ODD: Oppositional Defiant Disorder
- Social Work Graduate
- 3 days ago
- 19 min read
Description, symptoms, diagnosis, causes, support/management, caring for parents, prognosis, ODD in adults, social work practice.
Four sections follow:
Background Material that provides the context for the topic
Suggestions for Practice
A list of Supporting Material / References
Appendix 1: Occupational Therapy and Speech Therapy Approaches
Feedback welcome!
Background Material
Oppositional defiant disorder (ODD) is a disruptive behaviour disorder involving an ongoing pattern of angry/irritable mood, argumentative/defiant behaviour and vindictiveness (Hawes et al., 2023). Children with ODD refuse to do what others ask them to do and get irritable, especially if they’re tired, upset or frustrated. While all children can do this from time to time, children with ODD behave like this a lot, and the behaviour interferes with their ability to do everyday things, like learn and communicate, manage emotions and get along with others. Children with ODD:
won’t do what people ask
think that what they’re being asked to do is unreasonable
get angry and aggressive about being asked to do things.
ODD isn’t common. ODD often begins during the preschool years, usually before age 8 years, ODD almost always begins before the early teenage years although ODD can be diagnosed in adults. (Cleveland Clinic, 2022; Hawes et.al., 2023; Raising Children Network, 2024).
This disorder is associated with substantial social and economic burden, and childhood ODD is one of the most common precursors of other mental health problems that can arise across the lifespan (Hawes et al., 2023). The majority of children and teens who have ODD also have at least one other mental health condition, including:
Attention-deficit hyperactivity/disorder (ADHD).
Anxiety disorders, including obsessive-compulsive disorder (OCD).
Learning difficulties.
Mood disorders, such as depression.
Impulse control disorders.
Conduct disorder (Cleveland Clinic, 222).
The population prevalence of ODD is 2 to 11 per cent of children. This range is so wide because some children may be misdiagnosed as having conduct disorder, and teenagers, as a population, are often underdiagnosed (Cleveland Clinic, 2022). Some children outgrow ODD or receive proper treatment for it, while others continue to have symptoms through adulthood. Boys are more likely to have ODD in their younger years than girls, but teenagers are affected equally (Cleveland Clinic, 2022; Hawes et al., 2023). First Nations children and adolescents are nearly three times more likely to be diagnosed with ODD compared to their non-First Nations peers (Woodcock, n.d.).
ODD can affect many aspects of a young person’s life. It can create challenges at home, make it harder to succeed in school, and strain relationships with friends and family. Early recognition and the right support can help manage symptoms and improve outcomes for the child and those around them (Scope, n.d.).
ODD In Adults
Adults with oppositional defiant disorder (ODD) display a pattern of negative, hostile, and defiant behavior that lasts at least six months and includes four (or more) of the following symptoms:
Often loses temper
Often argues with family and coworkers
Actively defies or refuses to comply with rules and laws
Deliberately annoys people
Blames others for his or her mistakes or misbehaviour
Easily annoyed by others
Angry and resentful
Spiteful or vindictive
Adults with ODD are more than just aggressive and irritating from time to time. They feel mad at the world every day and lose their temper regularly. This may manifest as verbal abuse or road rage. Adults with ODD defend themselves relentlessly when someone says they’ve done something wrong. They feel misunderstood and disliked, hemmed in, and pushed around.
Constant opposition to authority figures makes it difficult for adults with ODD to keep jobs and to maintain relationships and marriages. They are particularly quick to anger, they are impatient, and they have a low tolerance for frustration. They see themselves as mistreated, misunderstood, and unappreciated. They see themselves as the victim rather than the cause of the pain in the family system (Rodden, 2019).
Symptoms In Children
Signs and symptoms of oppositional defiant disorder usually begin by age 8. Symptoms usually remain stable between the ages of 5 and 10 and typically, but not always, decline afterward. Signs and symptoms of ODD can be grouped into three categories:
Anger and irritability.
Argumentative and defiant behavior.
