent editions!

When Hunter was a baby, Pat never imagined parenting him would mean becoming trapped in an argument that would last 15 years. From the time he was old enough to express himself, it seemed that he was looking for a fight with her.

“He’s a very strong-willed person,” says Pat, her polite demeanor belying an obvious understatement. “He’s manipulative, and he learned at a very young age how to make that work for him to get what he wanted.”

“The simplest things always seem to turn into huge problems because Hunter simply refuses to do what he is asked to do, whether it was brushing his teeth at age five, or raking the yard at age 15. The word ‘no’ lights his fuse, especially when in response to something he wants to do. He’s always doing these irritating things,” Pat explains, “as if he enjoys bothering you.”

Getting out of bed in the morning is the issue around which Hunter and his parents argue the most. “We’ve had the worst time in the world getting him up in the morning and into the shower. I know this is unbelievable, but he gets in the shower, stretches out in the bottom of the tub with the water beating on him, and goes back to sleep. From that moment on, we have to micromanage his morning to get him to the bus stop.”

Recently, Hunter was diagnosed with Oppositional Defiant Disorder, and Pat finally has a name for the behavior that’s been exhausting her all these years. Now, she needs a solution. How does a parent stop the arguments with a child whose primary way of communicating is arguing?

James Lehman:
A day with a child who has Oppositional Defiant Disorder is a series of battles in an undeclared war. It starts when they wake up, continues at breakfast, intensifies when they have to get dressed, and doesn’t end until they fight with you over bedtime.

Kids with ODD lose their temper quickly and often. They’re easily annoyed and frustrated by other people, resentful and hostile with adults, bossy and pushy with other kids. They blame everyone else for their difficulties and make excuses for their inability to cope. They gravitate toward negative peers and tend to be sulking, angry adolescents.

Unrestricted free time is a breeding ground for aggressive behavior for these children. In an unstructured environment, they become annoying, threatening or destructive to kids around them and to adult authority figures. They will use this time to deliberately antagonize anyone they see as “in charge.”

As a parent, you can’t satisfy a child with ODD, since their thinking is irrational. They clamor for your attention and then tell you to leave them alone. The sad truth is, kids with ODD aren’t very likeable. Parents often feel guilty about the fact that they love their kids, but don’t like being around them.

Parents get blamed for their child’s oppositional behavior and tend to heap even more blame on themselves. The parent of a child with ODD often feels incompetent and isolated. They live with the self-imposed shame that other people think they’re bad parents, and that humiliation grows larger as their world gets smaller. Left untreated, Oppositional Defiant Disorder can lead to Conduct Disorder, a more serious pathology that is a precursor for anti-social behavior and criminality.

Of course, for many parents, ODD is not the primary issue. Rather, they are dealing with continuous, low-level defiance that is not incendiary and aggressive, but is aggravating, annoying and disruptive to the family. Whether the defiance has turned into a diagnosis of ODD or has not, the parent’s approach should be the same.

How to Stop the War and Restore Peace at Home

Most parents lack the tools to deal with oppositional defiance. So they generally respond to this behavior with a range of responses that includes negotiating, bargaining, giving in, threatening and screaming. The problem is when you scream, argue or negotiate, you are giving your child’s defiance even more power.

Everyone from the school psychologist to your mother-in-law will tell you what this child needs is “structure.” But no one really shows you what kind of structure and how to put it in place. It’s not as simple as giving the child a time out. A child with ODD won’t use the time out to change his thinking. He’ll use it to plot revenge. Parents need to change their parenting style and method of operation with the child.

* Children with ODD need structure with an aggressive training component that is built around learning how solve the problems that trigger their defiant behaviors. Your child becomes oppositional when he is confronted with a problem and he can’t figure out how to fix it. The problem can be anything from not wanting to get up in the morning (as in Hunter’s case) to not wanting to do homework. Screaming at the child to get out of bed won’t work. You need to show the child that he has a problem that has to be solved and address it as such. Example: “Lying in bed after your alarm goes off won’t solve your problem. It makes you late and you miss the bus. What can you do to solve your problem?”

