Children are expected to test the limits of defiance and disobedience as a natural process of growing and maturing, but some children do not learn to restrain their anger and aggression and are seemingly unaffected by negative consequences of their defiant behavior. The most frequently diagnosed disruptive behavior disorders in children are Oppositional Defiance Disorder (ODD) and Conduct Disorder (CD). The difference between oppositional defiant disorder and conduct disorder is in the severity of symptoms and that ODD may progressively lead to CD with increasing age.
Oppositional Defiance Disorder
Oppositional Defiance Disorder is a diagnosis reserved for elementary grade children (usually 8-12 years of age), not adolescents, and is distinguished by arguing, fighting, loosing temper, blaming others, and intentionally annoying others. Although most children exhibit these traits at some point in childhood, what distinguishes ODD from normal oppositional behavior is the severity and how long the behavior has continually occurred.
To be diagnosed with ODD four (or more) of the following symptoms must be present for at least six months:
- often loses temper
- often argues with adults
- often actively defies or refuses to comply with adults’ requests or rules
- often deliberately annoys people
- often blames others for his or her mistakes or misbehavior
- is often touchy or easily annoyed by others
- is often angry and resentful
- is often spiteful or vindictive
Source: Child Mind Institute
Conduct disorder, a more serious condition than ODD, isn’t usually diagnosed until teenage years when behaviors such as frequent lying and violence are demonstrated. Kids with conduct disorders are often in trouble with authority figures like parents, teachers, and law enforcement officers. This condition requires intense treatment to prevent teenagers from a destructive lifestyle.
- aggression to people and animals
- threatening behavior towards others such as bullying, emotional abuse
- destruction of property
- deceitfulness and lying without remorse or quilt
- truancy in school
- perpetual rule breaker
- no respect for people’s rights or feelings
Source: Very Well Mind
Child psychiatrists or qualified mental health experts diagnose disruptive behavior disorders by interviewing parents and teachers about the child’s behavior as well as observing the child in multiple environments. In some cases, your child may need mental health testing.
Approximately 1/3 – 1/2 all children with ADHD may also have Oppositional Defiance Disorder and 1/4 – 1/2 will develop Conduct Disorder in adolescence. Such a high rate of comorbidity (multiple diagnoses) can lead to antisocial behaviors that place this child at risk for violence and a propensity toward crime. Untreated, these disorders may lead to substance use and abuse, exacerbating the symptoms and behaviors of all three conditions. Early diagnosis through a full evaluation and treatment is critical for these children as many of them may have been born with a disruptive disposition.
Treatments for disruptive behavior disorders
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:
- Cognitive-behavioral therapy teaches how to better solve problems, communicate, and handle stress as well as how to control impulses and anger. Find a Cognitive Behavioral Therapist What is Cognitive Behavioral Therapy
- Family therapy helps make changes in the family structure, dynamics and routines. It improves communication skills and family interactions.
- Peer group therapy promotes development of better social and interpersonal skills.
- Medicines are not often used to treat conduct disorder, but may be recommended for symptoms of coexisting disorders, such as ADHD.
John Hopkins Medicine, Treatments for Conduct Disorders
Very Well Mind, Cognitive Behavior Therapy
Association of Behavioral and Cognitive Therapies To locate a therapist
Council for Children with Behavior Disorders For definitions of behavior disorders
Children and Adults with Attention Deficit/Hyperactivity Disorders For more on disruptive behaviors
American Academy of Child and Adolescent Psychiatry To locate a child psychiatrist