Opposing oppositional disorder

All children misbehave, at least some of the time, but when misbehavior, in the form of defiance, hostility, or negativism, exceeds the norms of his or her peer group or causes significant difficulty in family or school functioning, then we need to be on the lookout for Oppositional Defiant Disorder. Oppositionally defiant children are more likely to loose their temper with minor provocation or argue with parents or authorities over preferences or timing of activities. They may refuse to conform to reasonable requests or family or school rules, arguing and defying adults and their rules, alike, and blaming others for their woes, refusing to take responsibility for their role in things going wrong. These children are noted for their touchiness – often described as having sensory threshold problems, they may have trouble with the color, texture, or tightness of their clothing, for example. They seem to have a dispositional tendency to complain, and evidence a sense of negativity, sometimes even in the midst of otherwise positive experiences. Disobedience can take both active and passive forms: refusing to do what is asked of him or her or, alternatively, doing so, but in a very slow and inefficient manner. Estimates suggest that between 5 and fifteen percent of school age children may qualify for the diagnosis of Oppositional Defiant Disorder, with boys meeting the criteria more than twice as often as do girls. Why do children misbehave and why do some children really misbehave? A number of factors seem to come into play here. First, some children may be temperamentally challenged, with higher degrees of excitability and lower capacities to tolerate sensory and activity changes, on a day-to-day basis. In some children, the impact of overworked or absent parents may leave the child unable to acquire necessary skills for emotional self-regulation. Finally, some youngsters may have other, undiagnosed, problems, such as anxiety, depression, mania, or attention-deficit. These conditions must be given proper treatment, along with care for your child’s oppositional or other behavioral problems. Check with your pediatrician, if think you may need a referral for a psychological assessment. How can parents help their children to overcome persistent oppositional behaviors? We need to understand that these children often misbehave because they do not yet know how to cope with their unique physiological and mental experiences of the world and the people in their lives. Parents can help their children learn to cope by setting up time and activity routines that provide necessary external structures for compliance, by making expectations regarding target behavior simple and clear, and by consistently following negative behavior with appropriate consequences and rewarding positive behavior with praise and positive, mostly social, rewards. I reviewed many sources in my preparation for this piece. One favorite was “The Difficult Child,” by Stanley Turecki, M.D. Dr. Turecki advises parents that they can be more effective with their children if they respond to temperament-based problems by labeling them instead of reacting to them and by adjusting to children’s legitimate needs by making reasonable accommodations. When non-cooperation comes as defiance or manipulation, then parents should employ behavioral consequences, such as (non-violent) punishment, withdrawal of privileges or other restrictions. His book correctly emphasizes that bad behavior does not imply a bad child – respond to the misbehavior in a neutral, planned and consistent manner and your child will learn to behave in a social world that is understandable and manageable for him – and eventually for you as well.

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