Oppositional defiance disorder: When your kid isn’t just “difficult”

Nothing prepared me for my daughter’s explosive rages and vindicative behaviour. But, there are solutions for families who have defiant children.

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“You’re wrong about everything, Mom. I hate you. And I don’t like your hair either!” screamed my five-year-old child while trying her best to punch me in the leg. Her screaming fit, which lasted an interminable hour, was sparked when I asked her to put on her shoes so we could leave for the store. Luckily, this time, no one was hurt.

We call these epic fits (screaming, kicking, throwing things) hurricanes. She’ll grab me, trying to punch and scratch me and I’ll attempt to restrain her so she won’t hurt either of us. While she’s usually better behaved in public, I’ve left the grocery store dragging my screaming daughter more times than I’d like to admit. At any given moment, my sweet child can morph into something unrecognizable.

Like other parents of defiant children, I was at a complete loss. It can be hard to know what’s causing our kids to act out, what steps are needed to stop the disruptive behaviour and when to seek help. Nothing prepared me for parenting a defiant child, but, as I found out, the news isn’t all bad: There are solutions for families who have defiant children.

What Defines a Defiant Child?
Kid 7 ways to deal with a defiant kidMy daughter had been a pleasant, easy baby. Suddenly all that changed when she turned three. She destroyed books and wrote on walls (sometimes right in front of me), and when I tried to stop her from doing something it would bring on another hurricane. I could use rewards, threaten consequences and take away prized toys and she still would refuse to do what I was asking. Occasionally (just to keep me on my toes), she’d comply—it was so unpredictable.

Parenting coach and author Elisabeth Stitt had a similar experience with her child. “From around 15 months to 27 months, every day was an exhausting battle of wills,” she says. But as her daughter learned to talk and negotiate her way in life, things became a little easier. Heaven help anyone who tried to rush her, though. This brought on a “category five tantrum.”

Defiance is a spectrum. There are strong-willed kids who were just born that way, others who may be reacting to a short-term traumatic event, and kids who might be formally diagnosed as having a more extreme condition called Oppositional Defiant Disorder (ODD).

Typically, a child is diagnosed based on anecdotal evidence from their parents or guardians, who often bear the brunt of the child’s defiant behaviour. The National Institute for Trauma and Loss in Children (TLC), a U.S. organization that provides childhood trauma training programs, notes it’s very hard to observe defiant behaviour in a clinical setting where children might not act up. The diagnosis of ODD, is defined as a pattern of irritable mood, argumentative behaviour and vindictiveness that lasts at least six months. The child is often easily annoyed or resentful, loses his temper quickly, argues with authority figures and refuses to comply to rules. Often, defiant children will deliberately provoke others and blame them for their own mistakes or misbehaviour.

According to a report from the American Academy of Child and Adolescent Psychiatry (AACAP), between one and 16 percent of children and adolescents have ODD. Boys with ODD are more apt to argue with adults and lose their tempers, while girls tend to lie and be uncooperative.

It is important, though, to separate a chronically defiant child (or a child with ODD) from a child who is exhibiting disruptive behaviour due to an acute trauma in their life (such as a divorce or a sudden move). As a reaction to a traumatic event, the defiance tends to be temporary; with consistent parental support, the behaviour should be short-lived.

This is why it’s important to look at what might be causing the behavior. “These disorders are misdiagnosed because you focus on the behaviours and not the cause of the behaviours, which can be trauma,” says Clair Mellenthin, LCSW, RPT-S, a registered play therapist based in Utah, who works with defiant children and their parents. “It is important to get to the root of the behaviour.”

What Sets Off a Defiant Child?
The word “trigger” has become the buzzword of our decade, but the term is appropriate here. As we gain more knowledge in psychology and behavioural studies, it becomes clear that behaviours can be triggered by events, or reminders of events, that are or have been traumatic for a child.

My child had medical issues that affected her behaviour. Because so much of her young life had been beyond her control, she sought to take back some of that control wherever she could get it. Anything that threatened her sense of control brought on a tantrum. Stitt had a similar experience with her daughter—things would escalate when she did not get her way.

