Even the best-behaved Aspergers children can be difficult and challenging at times. Aspergers adolescents are often moody and argumentative. But if your Aspergers child or adolescent has a persistent pattern of tantrums, arguing, and angry or disruptive behaviors toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). As many as one in 10 Aspergers children may have ODD in a lifetime.
Treatment of ODD involves therapy and possibly medications to treat related mental health conditions. As a parent, you don't have to go it alone in trying to manage an Aspergers child with ODD. Doctors, counselors and child development experts can help you learn specific strategies to address ODD.
It may be tough at times to recognize the difference between a strong-willed or emotional child and one with ODD. Certainly there's a range between the normal independence-seeking behavior of Aspergers kids and ODD. It's normal to exhibit oppositional behaviors at certain stages of a youngster's development.
However, your Aspergers child's issue may be ODD if your youngster's oppositional behaviors:
- Are clearly disruptive to the family and home or school environment
- Are persistent
- Have lasted at least six months
The following are behaviors associated with ODD:
- Hostility directed toward authority figures
These behaviors might cause your Aspergers child to regularly and consistently show these symptoms:
- Academic problems
- Acting touchy and easily annoyed
- Aggressiveness toward peers
- Anger and resentment
- Argumentativeness with adults
- Blaming others for mistakes or misbehavior
- Deliberate annoyance of other people
- Difficulty maintaining friendships
- Frequent temper tantrums
- Refusal to comply with adult requests or rules
- Spiteful or vindictive behavior
Related mental health issues—
ODD often occurs along with other behavioral or mental health problems such as attention-deficit/hyperactivity disorder (ADHD), anxiety or depression. The symptoms of ODD may be difficult to distinguish from those of other behavioral or mental health problems.
It's important to diagnose and treat any co-occurring illnesses because they can create or worsen irritability and defiance if left untreated. Additionally, it's important to identify and treat any related substance abuse and dependence. Substance abuse and dependence in Aspergers kids or adolescents is often associated with irritability and changes in the Aspergers child or adolescent's usual personality.
There's no clear cause underpinning ODD. Contributing causes may include:
- A biochemical or neurological factor
- A genetic component that when coupled with certain environmental conditions — such as lack of supervision, poor quality child care or family instability — increases the risk of ODD
- The Aspergers child's inherent temperament
- The Aspergers child's perception that he or she isn't getting enough of the parent's time and attention
- The family's response to the youngster's style
A number of factors play a role in the development of ODD. ODD is a complex problem involving a variety of influences, circumstances and genetic components. No single factor causes ODD. Possible risk factors include:
- Being abused or neglected
- Exposure to violence
- Family instability such as occurs with divorce, multiple moves, or changing schools or child care providers frequently
- Financial problems in the family
- Harsh or inconsistent discipline
- Having a parent with a mood or substance abuse disorder
- Lack of supervision
- Moms and dads with a history of ADHD, ODD or conduct problems
- Poor relationship with one or both moms and dads
- Substance abuse in the Aspergers child or adolescent
When to seek medical advice—
If you're concerned about your Aspergers child's behavior or your own ability to parent a challenging youngster, seek help from your doctor, a child psychologist or child behavioral expert. Your primary care doctor or your youngster's pediatrician can refer you to someone.
The earlier this disorder can be managed, the better the chances of reversing its effects on your Aspergers child and your family. Treatment can help restore your youngster's self-esteem and rebuild a positive relationship between you and your Aspergers child.
Tests and diagnosis—
Behavioral and mental health conditions are difficult to diagnose definitively. There's no blood test or imaging technique that can pinpoint an exact cause of behavioral symptoms, though these tests are sometimes used to rule out certain conditions. Physicians and other health professionals rely on:
- Information gained from interviewing the Aspergers child
- Information gathered from moms and dads and teachers, who may fill out questionnaires
- Their clinical judgment and experience
Normal child and adolescent behavior and development can be challenging in their own right, but ODD is distinct due to the frequent and significant disruptions that are caused in the youngster's life at home, school, or in a job where authority figures have clear limits and expectations for behavior.
