Looking for information on how to deal with ODD kids

November 7, 2008 6:38 AM

A friend of mine has a fifteen-year-old daughter who was recently diagnosed with Oppositional Defiance Disorder (ODD). I'm looking for information and resources on parenting ODD-diagnosed/defiant and volatile kids to pass along to my friend: web sites, internet support groups, names of books to read, tips, insights and recommendations derived from personal experience, whatever you have that you think would be helpful. Thanks!
posted by orange swan to human relations (17 comments total)

Oh, and if you have a story or information that you think might be helpful but feel it's too personal to post in this thread, please MeMail me. No one but me and my friend will ever see it.
posted by orange swan at 6:54 AM on November 7, 2008

Speaking as a former teenaged rebel like 99% of other teenagers, the parent probably doesn't have to do anything special. Therapy is not necessary and I'm even surprised that a diagnosis is necessary. Teenagers rebel - it's a fact of life since Cain killed Abel.

Give the kid some space but also stay involved in their life. Don't let them become a loner. Keep them involved in group activities. Trust that the training and examples that you have set will make a difference when they get through this phase in their life. Do not listen to a doctor that says that the kid needs medication to solve their behavioral problems! While therapy may be needed in extreme cases, kids will survive and grow up without it.
posted by JJ86 at 7:01 AM on November 7, 2008

ODD sounds made-up, geared toward those camps in the back of Sunset Magazine (Provo Canyon School, etc.). From personal experience though, I'll second JJ86 and add only that if the parent(s) wish to make the situation worse that they should use the diagnosis as an excuse not to engage with their kid, to treat it as a "phase" rather than an honest expression of identity. We can't tell what degree of "opposition" or "defiance" is involved here, but I have seen parents get all up in arms over their teenager wearing jeans with holes in them. Just sayin'.
posted by rhizome at 7:47 AM on November 7, 2008

A book called Parenting Teens With Love & Logic is a good book in that it provides a playbook for the parents: scenarios and examples that can actually be used in your own home.

(Although I'm pretty sure the behaviors that a doctor is calling "Oppositional Defiance Disorder," the Love & Logic authors just consider "normal teenage behavior." So there aren't any specific references to that diagnosis. But there are plenty of scenarios offered for tantrums, disruptive behavior, rebellion, etc.)
posted by pineapple at 8:03 AM on November 7, 2008

i'm gonna jump on the 'how could they tell?' bandwagon here. my 16 year old son received this diagnosis when he was in first grade. having a 7 year old act like a teenager was a clear cut problem. i don't see how this would be easy to see in a 15 year old, though. sounds like the parents need a second opinion. i would also guess that the odd diagnosis came along with a bi polar diagnosis or add/adhd diagnosis.

as for advice: try more individual things vs. group things--my son did well in tae kwon do, but not so much soccer. don't force groups on her, that'll just make her hate things more. as for meds, if the second opinion (or even third) are all saying the same thing, then meds would be a possibility.
posted by lester at 8:08 AM on November 7, 2008 [1 favorite]

You might want to hit the library and find something by Russell Barkley. "The Defiant Teen" if you can find it, otherwise he's written about younger children as well, and those books may be more easily found. Obviously, the doctor who made the diagnosis would probably be happy to make recommendations.

I'd recommend Jon Kabat-Zinn's mindfulness books/CDs for the parent(s), but I would pretty much recommend those to anyone going through a stressful period.

Arguing whether ODD is "made-up" is really unhelpful. "Disorder" implies that there is a great disruption in day-to-day life. Not, "Mom I hate you because you didn't let me go out on Thursday night."
posted by giraffe at 8:08 AM on November 7, 2008 [1 favorite]

From knowing a couple of teenagers who either did get this diagnosis or would have, had it been around at the time, I advise this:

Avoid panic. Panic is what convinces you to ship your kid off to unlicensed boot camp in Mexico. Panic makes you second-guess your own intuition as a parent and start thinking you need the police for non-emergency scenarios.

While a kid is going out of control, it's important for the sanity of the parent that the parent stay rational and control and not-volatile. To do this, parents need a support system in this situation as much as the kid does. A support group, an online group, a way to blow off steam, therapy, maybe all of the above when tension is high.
posted by desuetude at 8:19 AM on November 7, 2008 [1 favorite]

This has nothing to do with ODD. Rather, Howard Glasser wrote a book and has a DVD of a seminar called Transforming the Difficult Child which is a general approach to parenting and discipline. It is specifically geared towards ADHD, but we are using the approach for our 5 year old daughter with Down syndrome. We watched all 6 hours of the DVD (which quite honestly could've been summed up in an hour at most) and have found that it worked very well for her. Glasser claims that it works for children of *all* ages inlcuding teens, but I question the effectiveness with someone who can reason more than a young child.

