RKK is 10. His day usually starts out with argument of some sort — getting him ready to go to school is an ordeal. At school, there's trouble during assembly. In class, he swears at his friends and refuses to do most of the things the rest of the class is instructed to do. He isn't bad at games but is just not a ‘team person'.
After school, the homework battle is horrible. He refuses to work even for an hour. He constantly complains, and irritates his mother. Thirty minutes of work usually drags to two hours. At the end of it, both are irritable and lose their temper.
ODD is a disorder characterised by two different sets of problems. These are aggressiveness and a tendency to deliberately irritate others.
Frustrating
This can be a frustrating disorder, because the child believes he or she has a just cause to be so angry and blame parents or others for the behaviour, claiming they are unreasonable.
The signs of ODD tend to show up during pre-adolescence — ages seven to 13. At first, one may notice that although the child is becoming hostile and unmanageable at home, he does not present the same behaviour to the outside world. They tend to feel guilty — that they "must have done something". Over time, however, the child's behaviour will also deteriorate in school, and teachers may begin to complain. A child with ODD will be disruptive in class, disrespectful of teachers and aggressive towards peers.
ODD may not occur alone. The child may have some other neuropsychiatric disorder as well. The tendency for disorders in medicine to occur together is called comorbidity. Research shows that ODD occurs quite commonly with ADHD (Attention Deficit Hyperactivity Disorder).
The etiology of ODD is yet to be made certain. The usual pattern is for problems to begin between ages one and three. Most of this behaviour is normal at age two, but in this disorder it never goes away.
First, there will be some lucky children who outgrow it. About half the children who have shown ODD as preschoolers will have no problems at all by age eight. Second, ODD may turn into something else. About 5-10 per cent of preschoolers with ODD will eventually end up with ADHD and no signs of ODD at all. At other times, ODD turns into Conduct Disorder (CD). Third, the child may continue to have ODD without any other disorder. Fourth, they continue to have ODD but add on comorbid anxiety disorders, comorbid ADHD.
By the time these children are at the end of primary school, about 25 per cent will have mood or anxiety problems. It is very important to watch out for these signs.
ODD and ADHD
ODD is characterised by aggressiveness, but not impulsiveness. In ODD, people annoy others deliberately, while it is usually not so deliberate in ADHD. ODD signs and symptoms are much more difficult to live with than ADHD. Children with ODD can sit still whereas children with ADHD cannot sit still for even a short duration.
There is a significant difference between children and adolescents who have ODD and those with ODD and ADHD. An ADHD child may impulsively push someone and is likely to be sorry he did it. Whereas, a child with ODD plus ADHD might push someone and deny it.
Children with ODD or ODD plus ADHD are difficult to get along with, compared to those with ADHD alone. They set parents against grandparents, teachers against parents, and incite parents to abuse the child and cause tension between the parents themselves.
Currently, research shows that in many respects ODD and CD are related. CD is a more severe form of ODD. Children with ODD are difficult, but not dangerous. The common thread that separates CD and ODD is safety. If a child has CD there are safety concerns. Sometimes it is the personal safety of others in the school, family, or community. Often the safety of the child with CD itself is a great concern.
Dealing with a child with ODD is exhausting and trying. It is always advisable to seek professional help.
WATCH OUT
The general behaviour patterns that parents need to watch out for are:
If their child is
Negative
Defiant
Oppositional
Pessimistic
Aggressive
Argumentative
Angry
Resentful
Low frustration level
Accusatory
Unreasonable
Blaming
Spiteful
Vindictive
Bad-tempered
Foul-mouthed
Parents should not hasten to conclude the child has ODD if some of these symptoms are present even for a short span of time.
What is important is the duration of the symptoms, intensity and the number of symptoms.
The writer is a consultant psychologist and special educator.
