Parenting A Child With ODD (Oppositional Defiant Disorder)
If you’re struggling with parenting your child with ODD (Oppositional Defiant Disorder), you’ve got to check out these incredible resources by author Amelia Bowler, who is a behavior analyst (BCBA) and parent of a child with ODD.
Based on her experience as a mother and behavioral health practitioner, she authored the incredibly insightful and evidence-based book The Parent’s Guide to Oppositional Defiant Disorder (2020).
In 2022, she released The Teacher’s Guide to Oppositional Defiant Disorder, a very practical guide for educators with plenty of worksheets to support in the classroom.
These resources are highly recommended as a practical read for parents of children with and without ODD, or teachers with learners having this diagnosis.
Parents and teachers with children with other diagnoses, such as attention deficit hyperactivity disorder (ADHD), autism, conduct disorder or simply those who display challenging and defiant behavior, would also benefit from these books. There really are takeaways relating to any child, and not just for those who are parenting a child with ODD.
This article is simply a fly-by on this topic. I would recommend getting either or both of Bowler’s books for a deeper dive, and to access the resources she provides such as worksheets (in the teacher’s book) to go through the process of supporting a child/learner with ODD.
For now, let’s do a brief overview of what an ODD diagnosis entails and then dial right into how the practical advice in these books can help parents whose children already have a diagnosis or suspect their child has ODD or even ADHD.
ODD is diagnosed by qualified mental health professionals such as a trained General Practitioner (MD), Psychologist, or Psychiatrist.
Since there is no neurological or medical test to determine an ODD diagnosis, it’s a behavior disorder that is based on the report of caregivers regarding the child’s behavior.
This diagnosis doesn’t, however, tell us why a child is struggling. It simply tells us there is a mismatch in expectations of them compared to other children and their ability to meet those expectations.
Before looking at a diagnosis of ODD, a medical doctor will often first rule out health problems that might be a factor in behavioral changes. This is an important step to ensure something is not overlooked and therefore possibly complicating future treatments for ODD.
The designation of ODD describes the symptoms of ODD, as laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It’s defined by the following:
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months—as evidenced by at least four symptoms of the following categories and exhibited during interaction with at least one individual who is not a sibling:
Often loses temper
Is often touchy or easily annoyed
Is often angry and resentful
Often argues with authority figures or, for children and adolescents, with adults
Often actively defies or refuses to comply with requests from authority figures or with rules
Often deliberately annoys others
Often blames others for his or her mistakes or misbehavior
Has been spiteful or vindictive at least twice within the past 6 months (DSM-5 Changes)
Clinicians need to see a pattern of the child’s symptoms over a sustained period of time in addition to differences in the intensity and frequency of the above behavioral problems compared to peers of the same age, gender, developmental level, and culture.
For example, younger children (under 5) must present with these symptoms ‘most days’ over the course of 6 months, whereas school-age children must present with these disruptive behaviors at least once weekly for 6 months.
Bowler summarizes the behavioral challenges with ODD in the following three areas:
Difficulty regulating intense emotions
Difficulty moderating goal-directed behavior
Difficulty cooperating with other people (2020, p.16)
It’s important to reiterate that an ODD diagnosis is simply a description of observed patterns of behavior. It does not take into consideration or describe any of the reasons underlying the why behind the behavior.
As outlined by Bowler (2022), the reasons for the presenting behavior can include:
Emotional coping skills
Executive functioning skills
Adverse life experiences
Neurological structures (p. 21).
Highlights From A Parent’s Guide To ODD
“Oppositional and defiant are not medical terms; they are subjective…A child can only be considered ‘oppositional’ when confronted with an adult who expects to be obeyed. There is no known medical disorder that compels a child to do the opposite of what is expected….so [these terms] tell us more about how parents and teachers are feeling than about the child who refuses to cooperate” (Bowler 2020, p.17)
Understanding the skill deficits that underpin the subtypes of ODD
For those parenting a child with ODD, it can be helpful to understand the subtypes of the diagnosis, which include irritable, headstrong, and vindictive (Bowler 2020, p.23).