Anything that reduces a child’s ability to cope can also be a trigger, so sleep and hunger often plays a major role. Sujay Kansagra, physician and director of Duke University’s Pediatric Neurology Sleep Medicine Program, says that getting adequate sleep is critical. “Sleep is a core pillar in supporting normal brain function,” he says. “Without it, we are all prone to disruptions in energy, mood, and behaviour. Poor sleep can worsen behavioural problems in children, it may be the cause.” This issue can become especially problematic with the introduction of technology and its negative effect on sleep, he says. Unexpected changes in routine, harshly worded verbal orders, inconsistent transitions between activities or situations, disapproving body language, or requests that aren’t developmentally appropriate are also common triggers .

My Child Is Defiant—Now What Do I Do?
Early intervention is crucial with a defiant child. Several different treatment options are available, but the most successful options usually include a combination of parental training and play or talk therapy, depending on the age of the child and the severity of defiance. In fact, studies have shown the most effective way to reduce the behavioural issues is early parental intervention and training. (Often times, training the parent is easier than training the child.) ODD children who remain untreated can go on to have a more extreme condition called Conduct Disorder, which can lead to substance abuse and delinquency.

As a play therapist who consults frequently with exasperated parents, Clair Mellenthin agrees, noting that discipline with defiant kids can be tricky. “An authoritarian approach will normally backfire,” she says. “Try instead to catch your kids in the act of behaving well and use positive reinforcement. Most of these kids have low self-esteem and when parents are more punitive it tends to reinforce negative behaviour and worsen their self-esteem issues.”

It is clear that defiant children require a unique approach to parenting and discipline, which can be frustrating to figure out. Julie Polanco was desperate to help her defiant son and heal her family. “We tried many conventional discipline strategies first and none of them worked…In fact, he got worse.” Timeouts, punishment and grounding weren’t working. Finally, she says, they had a revelation. “He wasn’t the one who needed changing, we were. We were so focused on the bad behaviour, that we didn’t realize that he felt unloved and rejected.”

Polanco found that giving her son more control improved his self-esteem and made him happier. They chose to focus on his strengths and build his self-confidence by listening to him and offering support. Logical consequences, such as working to pay off a stolen item, worked best.

As for me, I realized that I couldn’t parent my five-year-old like I parented her older sister. I had to give her choices and not project my will onto her—I had to give her room. When she flew into a rage, I had to give her love and stay physically present, without letting her hurt anyone. It felt like a delicate dance. In the end, though, I sought therapy for both of my girls that included training for me on how to address their unique needs.

Therapy did as much for me as it did for them. I met with the therapist for fifteen minutes before every session. She helped me refine my parenting techniques, taught me new ways of relating to them and guiding them. They bloomed.

Parents, you don’t have to do it alone, and there is hope.

The Good News
For most kids, symptoms of ODD improve over time. The AACAP report claims that 67 percent of children diagnosed with ODD will be symptom-free in three years if they receive treatment.  Other studies show that the younger a child is at diagnosis, the less likely their symptoms will resolve completely. But what does that mean for their futures?

First of all, their odds of success increase markedly if they recieve treatment. And excellent parenting goes a long way. Science also tells us that a little pluck can help middle schoolers down the road. In a 40-year longitudinal study published in Developmental Psychology in 2015 found that defiance was a main indicator in determining which children went on to become successful adults (as defined by income level).

“One explanation might be that individuals with higher levels of rule breaking and defiance of parental authority also have higher levels of willingness to stand up for their own interests and aims, a characteristic that leads to more favorable individual outcomes,” say researchers. In other words, they make excellent salary negotiators and are persistent in the face of resistance when it comes to accomplishing their goals.

Mellenthin agrees. “These kids are so resilient,” she says. “They have so much strength and determination. The traits that drive you crazy as a parent are going to help them be very successful as adults.”

Stitt’s daughter, who is 21 now, is a force to be reckoned with. “For anything she values, she has been focused and driven in her approach. She is currently writing an honour thesis for her undergraduate neuroscience major,” Stitt notes. She says that her daughter is consistently self-motivated, hardworking, and organized.

After changing her parenting strategy, Polanco has also seen her son flourish, become a leader and stand up for himself. As for my daughter, who is still only six, the future remains unknown but hopeful. Watching her teach herself to roller skate with no one’s help was a clear demonstration of her persistence. I have no doubt that she will accomplish all the things that she sets her mind to—her defiance is becoming more productive.

There can be a broad range of defiance in children. If you feel that your child’s defiance is disruptive at school or at home, and has been for longer than you can tolerate, it is probably time to seek professional help. Luckily, with treatment and training for both the parent and the child, defiant children can go on to lead happy, fulfilling, and successful lives.

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