Vindictiveness.
In addition, many children with ODD are moody, easily frustrated and have low self-esteem. They also might misuse drugs and alcohol (Cleveland Clinic, 2022).
Anger and irritability
If children have ODD, they may:
Lose their temper easily.
Have frequent outbursts of anger and resentment.
Be touchy and/or easily annoyed by others.
Be frequently angry and/or disrespectful.
Argumentative and defiant behavior
If children have ODD, they may:
Excessively argue with adults.
Actively refuse to comply with requests and rules.
Blame others for their own mistakes.
Deliberately try to annoy or upset others.
Vindictiveness
Signs of vindictiveness in ODD include:
Being spiteful and seeking revenge.
Saying mean and hateful things when angry or upset (Cleveland Clinic, 2022).
Scope (n.d.) expand on some of the above, seeing the following as key symptoms of ODD:
Frequent anger or irritability Children with ODD often seem angry most of the time. Their frustration can be triggered by small, everyday situations, and their reactions are usually more intense than what’s typical for their age.
Easily annoyed or resentful A child with ODD may get upset quickly and often over seemingly minor things. They may complain that others are picking on them or feel that they are being treated unfairly, even when that’s not the case.
Arguing with authority figures Persistent arguing with parents, teachers, or other adults is a hallmark sign of ODD. These arguments are often frequent and not easily resolved. The child may regularly challenge rules, talk back, or refuse to accept adult instructions, even when they are reasonable or clearly explained.
Refusing to comply with rules Beyond arguing, a child with ODD may consistently refuse to do what they’re asked, whether at home, in school, or in social settings, even when consequences are clear.
Deliberately annoying others Some children with ODD will purposely try to irritate people around them. This behaviour is often intentional and used as a way to get a reaction or regain a sense of control in a situation.
Blaming others for mistakes Instead of taking responsibility, children with ODD often shift blame to others. If they make a mistake, break something, or cause a problem, they’ll insist someone else is at fault.
ODD symptoms can vary in severity. They can be:
mild, which means they occur in only one setting– for example, only at home, at school or with peers
moderate, which means they occur in at least 2 settings
severe, which means that some symptoms occur in 3 or more settings (Raising Children Network, 2024; Cedars Sinai, n.d.).
Symptoms In Adults
Symptoms at Home
Always needs to win the argument with a parent or spouse
Continues to fight against authority figures and society
Leaves socks on the floor just because it annoys the roommate
Cited for disorderly conduct by police
Involved in bar brawls or physical altercations in public
Has a hair-trigger temper (Rodden, 2019)
Symptoms at Work
Near constant arguments with a boss or coworkers
Commonly feeling oppressed by office rules
Purposely engaging in behaviors that irritate coworkers, like eating smelly foods for lunch
Sanctioned by human resources for violating company policies
Fired for being physically aggressive with coworkers in heated moments
Has meltdowns during meetings or annual reviews after receiving constructive criticism (Rodden, 2019)
Diagnosis
A child is more likely to develop ODD if they have the following risk factors:
A history of child abuse or neglect.
A parent or caregiver who has a mood disorder or who has substance or alcohol use disorders.
Exposure to violence.
Inconsistent discipline and lack of adult supervision.
Instability in their family, such as divorce, moving to different houses often and changing schools frequently.
Financial problems in their family.
Parents who have or have had ODD, attention-deficit/hyperactivity disorder (ADHD) or behavioral problems (Cleveland Clinic, 2022).
To be diagnosed with oppositional defiant disorder (ODD), children must have a pattern of angry and irritable moods, along with argumentative, defiant or mean behaviour that upsets other people and gets children in constant trouble with their parents, teachers and others, i.e. symptoms must show up in more than one environment. They must have at least four symptoms that affect daily activities for at least six months (Raising Children Network, 2024; Scope, n.d.).