The approach in a nutshell is to start by bombarding the child with attention, beginning simply with noticing what they're doing (no praise - you merely are saying what they're doing, which is inarguable). After they're used to that, you layer on what they're not doing (ie, "You got angry and calmed down. You yell or run away and you didn't slam the door."). Then comes the honest praise for what they're doing which usually comes as a label ("You wrote a thank you letter for Aunt Hortense's gift. You're very polite."). I think he uses the phrase, "accusing them of success."

Finally, time-outs (and don't ask me how this will work for a teen, but he claims they will), which are supposed to be given as emotionlessly as possible with huge low-effort for giving and as well as for taking. His phraseology is "Oops. Timeout." He recommends 15 second time outs and likens the process to if you were driving to work and every time you speed a friendly cop pulls you over and writes you a two dollar ticket and says thank you when he's done. The idea is that you don't give any emotional energy at all to the child for a time out, you break their momentum, and give them a quick thank you when they're done for taking the time out nicely. There's no argument about the time out (allegedly) because you've been spelling out "the rules" for some time by telling the child what they're not doing. His claim is that for older kids you can tie the time out to a larger reward system so if you get a refusal to take the time out, the response is "ok, you don't need to take the time out now, but you don't get <insert reward> until you do. You can take your time out when you want." (again, no strong emotion - you don't want to reward for this - all your reward goes in to bombardment of praise).
posted by plinth at 8:31 AM on November 7, 2008

I don't want to give details about my friend's daughter's behaviour. Suffice it to say that her problem behaviour is not to be classed with "the girl got mad because she wasn't allowed to go out somewhere on a school night", let alone "my friend wants to stop her daughter from wearing ratty jeans."

And yes, as giraffe says, I'm not looking to be told ODD doesn't exist because, regardless of whether it does or not, that's not going to help my friend with her daughter. If you don't believe in ODD, stick to providing advice that will be of use to parents who are trying to cope with dangerously rebellious teenagers.
posted by orange swan at 8:35 AM on November 7, 2008

You (she) might want to check out some books on autism, ADHD, Asperger's syndrome and Autistic Spectrum Disorder because those conditions all have issues that are basically what ODD is. IMO ODD (which isn't real in the sense that it's not in the DSM) isn't about defiance but about kids whose brains work in very different ways from the neuro-typical brain and who have a lot of difficulty in making changes/transitions. Some psychologists put ODD into the autistic spectrum.

Do you know if this was a diagnosis from a private doctor or from CAMH? I would be surprised if CAMH issued a formal ODD diagnosis, again because it's not recognized by the DSM.
posted by GuyZero at 9:58 AM on November 7, 2008

Torina at Busy Intersection has a daughter who has ODD (along with other physical and neurological issues). With her daughter it's clear that she's not dealing with just stubborn defiance but a compulsion to do the opposite of what's asked even when it goes against her interests.

Her solution is often to ask her daughter to do the opposite of what's needed; if her daughter is refusing (again) to brush her hair, Torina will tell her how much she wants her to go to school with unbrushed hair, and suddenly her daughter is "defiantly" brushing her hair. There are many other factors at work with her daughter so this might not necessarily work with a kid who only has ODD.

In any case, I'm sure Torina would be able to supply additional information about how she deals with it or where she finds resources and information.
posted by stefanie at 10:13 AM on November 7, 2008

I would advise her to look into family systems therapy. I do not have ODD, I have bipolar II, but it helped my partner and I immensely, as well as cousin and his immediate family.

My partner got a support system, access to a psychiatrist, and treatment for the mild depression that was noticed by the family therapist. He also got a lot more confidence and was able to set boundaries and feel like he could handle the relationship.

I got more support from him, and a lot more understanding and accommodation--he changed his expectations to fit the reality because he was much more educated about what he could do, what I could do, and what we needed to let go.

Obviously, in a parent-child relationship the dynamic is different, but I would still recommend it wholeheartedly.

I would also suggest that your friend's daughter be evaluated by a second psychologist or psychiatrist. By no means am I trying to minimize her diagnosis--rather, it's a complex condition and I think it would be worthwhile to have someone else take a look at it.

Especially if she has not been seen by a psychiatrist (MD), she should be. My cousin was originally diagnosed with ODD but he got another diagnosis, of Bipolar I, and after he was on proper meds for that it was like night and day. They still needed to work on a lot of things (which is where talk therapy and family therapy come in) but the diagnosis made all the difference.

