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Oppositional Defiant Disorder

Oppositional and defiant behaviors are a normal part of early childhood development. It is a normal and adaptive response to changes in physical or emotional states such as being tired, hungry, or angry. However, when these oppositional and defiant behaviors become established at an intensity and duration that are well beyond those of children at their current developmental level, it may be due to an underlying condition known as oppositional defiant disorder (ODD). Oppositional defiant disorder is characterized by a pattern of hostility, irritability, argumentativeness, and defiance that is impairing relationships with peers and adults alike. The frustrations over the constant conflicts build up and often may end up reinforcing maladaptive behavior while damaging the relationship between family members. There is a very high comorbidity rate of children with ADHD who may also have ODD. Figures may even be as high as 30 to 50 percent. The impulsive characteristic of ADHD puts children at risk of developing negative perceptions of adults and peers and being inadvertently reinforced for their problem behavior. Parents and teachers are often put in a position where they find it necessary to accommodate bad behavior in order to maintain peace in the environment.

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At The Anxiety Center, we help children with ODD develop the emotional regulation strategies and social skills necessary to develop meaningful relationships with their family, authority figures, and peers. This is done through structured behavioral therapy aimed at improving interaction patterns between the child and those around them and altering contingencies in the environment to increase the likelihood of desired behavior occurring. Cognitive behavioral therapy is often integrated into treatment to address emotional regulation difficulties and to challenge the misplaced beliefs and expectations about others. Parent involvement is an essential component of our treatment of ODD because oppositional and defiant behaviors are often inadvertently maintained by parenting strategies that have developed as a means to cope with the situation.

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