Causes
While experts don’t have a definitive cause for ODD (Cedars Sinai, n.d.), researchers believe that the cause of oppositional defiant disorder is a complex combination of biological, genetic and environmental factors:
Genetic factors: Research suggests that genetics account for about 50% of the development of ODD. Many children and teens with ODD have close family members with mental health conditions, including mood disorders, anxiety disorders and personality disorders. Further, many children and teens with ODD also have other mental health conditions, such as ADHD, learning differences, or depression and anxiety disorder, which suggests a genetic link between the conditions.
Biological factors: Some studies suggest that changes to certain areas of the brain that control emotions and judgement can lead to behavior disorders. In addition, ODD has been linked to issues with certain neurotransmitters, which help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages might not make it through the brain correctly, leading to symptoms.
Environmental factors: Childhood maltreatment and inconsistent parenting can all contribute to the development of ODD, as they can result in a chaotic family life. In addition, peer rejection, deviant peer groups, poverty, neighbourhood violence and other unstable social or economic factors may contribute to the development of ODD.
Co-existing conditions ODD often appears alongside other conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorders, or learning difficulties. These overlapping challenges can make it harder for a child to succeed in structured environments like school, which may fuel frustration and lead to further defiant behaviour (Cleveland Clinic, 2022; Scope, n.d.; Woodcock, n.d.).
Support
Support starts with accepting the child behaves in challenging ways more often than other children their age. The next step is working with health professionals to develop a behaviour support plan, which can make the behaviour easier to handle – for parent and child. A good behaviour support plan will help parents:
understand the causes of the child’s behaviour
work out how to encourage positive behaviour in the child
support the child to manage strong emotions and improve social skills
work on strengthening family relationships (Raising Children Network, 2024).
Consistent use of the following may help.
Use specific praise to encourage positive behaviour. For example, ‘It was really helpful when you put your plate on the bench’.
Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
Give short, clear and positive instructions. For example, ‘Please put the dishes in the sink’.
Give choices about when the child can do tasks, not whether the child will do them. For example, ‘Would you like to do your homework now or after the next TV show?’
Use consequences in the same way and for the same behaviour every time. This means the child knows what to expect. For example, always use a time-out for hitting.
Follow up on challenging behaviour straight away. For example, if the child doesn’t do what you ask, ask again and say, “This is the last time I am going to ask you”. If the child still doesn’t cooperate, use a consequence like loss of privilege.
Acknowledge the child’s strong emotions and offer to help. For example, ‘I understand you’re feeling angry. Do you want to talk about it?’
The child needs to know he or she is important to the parent. One way to let the child know they are important to parents is to spend enjoyable time together (Raising Children Network, 2024).
Evidence-based strategies are those that have been evaluated by researchers within school settings and found to be effective (NSW Government). Strategies include:
1. Build a student's skill set
Strengthen students’ social skills Explicitly teaching social skills, such as how to share, apologise and agree with others, and how to have a conversation (for example, listening, letting the other person talk, waiting their turn to talk).
Help students build positive relationships Positive relationships between students with ODD and teachers. peers and other school staff may help them with cooperation, motivation, and learning.
Talk with students about feelings A “feelings thermometer” on the wall can help students communicate how they are feeling without using words. Feelings card games help students learn what emotions look like.
Help students to manage their emotions If a student gets angry or has an emotional outburst, they can take steps to calm down. Encourage them to recognise a feeling, pause, take a breath, and tell themselves to calm down or use other strategies like counting to 10. Help them to think about why they may have become emotional once they have calmed down. An explanation of how the brain works (frontal lobe shut down), and the need for a break when a person is not regulated, may also assist in helping students to manage their emotions.
2. Provide a positive environment
Use lots of effective feedback Providing students often with verbal specific praise for positive behaviours can build confidence and reduce behaviours of concern This might include feedback for staying focused, interacting well with others, and listening to teachers. Feedback can be given both individually and for others to hear.
Provide positive and nurturing role models A warm and supportive role model can help students learn how to have good interpersonal relationships. Look for ways to model to students how to get along with others.