Respite care can be a godsend, your local social services/family services agency might be able to provide information about it. Your friend needs time away from her daughter so she doesn't collapse. My cousin went to a sort of group home one weekend a month. It was really nice for his family to have time to decompress without constantly waiting for the next time bomb.

It is kind of you to ask this for your friend, and I wish you, your friend, and her daughter the best of luck.
posted by sondrialiac at 11:56 AM on November 7, 2008

Okay, as a graduate student in clinical psych, I need to correct GuyZero. Oppositional Defiant Disorder IS in the DSM (see page 100). And I would put it in the classification of Disruptive Behavior Disorders... not the Autism spectrum.

Sorry about that. Anyway, I did a group presentation on Conduct Disorder (very similar to ODD, but a little more severe) for one of my classes. This is some of the information that we found regarding treatment:

-Your friend may wish to look into family therapy and/or couples/marital therapy as this disorder can be difficult on the family.

-The daughter should be taught interpersonal skills (e.g. problem-solving skills, social skills, coping skills, etc.).

-There may be some choices regarding medication, but that should be discussed with a psychiatrist.
posted by Nolechick11 at 11:58 AM on November 7, 2008

Oh--and as this thread demonstrates, your friend should steel herself for a lot of "advice" that is really quite ignorant. I suggest your friend should feel free to tell people to fuck off,.

In the case of close family members whose support is important, invite them to a session with an individual therapist or family systems therapist. Psychoeducation is awesome.
posted by sondrialiac at 11:58 AM on November 7, 2008

I wanted to back up Nolechick and point out that ODD is in the DSM and it's not related to autism. Treating it like autism or ADHD will be of little use. Sondrialiac's advice to be skeptical of advice is probably the most useful thing in this thread :)

I work with teens who sometimes come in with ODD as part of my research, and I have to say the big common factor is a disrupted home environment. I'm not saying ODD is a result of bad parenting, far from it, but I've never seen a kid come in who had the same parent figures applying consistent discipline, set bedtimes, curfews, clear expectations and enforcement from a young age who later developed ODD. Your friend should talk at length about parenting strategy with the diagnosing psychiatrist/psychologist, who can probably offer useful ways to manage her behavior at home.
posted by slow graffiti at 12:32 PM on November 7, 2008

My niece is ODD and has had this diagnosis for several years. It is not a "fad diagnosis" (which is not to say that in this case the diagnosis is or is not correct). It's a real disorder and an ODD child needs and responds to different approaches than normal childhood or adolescent defiance. In fact, using tried-and-true discipline approaches can backfire badly with an ODD child.

It isn't wearing holey jeans. It's ... well, it's being asked to take care of the dishes, and responding by throwing the knives around the kitchen. And then feeling bad about almost hitting a family member, so responding by knocking over the trash. There's a high degree of being unable to rationally and effectively communicate feelings. Yet directly engaging such children is threatening. They may be pathologically incapable of apologizing. You have to be able to accept that they just trashed the entire kitchen, and feel bad about it, but won't clean it up or say they're sorry. Unless you disengage, suggest mildly that they need to pick up the things they threw, and leave the room for an hour. In that case they might do it.

Carrot and stick reward/consequence parenting is something they will use against you. They will misuse someone else's toy (or radio or whatnot) so that by taking it away you punish the other person too. If you use a consequence (or delayed consequence) on them they will find something to use on you (say, you're reading the paper and have a box of crackers, but get up to answer the phone -- only to find the crackerbox turned upside down on top of the paper). Hey, you're teaching them how it works! My niece has long favored taking the passenger side rear view mirrors and turning them toward the car. You never notice it until you're trying to merge. Yet when you give them a reward they won't acknowledge it, may even reject it.

Basically, you have to have a very counterintuitive approach and have to anticipate things that are designed to get you to react, because that will give them excuses for raising the ante. Your temper will be tested and teased. You will of necessity develop a thick skin for cutting insults designed to shift blame. Whatever your weakness is, they will find it. Whatever poor parenting habits you have, they will gleefully magnify, to your daily chagrin.

And yet, under the right circumstances, the same child will be adorable. Somehow, it's possible. But it only happens when they feel the circumstances are right for them.
posted by dhartung at 12:39 PM on November 7, 2008 [5 favorites]

Thanks, everyone, for contributing. I emailed my friend this link and the one email I got and she is very appreciative and says she got some very useful advice.
posted by orange swan at 1:11 PM on November 11, 2008