In the books, Bowler goes into greater detail about the characteristics of each type, some of the associated skill deficits, and how to help this type of ODD child.
Throughout the book she continues to link new information back to these specific subtypes so, if you can see your child in these profiles, this might be a useful read for you.
Family members may find it helpful to re-frame ODD features as a series of skill deficits and past traumas, rather than a simple binary of good behavior vs. bad behavior or that the child is choosing to have behavior problems.
The irritable subtype includes children that can be explosive, complain often, say they are unhappy or angry, have low frustration tolerance, and be critical of others. These children can struggle with various social skills like emotional awareness, and executive functioning skills such as planning and problem-solving (p. 24).
Children with the headstrong subtype tend to be defiant with authority figures, very focused and determined with their own goals and interests, argue often, have reactions or interactions that appear socially inappropriate, and can be provocative with others. They might struggle with skill deficits in delayed gratification, problem-solving, flexibility, and executive functioning skills like planning and adapting (p.25).
The vindictive subtype is characterized by anger and wanting to ‘get back’ at others that the child perceives have wronged them. Bowler suggests that this may actually be a deficit in problem-solving skills being expressed as emotional processing. The child may see that the solution to the problem is to get revenge on the person rather than try to emotionally self-regulate or find a prosocial solution to the problem.
“Success is a much more powerful teacher than failure, so keep your focus on the proactive ways you can meet your child’s needs and build up those important life skills”
Bowler, 2020 p. 22
Risk Factors to Consider for Children with Emerging Oppositional Behavior
Children with the irritable subtype of ODD are more likely to be diagnosed with mood disorders later in life (Bowler, 2020, p.24).
The headstrong subtype is characterized by rule-breaking behaviors that can escalate and be re-assessed to fit the criteria for Conduct Disorder (p. 25). Whether your child already has a diagnosed anxiety disorder, or another mental health diagnosis, getting the support that you and your child need sooner than later will most likely lead to better outcomes. Since children with ODD are more likely to be diagnosed with additional mental health conditions later in life, getting help sooner can set them up for success.
The child is struggling to meet expectations, but why?
The diagnostic criteria for ODD do not tell us why the child is struggling to meet the expectations around them.
Bowler is quick to remove blame from the child and point out that there are likely some skill deficits, past traumas, or other patterns in their learning history that have contributed to the child being seen as a defiant child (Bowler 2020, p.18).
A diagnosis of ODD is the result of much complex nature (i.e., biological, neurological) and nurture (i.e., environmental, cultural, social) factors. There is no research to show exactly one specific reason a child ends up with an ODD diagnosis.
“To put it simply, most defiant and oppositional behavior happens when a child’s environment collides with his or her abilities” (Bowler 2020, p.33)
“To put it simply, most defiant and oppositional behavior happens when a child’s environment collides with his or her abilities”
(Bowler 2020, p.33)
Often well-meaning adults will implement strategies that either they experienced as a child growing up or have been recommended by others. This might include timeouts and removal of privileges when faced with challenging behavior.
Often, standard strategies that might have appeared to work for other kids will not work for a child with ODD. Even positive reinforcement may not work for them. Have you had your child say, “I don’t care” when either offered an incentive that they typically would love or faced with the threat of losing a highly valued privilege? That’s exactly what we’re talking about here.
Bowler (2022) summarizes these phenomena nicely:
“If your student has been hurt or neglected by someone who tried to control them, they might try to avoid both rewards and punishments. Even prizes and good grades can make them feel like they are accepting your control” (p. 67).
Looking to relationship building and skills training/teaching as a primary treatment method can be very fruitful. This goes hand in hand with the mindset shift of trying to see how the child might be struggling due to a mismatch in expectations or skill deficits, rather than there being any intentionality behind the challenging behavior. The child is struggling and there is a reason why. All kids have skill deficits in some areas.