Use rewarding learning or wellbeing activities Students may be more motivated if they can choose their favourite rewarding book or activities.
3. Be proactive
Classroom management Teaching students why a rule is important, including how breaking a rule impacts others, may lead to more positive behaviour.
4. Collaborate with parents or carers
Build strong home-school bonds Where possible, consider involving parents or carers through regular positive phone calls, teacher-home interviews, and homework which needs signing.
Use a home-school note system Send positive notes home in a students’ diary for positive behaviour at school, so that their family can encourage them at home. These notes could describe the positive behaviour for the parent or carer to understand (NSW Government, n.d.).
Management
Children with ODD need early professional diagnosis and treatment. Parents should talk to the GP about a referral to a paediatrician, psychiatrist or psychologist for diagnosis and assistance with developing social, emotional, behavioural and thinking skills. A mental health treatment plan may mean sessions are free or low cost (Raising Children Network, 2024).
Treatment of ODD, involving the child, family and school, usually consists of a combination of the following:
Parent management training (PMT).
Psychotherapy (talk therapy).
School-based interventions (outlined immediately above).
Parent management training for ODD This is the main treatment for oppositional behaviors. It teaches parents ways to change their child’s behavior in the home by using positive reinforcement to decrease unwanted behaviors and promote healthy behaviors. PMT has been shown to decrease conduct problems in multiple contexts significantly.
Psychotherapy for ODD Psychotherapy is a term for a variety of treatment techniques that aim to help people identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to the child and family.
Common types of psychotherapy that help treat ODD include:
Cognitive behavioral therapy (CBT): The child will come to understand how their thoughts affect their actions. Through CBT, the child can unlearn negative thoughts and behaviors and learn to adopt healthier thinking patterns and habits. CBT-based anger management training is useful in treating anger problems in children with ODD. In older children, problem-solving skills training and perspective-taking are helpful therapy strategies.
Family-focused therapy: This therapy is for children with ODD and their caregivers. During this treatment, the child and family will join together in therapy sessions of psychoeducation regarding ODD, communication improvement and problem-solving skills. It can help identify factors in home life that may contribute to or worsen aggressive behaviors.
Peer group therapy: A child learns better social skills.
Consistency of care: All people involved in the care (including grandparents and educational staff in a childcare, kindergarten and/or school setting) of the child need to be consistent in the way they behave and manage the child.
Social stories: Develop an understanding about expectations in certain social situations.
Managing other areas of concern that may be causing the child to display poor behaviour (e.g. difficulties understanding expectations, difficulties with reading and writing, difficulties expressing themselves and getting their message across).
Medications for ODD Although there isn’t medication formally approved to treat ODD, your child’s healthcare provider or psychiatrist might prescribe certain medications to treat other conditions they may have, such as ADHD, OCD or depression. If left untreated, these conditions can make the symptoms of ODD worse (Cedars Sinai, n.d.; Cleveland Clinic, 2022; Kid Sense, n.d.; Scope, n.d.; Smart Pediatrics, n.d.; Woodcock, n.d.)
High-Tech treatment options
Some of the above management approaches may now be available online (Smart Pediatrics, n.d.):
Telehealth-Based Parent Management Training (PMT) Telehealth platforms provide remote access to parent training programs, where therapists coach parents on behavior management strategies, communication techniques, and consistent discipline.
Interactive Behavioral Therapy Apps Apps like Mightier (https://www.mightier.com/resources/mightier-for-children-with-adhd/) and Breathe, Think, Do (https://sesameworkshop.org/resources/breathe-think-do/)offer games and exercises to help children with ODD learn self-regulation and problem-solving skills in an engaging, interactive format.
Digital Cognitive Behavioral Therapy (CBT) Programs Online platforms offer structured CBT programs for children with ODD to practice coping skills, emotional regulation, and anger management techniques. (See Appendix 3 in the CBT topic located elsewhere on this website – access via the contents tab.)