It can be difficult for doctors to sort and exclude other associated disorders — for example, attention-deficit/hyperactivity disorder versus ODD. These two disorders are commonly diagnosed together.
Many Aspergers kids with ODD have other treatable conditions, such as:
- Attention-deficit/hyperactivity disorder (ADHD)
If these conditions are left untreated, managing ODD can be very difficult for the moms and dads, and frustrating for the affected Aspergers child. Kids with ODD may have trouble in school with teachers and other authority figures and may struggle to make and keep friends.
ODD may be a precursor to other, more severe behavioral disorders such as conduct disorder, but this is controversial.
Treatments and drugs—
Ideally, treatment for ODD involves your primary care doctor and a qualified mental health professional or child development professional. It may also help to seek the services of a psychologist specializing in family therapy.
These health professionals can screen for and treat other mental health problems that may be interfering with ODD, such as ADHD, anxiety or depression. Successful treatment of the often-coexisting conditions will improve the effectiveness of treatment for ODD. In some cases, the symptoms of ODD disappear entirely.
Successful treatment of ODD requires commitment and follow-through by you as a parent and by others involved in your youngster's care. Most important in treatment is for you to show consistent, unconditional love and acceptance of your Aspergers child — even during difficult and disruptive situations. Doing so can be tough for even the most patient moms and dads.
Learning or improving parental skills—
A mental health professional can help you learn or strengthen specific skills and parenting techniques to help improve your Aspergers child's behavior and strengthen your relationship with him or her. For example, you can learn how to:
- Avoid power struggles
- Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both moms and dads will do with the Aspergers child
- Give effective timeouts
- Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount of time
- Offer acceptable choices to your Aspergers child, giving him or her a certain amount of control
- Recognize and praise your Aspergers child's good behaviors and positive characteristics
- Remain calm and unemotional in the face of opposition
Success requires perseverance, hard work—
Although some parent management techniques may seem like common sense, learning to use them in the face of opposition isn't easy, especially if there are other stressors at home. Learning these skills may require counseling, parenting classes or other forms of education, and consistent practice and patience.
At first, your Aspergers child is not likely to be cooperative or to appreciate your changed response to his or her behavior. Expect that you'll have setbacks and relapses, and be prepared with a plan to manage those times. In fact, behavior often temporarily worsens when new limits and expectations are set. However, with perseverance and consistency, the initial hard work often pays off with improved behavior and relationships.
Individual and family counseling—
Individual counseling for your Aspergers child may help him or her learn to manage anger. Family counseling may help improve communication and relationships and help family members learn how to work together.
Lifestyle and home remedies—
At home, you can begin chipping away at problem behaviors by practicing the following:
- Assign your Aspergers child a household chore that's essential and that won't get done unless the youngster does it. Initially, it's important to set your youngster up for success with tasks that are relatively easy to achieve and gradually blend in more important and challenging expectations.
- Build in time together. Develop a consistent weekly schedule that involves moms and dads and youngster being together.
- Model the behavior you want your Aspergers child to have.
- Pick your battles. Avoid power struggles.
- Recognize and praise your Aspergers child's positive behaviors.
- Set limits and enforce consistent reasonable consequences.
- Set up a routine. Develop a consistent daily schedule for your Aspergers child.
- Work with your spouse or others in your household to assure consistent and appropriate discipline procedures.
Coping and support—
For yourself, counseling can provide an outlet for your own mental health concerns that could interfere with the successful treatment of your Aspergers child's symptoms. If you're depressed or anxious, that could lead to disengagement from your Aspergers child — and that can trigger or worsen oppositional behaviors. Here are some tips:
- Be forgiving. Let go of things that you or your Aspergers child did in the past. Start each day with a fresh outlook and a clean slate.
- Learn ways to calm yourself. Keeping your own cool models the behavior you want from your Aspergers child.
- Take time for yourself. Develop outside interests, get some exercise and spend some time away from your Aspergers child to restore your energy.