* The focus of treatment should be on developing compliance and coping skills, not primarily on self-esteem or personality. ODD is not a self-esteem issue; it’s a problem solving issue. There’s no evidence that self-esteem leads to compliance, and emotions are not, in and of themselves, a way to kids to cope with their problems. Kids get self-esteem by doing things that are hard for them. Children with ODD need a lot of strong praise and support as well as realistic rewards. They don’t benefit from a pat on the back for doing something that’s easy for them to do. They should be praised for doing things that are challenging to them. Don’t create false situations for which to praise them to make them “feel better.” Parents need to learn several different parenting styles that meet the needs of this child. You need to be less of a “cheerleader” and more of a trainer and coach.

* Avoid senseless power struggles. Pick your battles with your child carefully and win the ones you pick. Many times you can win fights with this child by not arguing back. When you argue, his resistance gets stronger. Instead of arguing, set limits in a businesslike way and expect compliance.

* Have a plan for managing your child’s behavior. When you’re going to the mall, know what you’ll do when he acts out in the car. It’s important to lay out the rules ahead of time, when things are calm. For instance, before you go to the mall, tell the child, “When you lose it in the car, it becomes dangerous for me and for everyone because it’s distracting. So if you lose it in the car, I’m going to pull over for five minutes, and I’m not going to talk to you. You’ll have five minutes to get your act together. If, after five minutes, you have not regained control of yourself, then we’re not going to the mall. We’re going to turn around and go home.

* Have a plan you’ll use if he throws a tantrum in the store or if he acts out at a family gathering. And be willing to follow through on the plan until the child learns defiance doesn’t get him what he wants.

Parents dealing with ODD need a powerful mix of determination and strength. You can have a child with ODD and a peaceful home. The key is to decide: Are you going to change the world for your child or teach him to cope with it? It’s not practical or effective to try to change the world for your kid. But by setting limits consistently, concisely and clearly, you will teach your child to cope with the world and succeed in it.

James Lehman is a behavioral therapist and the creator of The Total Transformation Program for parents. He has worked with troubled children and teens for three decades. James holds a Masters Degree in Social Work from Boston University. For more information, visit www.thetotaltransformation.com.

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Comments

  1. I don’t think my kids have ODD per se, but there is one sentence here that really struck me:

    Unrestricted free time is a breeding ground for aggressive behavior for these children.

    Bingo! Whenever my kids have a big block of time with nothing specific to do, that’s when they start fighting and teasing each other.

    I have a home business and lots on my plate, but I really see now that it is my responsibility to try to eliminate endless hours of unstructured time.

    Thank you,

    Jane B.

    • But how ? How do you fill hours of structured time for a four year old ? I have five children ages 19, 15, 13 , 7 and 4 ( three of the five have odd ) . I am a stay at home mother , but now feel totally inadequate, frustrated , bored, and isolated. I have no clue how to accomplish all that I need to accomplish.

  2. Wow – I never even considered that this is what I am dealing with in my 10 year old daughter. I didn’t realize there was a name for it, I just thought she was strong willed and that I was just weak and lacked tools for dealing with her. We have been battling with her since she was 5 years old. This was a huge eye opener Thanks

  3. My 5 year old adopted son has been in the hospital since Monday for a psych eval because of this very behavior. I had never heard of ODD until recently, and it fits him to a tee. I’ve had to pull him out of 4K because of his daily and continual tantruming at school, which included hitting and kicking other children and his teachers. I will be reading alot more on this subject. Thank you for your suggestions.

  4. Hurray! This is what I’m going through with one of my twins. It’s like something clicked on in him when he turned 5 in July. EVERYTHING is an argument, even things he liked to do. He’ll change his mind just so he can argue with me. There’s a name for it and ways to cope. Thank you. What we’ve been doing hasn’t been working and these past few months have been torture.