Wearable Devices for Behavior Monitoring Devices like Pip use biofeedback to track emotional states and stress levels, helping children and parents become more aware of emotional triggers that may lead to defiant behaviour (https://suburban-mum.com/the-pip-stress-management-device-review/).
Occupational therapy and Speech therapy approaches can provide support for children and their parents / carers. See Appendix 1.
Looking after parents/ carers with a child with ODD
Parents and caregivers who have a child with ODD should take time to care for themselves.
Make time every day to read a book, watch a TV show, go for a walk, or do something enjoyable. Start with 5 minutes at the end of the day if necessary.
Ask family, friends and other members of support networks to look after the child for a little while.
Make time for physical activity – for example, walking, yoga or swimming.
Make time to do fun activities with your partner. A child’s challenging behaviour can be stressful for relationships.
See a counsellor or other professional.
Share support, advice and experiences with other parents (Raising Children Network, 2024).
Outlook / Prognosis
Children with ODD can experience significant issues in school, at home and in social relationships. Mild to moderate forms of ODD often improve with age, but more severe forms can evolve into conduct disorder (Cleveland Clinic, 2022).
With the right support, children diagnosed with Oppositional Defiant Disorder can make meaningful progress and lead positive, successful lives. The earlier a child and their family begin working with professionals such as therapists, behavioral specialists, or support staff at school the more manageable the behavior tends to become over time.
Many children respond well to structured treatment plans, especially when parents and teachers are actively involved. As they learn healthier ways to handle frustration, follow rules, and express their emotions, the intensity and frequency of defiant behaviors often decrease.
Creating a strong support system is key. This includes regular therapy sessions, clear communication with educators, and ongoing involvement from family members. A team-based approach helps the child feel understood and supported in all aspects of life from home and school to friendships and social activities (Scope, n.d.).
However, if left untreated, ODD a child may have difficulties with:
Following instructions.
Vocabulary whereby a child cannot clearly get their message across due to limited word knowledge.
Understanding jokes and figurative language during interactions with others, and when watching TV shows and movies and reading books.
Managing a full school day due to poor strength and endurance.
Participating in sporting activities leading to an inactive lifestyle, increasing the risks of other health related issues such as obesity, diabetes, cardiovascular disease or similar conditions.
Self-esteem and confidence.
Bullying.
Fine motor skills (e.g. writing, drawing and cutting) due to poor core stability.
Completing self-care tasks (e.g. doing up shoelaces, buttons, zips, using cutlery).
Self-regulation and behaviour.
Accessing the curriculum because they are unable to attend to tasks long enough to complete assessment criteria.
Sleep habits, impacting upon skill development due to fatigue.
Social isolation because they are unable to cope in group situations or busy environments, impacting on their ability to form and maintain friendships.
Anxiety and stress in a variety of situations leading to difficulty reaching their academic potential.
Reading/understanding social situations and being perceived as ‘rude’ by others.
Social communication, such as eye contact, appropriate distance when talking to someone, turn-taking within a conversation.
Academic performance: Developing literacy skills such as reading and writing and coping in the academic environment.
Academic assessment: Completing tests, exams and academic tasks in higher education (Kids Sense, n.d.).
Suggestions for Practice
The following points drawn from the Background Material above, appear relevant for social workers seeking to offer support to those with ODD:
Knowledge of the criteria for diagnosis and the recommended management strategies are essential. In particular be prepared to refer to the relevant professional for support, e.g. to a GP for a mental health treatment plan.
Be aware of other mental health problems that could accompany ODD or arise because of it: ADHD, anxiety disorders, learning difficulties, mood disorders, impulse control disorders and conduct disorder.
Teenagers are often under diagnosed with ODD.
First Nations young people are three times more likely to be diagnosed with ODD as their non-First Nations peers.
ODD can occur in adults. It manifests in a pattern of negative, hostile and defiant behaviour. Because of ODD adults can find it difficult to keep jobs and maintain relationships and marriages.
