I knew my son was different when his tantrums lasted hours at a time. I would dread waking up in the morning because I didn’t want to have to face another day with Dylan’s defiant behavior. Each day was an all-out war between the two of us, and it was over anything and everything.

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Sometimes he would yell at me because his underwear was too high or too low, and it wasn’t ‘right’. He wouldn’t wear sneakers because they were too big or too small, even though he’d worn them just the day before. Sometimes he’d spit at me because I’d send him to time out for telling me he hated me. Situations like these would go on every day, all day.

My husband suggested that we try Parent-Child Interaction Therapy (PCIT), a treatment program that reestablishes the relationship between parent and child. Therapy programs like PCIT are imperative to changing the dynamics in a household where a child has a disruptive behavioral disorder such as Oppositional Defiant Disorder (ODD).

Dr. Brandi Noirfalise, counselor at Sac River Counseling said, “When parents come in to receive PCIT, there is often negative behavior going on in the household. We try to normalize that experience for the parents.”

The first part of PCIT includes Child-Directed Therapy (CDI) where, “We try to redevelop that relationship between the parent and child,” explained Dr. Noirfalise. “I have seen families come in, and they’re distraught. After they go through the program, it reduces stress.”

The second part of PCIT is Parent-Directed Therapy (PDI) where the parent works on leading the play while the child works on listening. “PCIT is recommended as the first line of defense as treatment for Attention Deficit Hyperactive Disorder (ADHD),” says Dr. Noirfalise. “We want to treat kids at the behavioral level before prescribing medication.”

“The difference between PCIT and other forms of therapy,” said Dr. Noirfalise, “Is that it’s evidence-based practice. It was developed specifically for children with ODD and ADHD. It [PCIT] focuses on the relationship between parent and child.”

If you think that your child could have ODD, please seek help. Early intervention can help you and your child get through the tough times and give you the answers you so desperately need. Here are six behavioral traits that stood out to me as problematic:

1.) Tantrums: Tantrums that lasted hours and hours over absolutely nothing. Throwing, hitting, spitting, crying, screaming and yelling with no end in sight. These tantrums are much different than your typical toddler meltdowns. Trust me – you will know the difference.

2.) Defiant Behavior: Doing the exact opposite of what is asked of your child, whether it is something small like brushing their teeth or something big like not hitting. Children with ODD thrive on challenging other people; especially adults. The key is to not engage in their behavior but rather, set boundaries and keep a routine that works for your family.

3.) Mood Swings: One minute your child is happy and laughing, and the next he’s grumpy and mad. This could be over something as minute as a toy not working the way he wanted it to. Children with ODD tend to be hyper-sensitive, and when they cannot control everything around them they get overwhelmed, which can look like severe mood swings. You should have your child evaluated for Bipolar Disorder if you think the mood swings are severe enough, or if there are members of your family who suffer from this illness.

4.) Lack of Sleep: Interrupted sleep can add to an already explosive child. A lot of children with some sort of behavioral disorder either have a hard time falling asleep, staying asleep or both. Think about how you feel as the parent when you get less than your fair share of shut-eye. You’re probably grumpy, on edge and a little impatient. The same goes for your children. Now add to that a mental disorder and you’ve got a recipe for a very difficult day.

5.) Praise: Children with ODD don’t always like praise. If this is the case in your situation, find something that she does like, such as imitating play. Imitating play is exactly what it says. When she makes the cow jump, you make the cow jump. When she vrooms the car on the carpet, you vroom the car on the carpet. This type of play therapy can be done anywhere, and it validates to the child that you are engaged, listening and interested in what she is doing.

6.) Lack of Affection: Children with ODD do not always show affection. Try not to make a big deal about it, and just move on. Relish the moments when he does give you a hug.

Most importantly, hang in there. Don’t be too hard on yourself as the parent, and give yourself a break when you need it. Having a child with ODD is extremely difficult and can feel very isolating. Try and find a support group in your area or join an online forum where you can get support from other parents who know what you are going through.


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