  5. Tara Willoughby says:

    Thanks again Ellen for shedding light on a topic that hits home, literally and figuratively.
    My eldest of three boys could be dubbed as a ‘boy’, hitting arguing, strong headed, etc. but shows many more of these traits, few friends and even less real friends, explosive aggression to his brothers, thinks people don’t like him… I took him into to have ADD testing, not for disruptive in class behavior but because I have a mild case, and since he struggles with school I thought I would get him tested and start work on learning skills, well he doesn’t have ADD but ODD, the only thing the doctor would offer to us was to pull my son out of his french immersion school and then she will see us, this was after I told her I wanted him to learning coping strategies. Thank you for shedding some light on this topic, I can see my brother in this too.

  6. My son was diagnosed with ODD in K4. It was both a relief to get the diagnosis and a frustration. It seemed a bit of a validation for what a nightmare and struggle the last 5 years had been with him, but I also felt a lot of guilt that it was because of my parenting. He is now in 1st grade and so far seems to be doing great! Every day is still a struggle, and I am still looking for the “right” way to deal with him, but I am finally feeling some hope and moments of calm in my day. There don’t seem to be many resources. Anyone know of any good ones?

  7. Everyone should be aware that Asperger’s Syndrome is quite often miss diagnosed with Bipolar and Oppositional Defiant.
    It seems when children with Asperger’s or high functioning autism are mis-diagnosed for years and do not get the proper training and support they can learn to act “Oppositional Defiant”. Their frustration of having to put up with parents and teachers, who do not understand that they just have trouble transistioning and find changes in routine brings a high level of anxiety, can lead to all sorts of difficult behaviors.

    If your child is having these kinds of issues, don’t assume that it is ODD. You could be missing the big picture. If you want your child to grow up to be a successful individual, you have got to get the correct diagnosis.

    You must have them tested by an expert in Aspergers, as it is not easily identified in every case.
    No matter the diagnosis, Applied Behavioral Analysis (ABA) is scientifically proven to work. Seek a professional Board Certified Behavioral Anaylst (BCBA) for more information.

    I learned just a couple of techniques from the ABA method and I have been able to raise a son with Aspergers, care for an elderly woman with Alzheimers Disease, and work as a cashier at Wal-Mart. The concept of ABA works on every child, even those without challenging disorders.(It can even work on your spouse or mother-in-law!)Check it out.

  8. My son was exactly like this until… we started to (I don’t know the English word for this) we started to undo the negative effects of vaccination with a homeopathic treatment. We really have a different and lot happier boy in the house. We have to get used to this, he even listens to us, very strange if you are used to something else. So please, try this out, it makes such a lot of difference in our and his life. I never really believed it could work, but it did.

    • Hi Jouke,
      Can you reply with what you call the name of it? I really want more information on this. Thanks!

      • Ellen K says:

        Jessica,
        This may come a little late, but I believe what Jouke is talking about is chelation therapy. This can be done in various ways and removes the heavy metals and other toxins from the body.

  9. There is an underdiagnosed pervasive developmental disorder called Pathological Demand Avoidance Syndrome. Many of these children would otherwise be treated as having an ASD and many of the strategies for ASD are directly counterproductive in PDA eg ‘structure’ and ‘routine’ and ‘direct language’. I have found that thinking of the meltdowns as a kind of panic attack is very helpful.

  10. This is really interesting. my son, who is now 31, was diagnosed with ADHD, but becuase of his ability to concentrate for long periods of time, I never really believed he was ‘hyperactive’. The outbursts and power struggles made raising him an absolute nightmare. Every time I thought we’d turned a corner, his non-compliance exacerbated. He cheeked his medication, and simply refused to let me parent him. Family members told me I spoiled him or mentioned my poor parenting skills at every opportunity. Until my son reached high school, I was totally blamed for his behavior. It was beyond heartbreaking, and in those days, there was little support available. Today his life is still pretty rocky, but he is not willing or able to adapt his behavior. While he did learn some valuable coping mechanisms, inaccuarte diagnosis and too short of inpatient treatment were just not enough for my son to develop his full potential. He has an incredible amount of intelligence, but has missed many opportunities due to his behavior. My heart goes out to all of you parents that are dealing with behavior issues, and it is heartwarming to know there is much better understanding and support available today. It does get better eventually, so never give up!