Be aware of the symptoms in children, under the three headings of anger and irritability, argumentative and defiant behaviour and vindictiveness (details in Background Material above).
Diagnosis is more likely if risk factors are present, e.g. abuse, parent with substance disorders, exposure to violence, lack of supervision, family instability, and parents who have ODD, ADHD or behavioural problems.
After a diagnosis there are a number of options for offering support. Parents and caregivers should be educated about these. There are three main options: parent management training, psychotherapy (e.g. CBT, family focused therapy, consistent care), and school-based interventions. Medication is not formally approved for ODD but could be prescribed to treat other mental health conditions such as ADHD, OCD or depression. Details on management options can be found in the Background Material above.
The prognosis for ODD, if left untreated, is poor because of the difficulties children and adults will face. Therefore it is important to encourage those with ODD to use the management options.
It seems social workers have two roles in supporting a person with ODD and their parents / caregivers. In cases where the individual fits the criteria for a formal diagnosis then a visit to the GP or other professional qualified to make such a diagnosis would be appropriate. If the diagnosis suggests ODD, then the management strategies outlined above can be implemented with the support of a mental health plan from the GP. The social worker role in this process will be to monitor the situation, support parents /caregivers, and, if relevant, provide feedback to the professional administering the therapy. The social worker may also have a role in supporting the parent to contact the school so teachers can adopt some of the strategies suggested by the health professional.
However, if the symptoms of ODD do not appear serious enough for a formal diagnosis, then the social worker will be able to guide the parents / individual in strategies to manage the presenting issues. This could involve the following:
Listening empathetically to the parent / individual to gain a full idea of the presenting problem.
Utilising a biopsychosocial assessment to obtain as full a picture as possible of the influences, both positive and negative on the person and family.
Identifying what seems to be working at certain times, or in certain situations.
Educate the parent / caregiver / individual in the strategies suggested in the Background Material above and choose strategies that seem manageable to trial.
With the parent / individual devise a behaviour support plan to help parents:
· understand the causes of the child’s behaviour
· work out how to encourage positive behaviour in the child
· support the child to manage strong emotions and improve social skills
· work on strengthening family relationships.
The plan would involve some of the following:
· Use specific praise to encourage positive behaviour. For example, ‘It was really helpful when you put your plate on the bench’.
· Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
· Give short, clear and positive instructions. For example, ‘Please put the dishes in the sink’.
· Give choices about when the child can do tasks, not whether the child will do them. For example, ‘Would you like to do your homework now or after the next TV show?’
· Use consequences in the same way and for the same behaviour every time. This means the child knows what to expect. For example, always use a time-out for hitting.
· Follow up on challenging behaviour straight away. For example, if the child doesn’t do what you ask, ask again and say, “This is the last time I am going to ask you”. If the child still doesn’t cooperate, use a consequence like loss of privilege.
· Acknowledge the child’s strong emotions and offer to help. For example, ‘I understand you’re feeling angry. Do you want to talk about it?’
· Spend enjoyable time with the child so they know they are important to the parents.
Inform the school and include teachers in any action plans. Seek their support and support the school in its endeavours to assist the child.
Social workers will find more resources around supporting parents / caregivers in the Parenting topic elsewhere on this website.
At subsequent sessions evaluate progress or lack thereof and move to other strategies as appropriate.
Throughout this process support the parents / caregivers using the strategies included in the Background Material (and the topic on Caregivers, elsewhere on this site). For example, make time daily for oneself (even five minutes), seek support from family and friends, engage in physical activity, spend enjoyable time with a partner, engage in counselling, join a parent support group.
Social workers will have their own way of supporting parents built on their practice experience thus far. Many approaches outlined elsewhere on this website may be relevant to consider: BPSS, child aware practice, co-regulation, crisis intervention, problem solving, solution-focused therapy, task centred and trauma-informed practice.
