How to Handle Oppositional & Defiant Behavior

“My daycare provider is pressuring me to take my son to his pediatrician because she feels that he has ODD. He is 5 years old and he constantly says no, is aggressive and doesn't follow directions. I don't feel that he needs to be put on drugs, can you tell me how else I can deal with my son to help him?”

Let’s begin by assuming that your son does meet diagnostic criteria for Oppositional Defiant Disorder, or “ODD.” Even if this is the case, I doubt a medication would be effective. Psychotropic meds are sometimes used to treat ODD symptoms if the child is abnormally aggressive, hurting him/herself or others during explosive fits of anger. Many professionals agree this is an acceptable reason to medicate ODD, but, aside from that, there really is no medication to make a naughty child behave. Furthermore, it’s certainly not up to your daycare provider to decide whether your child needs meds; that is a discussion for you to have with a pediatrician or child psychiatrist and it is a decision that ultimately only you and your partner can make.

Now let’s examine whether your child truly has ODD. Symptoms include quickness to anger, argumentativeness, noncompliance with directions, annoying others on purpose, refusing to accept responsibility for one’s actions, irritated easily, an attitude of resentfulness, spitefulness, and/or vindictiveness. Four or more of these symptoms indicate ODD may be a factor for your son, but keep in mind that almost every child will behave in a manner consistent with ODD at least some of the time. Therefore, a mental health professional would also want to know how long the symptoms have persisted, how frequently the child typically “acts ODD,” and what, if any, specific events or situations seem to trigger the behavior.

Since drugs are (mostly) out to treat ODD, that leaves behavioral management as the treatment of choice. “Behavioral management” or modification is a fancy way of saying your response as your son’s caregiver is critical to helping him change. Does the behavior ultimately work for your son, getting him what he wanted in the first place? If so, congratulations: you just positively reinforced naughtiness, and you can bet a child of any age will remember that “throwing a fit” is an effective means of accomplishing goals. Yes, we all have our weak moments as parents in which we “give in,” but a consistent response that communicates to the child that naughty behavior is not acceptable and will not get him what he wants is the way many experts agree you should “behaviorally manage” ODD.

But there’s more (much more really, but for the sake of brevity I’ll give you just two more key considerations to ponder at this point): First, many parents naturally tend to focus on the dark side of things, so caught up in what is driving them nuts that they miss or ignore what the child is doing right. In my work with families, it always saddens me when I ask a parent to describe their child’s strengths and they are at a loss. This is usually telling that in order for a child to change his or her behavior, the parents will first need to change their attitude toward the child. Watch for your son to do something good: whether it’s helping a sibling, picking up his toys, or just brushing his teeth. Any good behavior you can catch is what needs to be consistently positively reinforced.

Which brings me to point #2: The best way to offer positive reinforcement is not with tokens such as chips or stickers or toys or trips to Chuck E. Cheese’s. These “external reinforcers” have their place, but through them you fall into the dangerous trap of bribing your son to behave rather than teaching him to be good for the sake of being good. When you catch your son engaged in positive behavior, tell him you’ve noticed, say how nice it is to see him acting in this way, and mention how much it means to you. Give your child the proverbial pat on the back or, better yet, a hug. We’ve forgotten in our hectic, hurry-up-and-go fast food society how much these “little” moments really do mean. Our kids want to be noticed, they want to know they’re more important to us than anything else in life, and they will resort to all sorts of shocking behavior (both good and bad) to get our attention. It’s our job as parents to actually attend to our children, showing them right from wrong with our loving approval or disapproval for what they’ve done.

In sum, for my money, ODD (if such a thing truly exists) is corrected through appropriate parental responses to typical child behaviors. This takes time—much more time than seeing a doctor and driving to a pharmacy—but the positive outcomes will change your son for the better for the rest of his life. To read more on this subject, I recommend a fantastic book from which I’ve adopted many of the suggestions included herein. It’s called From Difficult to Delightful in Just 30 Days: How to Improve the Behavior of Your Spirited Child by Dr. Jacob Azerrad, and you can probably find it in a public library near you.

Disclaimer: Although the advice contained in this Web site frequently makes mention of diagnostic criteria and treatment options, it is not intended to replace the opinion of a qualified mental health professional who could directly and more specifically address the issues and concerns at hand; nor is the advice contained herein offered as substitution for psychotherapy or other professional mental health services. Individuals with mental health concerns are advised to seek treatment in person through a licensed professional. The author of the content on this Web site, Bryan J. Hall, LMHC, makes no guarantees regarding the advice offered and reminds readers to use personal discretion when deciding what, if any, advice or suggestions to accept and implement.