by Anthony Kane MD

Introduction

Developing healthy peer relationships is critical for normal development of a child. Peer relationships have been found to be an important predictor of positive adult adjustment and behavior. Difficulty in finding friends leads to feelings of low self-esteem and these feelings usually continue into adulthood.

Children with poor social skills are at risk for delinquency, academic underachievement, and school drop out. Even though inattentiveness, impulsiveness, and restlessness frequently persist into adult life, these problems are of less importance as child gets older. Rather, main difficulty ADHD patients encounter as they reach maturity is their inability to interact appropriately with others.

An ADD ADHD child often lacks social skills that are essential to success in life. These children can be socially inept, and their lack of interpersonal skills may cause them a multitude of difficulties. In addition, positive relationships with friends in childhood provide a critical buffer against stress and help to protect against psychological and psychiatric problems. ADHD children lack these positive interactions and thus are at risk for a number of emotional problems.

Probably 60% of ADHD children suffer from peer rejection. ADHD children are less often chosen by peers to be best friends, partners in activities, or seatmates. As children grow older, their social problems seem to get worse. Their inappropriate behavior leads to further social rejection and exacerbates their inability to relate to others appropriately. Long term these children are more likely to have difficulty finding and maintaining successful careers. This is not surprising since social aptitude can make or break careers and relationships in adult world.

Causes of Poor Peer Relationships

ADHD children are frequently disliked or neglected by their peers. It is difficult to determine all factors that make a child unpopular, but children who frequently display aggressive or negative behavior tend to be rejected by their peers.

Impulsivity and Aggression

ADHD children tend to be more impulsive and aggressive than other children. Teachers observe that social interactions of ADHD children more often involve fighting and interrupting others. These children are more intense than others and behave inappropriately in social contexts. For example, ADHD children are more likely to yell, run around and talk at unsuitable times. They also tend to want to dominate play, engage in off task behaviors and engage more in teasing and physical jostling of peers. This sets up a process of peer rejection.

Academic Problems

ADHD children often do not do well in school. Poor school performance by itself does not result in social rejection. However, way child responds to his academic difficulties can contribute to inappropriate social behavior. Children who cannot engage themselves with classroom work assignments often disrupt and irritate their peers.

Inattention

by Anthony Kane, MD

Introduction

Oppositional defiant disorder (ODD) is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work.

Oppositional defiant disorder is sometimes a precursor of conduct disorder. Much of literature tends to lump these two conditions together. However, they seem to be distinct entities and, although conduct disorder does have a genetic component, ODD does not.

Description

Oppositional defiant children show a consistent pattern of refusing to follow commands or requests by adults. These children repeatedly lose their temper, argue with adults, and refuse to comply with rules and directions. They are easily annoyed and blame others for their mistakes. Children with ODD show a pattern of stubbornness and frequently test limits, even in early childhood.

These children can be manipulative and often induce discord in those around them. Commonly they can incite parents and other family members to fight with one and other rather than focus on child, who is source of problem.

Behavioral Symptoms

Common behaviors seen in oppositional defiant disorder include:

Losing one’s temper Arguing with adults Actively defying requests Refusing to follow rules Deliberately annoying other people Blaming others for one's own mistakes or misbehavior Being touchy, easily annoyed Being easily angered, resentful, spiteful, or vindictive. Speaking harshly, or unkind when upset Seeking revenge Having frequent temper tantrums

Many parents report that their ODD children were rigid and demanding from an early age.

Normal children, especially around ages or 2 or 3 or during teenage years display most of these behaviors from time to time. When children are tired, hungry, or upset, they may be defiant. However, children with oppositional defiant disorder display these behaviors more frequently and to extent that they and interfere with learning, school adjustment, and, sometimes, with child's social relationships.

Diagnosis

The diagnosis of ODD is not always straight forward and needs to be made by a psychiatrist or some other qualified mental health professional after a comprehensive evaluation. The child must be evaluated for other disorders as well since ODD usually does not come alone. If child has ADHD, mood disorders, or anxiety disorders, these other problems must be addressed before you can begin to work with ODD.

If you feel your child may have ODD, there is a quick screening test. Go to:

http://addadhdadvances.com/ODDtest.html

Causes

What is cause of ODD? The real answer is that nobody knows. However, since as scientist we hate to admit this, we have currently have two theories.

The developmental theory proposes that ODD is really a result of incomplete child development. For some reason, these children never complete developmental tasks that normal children learn to master during toddler years.

The learning theory suggests that ODD comes as a response to negative interactions. The techniques used by parents and authority figures on these children bring about oppositional defiant behavior.

ODD is most common psychiatric diagnosis in children and it usually persists into adulthood. One would think a lot of research would be done on this condition. That is not case. While there are hundreds of research studies on ADHD and childhood mood disorders, there is very little research on ODD.

Co-morbidity