  11. We adopted Jordan at age six. He was diagnosed as ODD within a year. Medication worked for us because he was ADD as well. It seemed that when we could help the ADD, he was able to respond to the environment structure. Today he is twelve and makes the A honor roll. Do we have rough moments? Yes but we can handle them better by going back and remember this is like a panic attack for him. Also, when he saw we were working hard too, it struck a chord with him and he tried harder.

  12. Elena - Romania says:

    I’ve read the article and thought it would have helped me a lot had I read it when my own kids were little.
    How early can such a disorder be diagnosed?

  13. We are still struggling to find the right way to parent our 17-year-old son. His therapist recommended a boo, The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated and Chronically Inflexible Children by Ross W. Greene. I’m still reading it, but it’s like watching a scene from our family.

  14. I am a counselor and have worked with children who have been diagnosed with ODD for 13 years. I caution parents to be very careful with this diagnosis. Sometimes fractured parenting styles promote ODD like behaviors. We have all seen Nanny 911 right? Are all of those kids ODD?

    A proper diagnosis comes from extensive testing by doctors who are trained. The behaviors of children with ODD are often repelling, but they are desperately in need of love they find hard to get. Patience, empathy, love and understanding are vital to their development.

  15. Yes, I have a 10 y.o. son with this. He also has a PDD-NOS and depressive/mood disorder not otherwise specified. It’s been a nightmare.

    EVERY thing can be a fight with him. I would really like to get this program so I can learn how to change in EFFECTIVE ways before it’s too late. I am so thankful I am only dealing with this in one of my six children, and I worry that a bad influence lives under my own roof for the other children.

  16. I just saw another post up above and wanted to agree. My son was diagnosed first with Bipolar I at the age of six!!!! Now he is dx with PDD-NOS (autism spectrum) and depressive/mood disorder NOS.

    I would be very careful if someone attempts to label your child Bipolar. Mine was up all night, only slept 5 hours, raged, terrible mood swings–very swift from the best day of his life because of icecream dripping down his arm creating a “tatto” to trying to kill his father in an hour and a halfs time. It definitely seemed to fit the bill at the time.

    ALSO, I think the ADD meds he had tried for awhile really started all of this. He had many issues before these meds, which is why he was on them, but the rages toward others started after those meds. Too bad he was on them for awhile before we realized it could be them.

  17. My son is strong willed, thru a lot of hard work with the parent of an older strong willed child and books, I have been able to have a normal raltionship with my son and he no longer disrupts or exhausts us as parents. I HIGHLY suggest two books. “the strong willed child” James Dobson.The second which I read in one day,gave me
    understanding to how he thinks,
    It is by Cynthia Tobias called “You can’t make me,
    but I can be persuaded” awesome,awesome,awesome.
    With the right tools you can turn them around, never stop looking for them.

  18. Another book that might be helpful for challenging children is Transforming the Difficult Child, the Nurtured Heart Approach. It outlines a structured behavior and reward system. It’s also known as Energy Parenting, as it teaches children to get your positive energy rather than your negative energy. The author is Howard Glasser. It was a godsend for us when my son was 5 and out of control. He is 10 now and truly transformed. He wants to please and be helpful rather than defiant.

  19. Please be careful of the ODD diagnosis. As a psychologist who has worked with children and teens with aggressive, acting out behavior, some who committed violent crimes I find ODD a “catch all” diagnosis that does not help anyone find a source of anger, nor an appropriate treatment. ODD is not a biologically based (brain based) diagnosis. I feel it primarily exists for doctors and psycholgists to give aggressive/acting out behavior a name, when they can’t think of anything else to call it.
    Like others have stated here, ODD behaviors can have many sources–autism spectrum, mood disorders, family dynamics, parenting styles, food allergies, and yes, temperment. The best way to treat a child with an ODD presentation is to get a thorough psychological and neuropsychological evaluation by someone who specializes in working with and diagnosing children and teens. Do not accept a diagnosis of ODD without further investigation of an underlying cause. I know of NO child who acts out, argues, or tantrums due to “only” ODD. ONce you understand the underlying cause, then you can target treatment to really help your child manage their feelings and behaviors.
    Susan Giurleo, PhD
    http://www.childdevelopmentpartners.com

