In Consultation


In Consultation

Enlisting the ODD Child: How to move beyond the power struggle

By James Levine

November/December 2008


Q: I'm a public school counselor with a fifth-grade boy diagnosed with AD/HD and ODD. At least five behavioral plans have been tried unsuccessfully. What should I do?

A: Children diagnosed with oppositional defiant disorder (ODD) inspire many myths. School personnel and even parents believe that these children enjoy frustrating others, don't care what anybody thinks about them, and are impossible to teach.

But ODD is a label for various behaviors, and it indicates nothing about why such children act as they do. Are they experiencing repeated trauma? Do they have Asperger's Syndrome and are getting more sensory stimulation than they can handle? Are they worn out and angry from living with anxiety or depression?

Harried teachers and counselors often resort to interventions without devoting enough time to learning what's driving the child to behave in this way. Once a reasonable hypothesis has been made about the cause of their actions, however, cognitive-behavioral techniques and traditional relationship-building strategies can help even the most challenging children.

Tim, 11 years old and entering the fifth grade, angered not only his teacher and principal, but many of his peers. When I observed him in the classroom, he was distractible and impulsive, continually scanning the room, calling out, and touching things and people. There was no denying the glint in his eye when the teacher sent him off to the principal's office…

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