Juhi, is a 7 year old girl, hailing from a well-to-do and well educated family. Since her early childhood, Juhi has been a difficult child. It would always take more than one round of instructions to get Juhi to follow and act according to what was being said. She would also argue back with her parents whenever she was told something, along with a tendency since early childhood, to get angry at the drop of the hat. However, things have gone beyond the level of tolerance for Juhi’s parents. At home, Juhi has started directly disobeying everything that is told to her by her parents. If even the slightest thing does happen without her consent or will, Juhi starts throwing and destroying whatever she gets at hand, irrespective of how precious it may be. Even after her temper tantrums calm down, there is not a speck of remorse to be seen in Juhi. 3 days back, Juhi’s parents had been called by her school principal. Juhi had knocked down a bottle of paint of her friend’s desk. On being asked to clean it up by the teacher, Juhi had looked into the teacher’s eyes and informed that she would not. On being insisted upon, Juhi took another bottle of paint from her friend’s desk and threw it on the teacher’s face. Not stopping at that, she picked up the mobile phone of her teacher and slammed it against the window, thus crashing both the phone and the window. When asked for an explanation about her behaviour, Juhi reported that had her teacher not insisted that clean up and apologise, none of these things would have happened.
When Juhi was brought in for her consultation by her parents, it was apparent that Juhi had what is commonly known as Oppositional Defiant Disorder, along with a few symptoms of Conduct Disorder. Oppositional Defiant Disorder (ODD) is one of the disorders under the umbrella of Disruptive Behaviour Disorder (DBD), where as the name implies, the manifesting symptoms cause significant distress and disturbance in the lives of the patients as well as the caregivers, mostly the parents and teachers.
The most common behaviors that children and adolescents with ODD show are:
So, a lot of children do present as being difficult. How then can the parents distinguish between age appropriate difficult behaviour and the presence of ODD in a child? Following are some pointers in this direction:
Children with ODD show an ongoing pattern of extreme negativity, hostility, and defiance that:
The following behavioral symptoms are associated with ODD:
Treatment for ODD usually consists of a combination of the following:
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