For kids with ODD, you may see deficits in the following areas, as outlined by Amelia Bowler (2022):
Emotional self-regulation, including emotional reactivity, coping skills, and physiological processes
Executive functioning skills, including self-control, attention switching, focus, and planning
Social problem-solving, including self-advocacy, perspective-taking, and communication (p.25).
Taking this into consideration, caregivers who are parenting a child with ODD can work on parent-child interactions rather than focus on eliminating challenging behavior or trying to change your child.
Taking control of your own reactions to your emotions and modeling this for your child will help improve parent-child interactions by setting a calm, productive, and positive tone oriented to better communication and mutual understanding.
Bias Resulting in Differing Rates of ODD Diagnosis
Bowler points out in the 2022 publication for teachers that rates of ODD vary widely across regions. The reader is encouraged to consider bias, especially as a teacher.
To counteract this, teachers can choose one single behavior to track, count frequency over a period of time, and compare a few students of varying backgrounds and ethnicities. This will give an educator an objective way to determine if a student truly is showing challenging behavior more frequently than other students (p. 41).
It’s also worth noting that, especially in a school setting, it’s important to consider cultural differences and biases in the way that we might consider differences in neurotypes (p. 41).
If a teacher has a new student from a culture that they have little knowledge or experience, they may try to research that culture to gain a deeper understanding of the student and therefore have more positive interactions with them.
A neurodivergent student (ND) may do or say things in ways that offend school staff. Understanding a student’s perspective, and how their neurotype presents in day-to-day life, can help with mutual understanding and reduce needless offense when there is no intention of disrespect but, rather, the behavior displayed is simply a result of their neurotype (p. 41).
Re-Framing and Relationship-Building For Parenting A Child with ODD
As a behavior analyst, I find it important to look to the environment for clues about why a child is struggling, of which we as adults are part of.
The way Bowler challenges common views on a child’s ‘bad behavior’, and even a re-framing of rewards and incentives provides fresh ideas for burned-out caregivers who may feel like they are spinning their tires.
Bowler provides some great advice for both parents and teachers on how to manage their own frustrations by adopting an optimistic lens and using a strengths-based approach with the child who is struggling. This can involve re-framing how we view what is going on for the child.
Adults can learn to look at difficult behavior and remind themselves: “they’re not giving me a hard time. They’re having a hard time” (Bowler 2022, p. 47)
Related to this is the idea of building a warm relationship with the student or child. For a parent, a relationship can break down over years of challenging cycles of coercion and the child’s reactions to attempts at being controlled.
The same can be true of relationships between teachers and students. Bowler goes into great detail about how to build or rebuild a warm and positive relationship with a child, which is the foundation for creating realistic expectations and a safe space for them to feel understood.
There’s too much to unpack here about this process but, to summarize, getting to know the child’s values is a critical element of this. Not only does this help build rapport but also provides opportunities to consider what motivates them and brings meaning to their life.
Recognizing and Helping A Child in Distress
As humans, we all experience moments where we react with a fight, flight, or freeze response. It’s simply how our brains are wired.
Recognizing what this looks like in a child, and their specific triggers can be helpful in understanding how to better support them. Understanding these reactions can help provide context when searching for the ‘why’ behind a behavior. Bowler clearly describes how a child may respond in each of these three ways (2022, p. 86-87). In response, she imparts some wisdom to parents and educators:
“From one teacher to another, my best advice is to bring three important gifts into the classroom with you: calm…confidence…compassion” (2022, p. 88-89)
If you’re parenting a child with ODD or the teacher of one, I’d recommend reading both of one the books to get her elaboration on these three specific tools or ‘gifts’ as she calls them.
In addition to understanding visceral reactions in the fight, flight, or freeze categories, we can look at behavior as either unintentional physiological reactions (respondent) or operant (a result of learning history).
This leads to examining the why behind operant behaviors so we can better understand how to support a learner that is struggling for a variety of reasons. We can better understand the why by looking at the four functions of behavior through observed behaviors: escape from stimuli, access to tangibles, access to attention, or automatic (access to physiological sensations that result from the behavior).
