Naughty children are being diagnosed with Oppositional Defiant Disorder

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CLAMmain

Nearly every child in Cornwall would admit to arguing with their parents and having the occasional tantrum if things don’t go their way.

But a growing number of children are now being diagnosed with a medical condition for such behaviour, which experts say could lead to mental health problems later in life.

Oppositional defiant disorder, commonly known as ODD, is characterised when young children frequently argue and disobey the adults who look after them.

In teenagers the patterns of behaviour can be more extreme and lead to aggression, persistent lying and theft and “serious violation” of rules.

NHS guidelines state that half of children with such conduct disorders not only miss out on parts of their childhood, but go on to develop serious mental health problems – such as anti-social personality disorders – as adults.

But critics say giving this behaviour a recognised clinical term is just another way of excusing children who are simply “naughty”.

 

Dr Liz Bragg, an associate specialist in paediatrics and a spokesperson for the Royal College of Paediatrics and Child Health (RCPCH), said: “ODD is often considered to be extreme behaviour, for example excessive arguing, throwing temper tantrums and blaming others for your mistakes.

“It can be associated with such conditions as attention deficit hyperactivity disorder (ADHD) and depression and may follow on from adverse childhood experiences.

“Individuals who have ODD tend to have low self-esteem. This is a complicated condition and thought to be a result of a combination of biological, genetic and environmental factors.

“While this condition is likely to run in families it doesn’t mean you’ll definitely get it, just that you might be more vulnerable to developing it than someone else who has no family with it.”

Signs of ODD generally begin during preschool years, but it has been known to develop during primary school and sometimes secondary school.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing ODD.

 

The five criteria for diagnosis of ODD

Angry and irritable mood

  • Often loses temper
  • Is often touchy or easily annoyed by others
  • Is often angry and resentful

Argumentative and defiant behaviour

  • Often argues with adults or people in authority
  • Often actively defies or refuses to comply with adults’ requests or rules
  • Often deliberately annoys people
  • Often blames others for his or her mistakes or misbehaviour

Vindictiveness

  • Is often spiteful or vindictive
  • Has shown spiteful or vindictive behaviour at least twice in the past six months

Experts say these types of behaviour should be displayed more often than is typical for a child of the same age.

For children younger than five years old, the behaviour must occur on most days for a period of at least six months.

For children five years old and above, the behaviour must occur at least once a week for at least six months.

Dr Mair Edwards, a clinical psychologist based in Anglesey, said ODD usually stems from lack of boundaries in parenting and lack of appropriate “socialisation”.

She said approximately 10% of children may display ODD but this may have increased in recent years.

She said: “The most effective management is for parents to attend an effective parenting programme and for the child to receive praise and rewards for positive behaviours and loss of privileges or loss of access to wanted things if misbehaving.

“If parents are consistent children rapidly learn what they need to do and the ODD will subside.

“Some parents may struggle to be consistent in their parenting due to depression, alcohol and substance misuse, and living in deprivation which makes daily life such a struggle that parents are preoccupied with just surviving.

“The combination of cuts to benefits making families poorer and cuts to services that support families is a double whammy and will cost the next generation dearly.”

Both Dr Bragg and Dr Edwards say medication for ODD is not the answer.

 

Dr Edwards said: “Doctors don’t treat ODD with drugs – we manage this condition by trying to find different ways to modify the child’s behaviour.

“Counselling for the child might also help and we know finding ways to improve self-esteem definitely helps.

“However, if the child also has ADHD or depression, we would treat that with appropriate medication.”

Dr Bragg added: “If the child continues to exhibit ODD into late childhood they are at significantly higher risk of developing conduct disorder, and by adulthood may develop anti social personality disorder.

“Left untreated children with ODD are also likely to develop emotional disorders associated with low self-esteem and poor self-efficacy (low mood and anxiety), be at higher risk of developing alcohol and substance misuse, and more likely to be known to youth justice.

“The cost to society if parents don’t improve their parenting skills is immense – but in order to improve parenting skills we need to fund services such as SureStart/Flying Start properly.

“In my opinion medication is highly unlikely to be an effective intervention as behavioural disorders require behavioural management.”
source;http://www.cornwalllive.com

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