  20. Check out artofliving.org A nonprofit amazing group of trained volunteers who teach the art of destressing through breathing, meditation and yoga. It truly is easier done than said. It is geared for both Adults and Children. Not the norm for us Westerners and I was amazed to learn how many Drs. and PhDs have taken and prescribe this course.

  21. I have been receiving this newsletter for the last year or so. This is the first time I feel compelled to respond. I am the step father of an 11 year old boy who has been what I describe as ‘terrorizing’ his mother since he was about 5. Everything in the description of ODD fits with his behaivior. But I also see the wisdom of very careful diagnosis. From the moment he wakes up til the moment he goes to sleep is one fight after the other about everything. Very often escalating to violence. It rarely overflows onto me and I only get involved when he becomes violent to his mother. When he is alone with me he is obediant and we rarely ever fight or argue about anything. Baby-sitters and family members describe him as a perfect gentleman. School problems are often but limited to recess times and after school care. Can this disorder be so easily ‘turned on’ and ‘turned off’ like this?

  22. A lot of they symptoms discribed for ODD can be applied to my 8 yr old son though not all of them. I wondering if this type of behavior is hereditary or environmental? My son’s father is extremely hotheaded and would break down in temper tantrums at a drop of a hat. We divorced because of this. When I watch my son with his father he behaves the same way and his father doesn’t try to disipline him whereas I would of immediately. This child is a very sweet & loving child but when he goes off there is no reasoning w/ him and he always has to have the last word. I’ve taken to sending him to his room and ignoring him when he misbehaves and this seems to work better than previous disaplines but he just refuses to get the message. The child cannot keep his mouth shut and it gets him into lots of trouble. I’ve read many books about his behavior and tried many methods but to no avail. The child everybody used to love and enjoy no one wants to be around anylonger. I would love to try the Total Transformation Program but the cost is too much for a single mom. Could you possibly publish some more in depth advice and methods for dealing w/ a child like this from the TTP?

  23. This is the personification of my son. Mornings are getting a bit better, mostly because we choose to limit our communication.

    We tried to set “rules” for the house – the structure of which you speak. That lasted about three days then the negotiating began.

    I understand the need to avoid argument because he is so reactive, but how do I tell my husband to just ignore it when a 10 year old tells him to F*** off or S*** his D***?

    We do love him so much, but we are just exhausted. I don’t know how to get across the idea of being respectful. We do our very best to be good role models, but we have our limits.

  24. You might try this website…

    http://www.docspeak.com/ODD/index.htm

    I found his website very informative and I bought 65 copies of his book – as a Teacher Appreciation Gift for the teachers in the school at which I was the PTA President.

    or

    Is Your Child Too Defiant?
    Carolyn Jabs

    This article appeared in the March, 1999 issue of WorkingMother magazine

  25. I have a daughter who may or may not have ODD, but she is a close fit. She is now 11 and has been fighting me since she was a toddler. I often say that she is programed to do exactly to opposite of what I tell her to do. My most difficult problem is the “natural consequences” that end up effecting her siblings.

    My son has Asperger’s, for example I prepare him to drive to town to go to the mall (he is usually fine if he knows what to expect) and my younger daughter is well behaved and goes along with anything. The defiant daughter will purposely ruin a trip if she decides she doesn’t want to go. Or if I say “We won’t go to town if you don’t behave” then I end up punishing her siblings. I am effectively a single mom because my husband frequently is working out of state so I can’t leave the misbehaving child home with him. The one time I left my 11 year old home alone for an hour I smelled sulfer when I got home because she was lighting matches, so leaving her home isn’t an option.

    How can I punish her without punishing her siblings too?

    Joy