Dear Director: The ODD Edition

Dear Director,

We adopted our 8-year-old son when he was 2, knowing he had a rough past full of neglect. But we never could have imagined he would be so hard to get along with and even more difficult to parent. He is our 4th son, so we are seasoned parents, but nothing we do seems to work. He fights both me and his dad on every request we make of him. Almost worse then that, he is constantly bickering with, picking fights with, and all out annoying his 3 brothers. He was just diagnosed with Oppositional Defiant Disorder. What is going on?

Signed, Confused

Dear Confused,

It is hard to know, when we take a young child, what his personality, learning style, behavioral issues, or developmental challenges may arise as they grow up.  We like to think of children as “tabula rasa”—clean slates, but they come with unspoken trauma footprints-things we may not know until their brains and language skills and neurological systems grow and are challenged.

Two things come to mind. One is, be careful not to expect this child’s six years with you to translate into being “developmentally on target.” Children with trauma and neglect histories often are delayed in one or more areas of development, like cognitive (how we think about things, and make sense of them), emotional (how we express emotions and manage them internally) or social (how we interact with others, and make and keep friends). He may be delayed in some way, and therapeutic intervention would help him overcome that deficit. Does he have the words to express his frustration at his brothers or his anger when they don’t include him in play? Can he calm himself or does he lash out? Therapy can work on these for sure. Additionally, remember to parent the age you see, so if he is having a tantrum for losing a game with his brothers, interventions should match the two-year old he presents as at that time.

But the more important thing with the diagnosis of Oppositional Defiant Disorder is to remember that they are diagnosing the behaviors, possibly to get medication or services, but not the underlying cause. When I see a child being oppositional, I think, this child is trying to control their world in an attempt to manage anxiety that is causing them to feel out of control. All anxious people do it-try to control things. We may not know what is causing that anxiety, but if you see the behavior in this way, then you can begin to rethink the reason it is happening at that time, and work on reducing the thing that is causing the anxiety, to reduce the behavior. Sometimes it is enough to say, “I see you are worrying because your brothers understand the rules of the game better and keep winning, and you are afraid you will never win.” If you are right, BINGO! And if not, maybe with your help he can tell you want is going on.

Another excellent strategy is to make sure, especially in situations that you know will cause this behavior to rear its head, is to provide your son choices whenever possible. My mother would say, give two choices but make sure both are good with you, or what she called “the illusion of choice.” Say, “do you want to take a bath before dinner or after,” or “do you want to help your dad clean up the dishes or help mom fold the laundry.” If he feels in control, he is less likely to fight following the directive. With his brothers, if any of them are old enough to understand this, offer it as a suggestion. But also watch that they are not raising his anxiety by asking him for too much maturity or taunting him for his age and understanding. Pay attention to their interactions for other clues to what is triggering his anxiety.

Very truly yours, The Director