References
Cleveland Clinic. (2022). Oppositional defiant disorder (ODD). https://my.clevelandclinic.org/health/diseases/9905-oppositional-defiant-disorder
Cedars Sinai. (n.d.). Oppositional defiant disorder in children. https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/o/oppositional-defiant-disorder-odd-in-children.html
Hawes, D.J., Gardner, F., Dadds, M.R., Frick, P.J., Kimonis, E.R., Burke, J.D., & Fairchild, G. (2023). Oppositional defiant disorder. Nature Reviews Disease Primers, 9, Article 31. https://doi.org/10.1038/s41572-023-00441-6.
Kid Sense. (n.d.). Oppositional defiance disorder (ODD). https://childdevelopment.com.au/areas-of-concern/diagnoses/oppositional-defiance-disorder-odd/
NSW Government. (n.d.). Evidence-based strategies for oppositional defiant disorder (ODD). https://education.nsw.gov.au/campaigns/inclusive-practice-hub/all-resources/primary-resources/understanding-disability/oppositional-defiant-disorder/evidence-based-strategies
Raising Children Network. (2024). Oppositional defiant disorder (ODD): Children and pre-teens. https://raisingchildren.net.au/guides/a-z-health-reference/odd
Rodden, J. (2019). What does oppositional defiant disorder look like in adults? https://www.additudemag.com/oppositional-defiant-disorder-in-adults/
Scope. (n.d.). Oppositional defiant disorder (ODD): Symptoms and treatment. https://www.scopeaust.org.au/news/oppositional-defiant-disorder-odd-symptoms-treatment
Smart Pediatrics. (n.d.). Oppositional defiant disorder (ODD). https://smartpaediatrics.com.au/services/oppositional-defiant-disorder
Woodcock, E. (n.d.). Oppositional defiant disorder (ODD). https://mindboxpsychology.com.au/child-psychology/treatment-for-oppositional-defiant-disorder/
Appendix 1
Occupational Therapy and Speech Therapy approaches
Occupational and speech therapy approaches that can provide support for children and their parents / carers.
Occupational Therapy approaches include:
Expand abilities: Developing a gradually broadening range of skill areas.
Social stories: Providing ideas and education around social story development.
School transition: Advocating and professionally supporting the transition to school and liaising with teachers, as required.
Visual cues can be used to support routine and to introduce new, or a change in tasks.
Gross and fine motor skills: Determining the current age level of a child’s gross and fine motor abilities.
Devise goals: Set functional and achievable goals in collaboration with the child, parents and teachers so that therapy has a common focus beneficial to everyone involved.
Educating parents, carers, teachers and others involved in the child’s care about ODD and the age-appropriate skills a child should be demonstrating.
Direct skill teaching through a task-based approach.
Strategies: Providing management strategies/ideas to assist the child in the home, at school and in the community.
Task engagement: Providing alternative ways to encourage task engagement.
Developing Underlying skills necessary to support whole body (gross motor) and hand dexterity (fine motor) skills, such as providing activities to support:
balance and coordination
strength and endurance
attention and alertness
body awareness
movement planning (Kid Sense, n.d.)
Speech Therapy approaches include:
Speech and language assessment to help the family to understand how the child is processing, understanding, learning and using language and communication.
Communication strategies: Providing the family with strategies and techniques to increase and enhance communication with the child.
Daily activities: Helping the child to understand the environment, routines and language.
Developing language: Helping the child to understand and use richer language and to use language more spontaneously.
Conversation skills: Developing conversation skills (e.g. back and forth exchange, turn taking).
Concept skills: Developing concept skills, especially abstract concepts, such as time (e.g. yesterday, before, after).
Visuals can be used to help with understanding and the child’s ability to express their needs, wants and thoughts.
Social skills: Development of social skills (i.e. knowing when, how to use language in social situations).
Enhancing verbal and non-verbal communication including natural gestures, speech, signs, pictures and written words.
Visual strategies: Using visual information to help understand, organise and plan the routine for the day.
Liaising with educational staff regarding the nature of the difficulties and ways to help the child to access the curriculum (Kid Sense, n.d.)
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