Is ODD Preventable?

There is absolutely no evidence that ODD (oppositional defiant disorder) is preventable.  If you ask me, I don’t think it is.  But I truly believe that the severity and duration of the symptoms or behaviors can be minimized.  As I’ve noted in the post Lessons Learned from ADHD & ODD, there seems to be a link between the two disorders.  Kids diagnosed with ADHD start off doing things that parents and other adults perceive as not allowed (ex: not following instructions the first time given, not being able to focus, not being able to calm down within an acceptable period of time, etc.).  Over time, parents and adults become increasingly frustrated and upset that these children cannot be controlled so they start to interact negatively with these children.  This is what happened to my son.  I grew stressed and frustrated trying to manage the disorder and the rest of our needs all by myself.  Many times I would yell at him or I would put him in time-out or take away things as a form of punishment to try to get him to comply.  Schools, daycares and afterschool programs would reprimand him, send him to time-out or even issue suspensions (and there were several) when it just became too difficult for teachers and caregivers to manage the behaviors.  He has even been expelled twice because schools could not provide him the kind of support and services he needed.  This repeated pattern of negative interactions happened for many years.  My son started to feel that rejection too.

When children receive constant negative feedback, they start to become even more negatively oriented towards adults.  And if their temperament is such that they struggle with the ability to control themselves in the face of frustration or anger, then I think it’s a recipe for ODD.  This is how my son’s childhood unfolded.  And I cannot help but wonder if the severity of his ODD could have been minimized early on by having a different mindset and using different approaches, like I do now.

Stress and trauma also contribute to the development of ODD according to some studies.  When my son was in pre-K, he calmly recounted out of the blue an incident about being locked in a broom closet.  I’m fortunate enough that my son had sophisticated vocabulary skills starting when he was 2 years old so he was able to tell that story in extreme, vivid detail.  His father’s girlfriend at the time, out of frustration at him for not behaving appropriately, put him in time-out in a broom closet.  His father wasn’t home when it happened.  (And when I told him about it, interestingly enough, he did not defend my son.  Family services investigated her/them but found no “abuse”.)  Needless to say, a lot happened by the time my child was halfway through grade school.

I share these early stories because 10+ years later, I often wonder if the outcome for my son would’ve been better earlier on if everyone involved had been more calm, more patient, more empathic and more aware and knowledgeable of the consequences from negative interactions.  I will never know the answer to this but I do know this.  If negativity from all people involved – especially parents and schools – can be minimized or avoided all together as early as possible, the outcome for children with ODD may be better than ours have been.  These children deserve and need a lot of help; not unfair consequences, not rejection or exclusion, not condemnation.  If we do not do this, some children with ODD go on to develop something called conduct disorder (CD), which is a much more severe behavior disorder that includes stealing, hurting people, setting fires, etc.  At that point, we collectively failed in preventing a behavior disorder from evolving into something worse, impacting society.

While I don’t think ODD can be “prevented”, we all can certainly work harder towards minimizing how bad and how long the behaviors persist.

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