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Oppositional Defiant Disorder
WHAT YOU SHOULD
KNOW
A child who routinely and persistently argues and refuses
to follow rules can be said to have "oppositional defiant
disorder." Because such children anger so easily, they have
trouble getting along with family, friends, schoolmates, and
teachers. They may also have learning difficulties and may have
trouble expressing themselves.
The disorder is found in children ages 3 to 18 years.
Before the teenage years, it affects more boys than
girls.
Causes
Doctors do not know the cause of oppositional defiant
disorder. The problem seems to be more common among children
who have other emotional problems and in those whose parents
have serious marital problems.
Signs/Symptoms
Symptoms may first show up in the home. Later, children
exhibit defiant behavior in other places. A child who displays
the following symptoms for more than 6 months is considered a
victim of the disorder:
-
A tendency to argue at every
opportunity
-
Refusal to follow adult
requests and rules
-
Anger
-
Loss of temper
-
Stubbornness
-
Annoyance with others for no
apparent reason
-
Deliberate attempts to
aggravate others
-
Swearing at or blaming
others
-
Hostility
-
A low tolerance for
frustration
Because of these traits, the child may be considered a
bully by his peers. During the school years, the youngster may
have poor self-esteem. Alcohol, cigarettes, or street drugs may
also become a problem.
Care
The usual approach to this problem is counseling for both
child and family, with an emphasis on ways to cope with such
behavior. If a child becomes dangerous, hospitalization may be
necessary.
IF YOU'RE HEADING FOR THE
HOSPITAL...
What to Expect While You're
There
A severe case of this disorder can require either
full-time hospitalization in a locked inpatient unit, or a
partial care program in which the child is able to return home
after each day's treatment. Inpatients may wear their own
clothes, but are customarily searched for sharp objects such as
scissors or nail files, which are held in a staff office.
Patients who present a danger outside the hospital can be
involuntarily hospitalized for up to 3 days by the police or a
doctor. During hospitalization, you may encounter the following
procedures.
-
Group Therapy: These meetings are somewhat like a
support group session, allowing patients to share coping
experience. The meetings are run by medical
staff.
-
Individual Therapy: This is a time for the child to
meet alone with a therapist to discuss ways of dealing with
the illness.
-
Family Meetings: In these sessions, medical staff
will prepare you and your family for the child's return
home.
-
Time Out: If the child becomes unable to control
himself, the staff may separate him from the other
patients, either in his own room or---if he seems
violent---in a "safety room."
-
Restraints: Patients who pose a danger to themselves
or others may be physically restrained with leather
bands.
WHAT YOU SHOULD
DO
-
Make sure that the child
takes any prescribed medication regularly. Check with your
doctor before giving any other drugs, either prescription
or over-the counter.
-
Make it a point to praise and
reward the child for doing well.
-
Set clear rules about
behavior at home and at school. Make sure the youngster
understands exactly what will happen if the rules are
broken. One effective punishment is taking away something
enjoyable, such as TV privileges.
-
Call a time-out when the
youngster gets out of control at home. After he or she
calms down, talk about what happened.
-
Explain the disorder to the
child's teachers and anyone else who deals with the
youngster regularly.
-
Set aside a time each month
for family members to discuss the situation and assess how
things are going.
-
Plenty of exercise and active
playtime can help. Encourage it.
-
Regular sleep is also very
important. If the youngster can't sleep, let your doctor
know.
-
Accepting this disorder may
be difficult, even though it provides an explanation of the
youngster's behavioral problems. Don't hesitate to express
your feeling to doctors, family, and friends. Joining a
support group can also help.
Call Your Doctor
If...
-
The child can't sleep, or
sleeps too much.
-
The child gets out of control
and becomes destructive.
-
You feel you can't cope with
the situation.
Seek Care Immediately
If...
-
The child threatens to hurt
himself or others.
-
You fear you're going to lose
control and hurt the child.
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