Yes, the child might be seeking attention but why? Yes, they may be trying to escape a specific task or situation, but why?
To explore these questions about why a child is engaging in certain behaviors that are resulting in specific outcomes for them, Bowler describes a few tools. First, she explains a functional assessment to better understand the function or purpose a behavior is serving a child.
She then describes additional tools for a variety of learners such as the Collaborative and Proactive Solutions model (CPS) by Dr. Ross Greene, as well as the biopsychosocial model to dig deeper into the why behind the function.
She also mentions using the Interview-Informed Synthesized Contingency Analysis interview (IISCA) from Dr. Greg Hanley as a means of understanding what environmental factors are resulting in a child continuing to engage in a specific behavior without parsing out one single function, as often there can be more than one (2022, p. 96-101).
“Behavior happens for a reason. Your student’s behavior is affected by many things, including health, other people, and their personal history. If you want their behavior to change, you might need to show them a better way to get what they need, or change something in their environment.”
Bowler, 2022, p. 106
How The Highlights Connect To All Children: Beyond Parenting a Child with ODD
All children benefit from their caregivers modeling prosocial behaviors and self-regulation. As mentioned earlier, this was a significant takeaway for me that applies to all parents and educators.
Parent training (sometimes called parent management training) as a first step in the process to changing family dynamics can be impactful.
Whether this is through family therapy, individual therapy, or working with an experienced parenting coach, parents learning to regulate their own emotions and reactions can help reduce the number or magnitude of power struggles and temper tantrums, and increase positive behaviors because the parent is setting the tone and modeling what the child can do when in distress.
As humans, we can’t avoid our emotions and the physiological sensations that come up as a result of those emotions. We can, however, learn strategies to modulate our reactions to these emotions and continue to model this throughout our child’s life.
Another relatable area is in regard to social skills. Children with and without ODD can struggle with social skills such as perspective-taking, and social problem-solving (Bowler, 2022, p. 25).
Working on developing these skills with patience and respect can go a long way to supporting a child with ODD. Don’t use moments when tensions are high as a ‘teachable’ moment.’ Teaching and practice of these skills should happen in times of calm when the child (and adult!) are regulated.
Finally, taking a function-based approach, but with a broader understanding of the why behind a behavior, is relevant for any child. If you’re seeing a pattern of concerning behavior, track what is preceding and following the behavior to find patterns. Using the CPS, IISCA or biopsychosocial models can help you further understand what is going on for a child. This is not just true for kids with an ODD diagnosis.
Checking out Bowler’s 2022 book provides some resources and worksheets that walk you through the process of examining behaviors in greater detail and applying many of the strategies she suggests throughout the book.
Main Take-Away For Those Parenting a Child with ODD And Practitioners Supporting Them
My main takeaway as a practitioner and parent was the importance of a parent learning to self-regulate their own behavior as a means of modeling and being in a place where you can support their child.
For this reason, parents may need to seek out their own psychotherapy or counseling, especially if they have past traumas to deal with, or are finding it hard to self-regulate around their child.
Some practical ways to get help may include parent support groups, positive parenting classes geared towards parents of children with ODD or related challenges, or actually working with a behavior analyst, counselor, or psychologist experienced with ODD to create a treatment plan.
The Bottom Line on Parenting a Child with ODD
Children with ODD likely have skill deficits that are contributing to their behavior. These can be remedied through behavioral health interventions such as behavior analysis.
Parents in this situation are also encouraged to practice their own self-care as they work on modeling self-regulation skills for their children.
Those who are parneting a child with ODD can be experience their own mental health distress, making it increasingly challenging to implement positive parenting strategies.
If you’re finding yourself in this position, it might be time to seek professional help with parenting a child with ODD from a behavioral health practitioner or a mental health professional for yourself. For further guidance on this, read our article How to Find A Child Therapist.