It is very important to realize that all children are unique and that their temperaments differ.  Two children growing up in the same house might differ completely on the introversion-extroversion continuum.  One might be a social butterfly, whilst the other one might always be hiding behind your legs at birthday parties.  We should celebrate their differences and help both of them to learn the necessary social skills they will need in the future and find their own B.F.F.

What can you as a parent do?

• Teach your child what friendship entails. Children should know what is seen as friendly behavior and what not.  Gossiping is unacceptable and hurtful behavior. In order to maintain friendships, they should continuously work at it. Point out to your child when you notice she is doing something nice for example sharing her lunch with her friend.
• Do not push your child to be popular. Some children will have many friends and others only few.  At the end of the day it is important for your child to have someone they can confide in and trust completely.



• Encourage diversity in friendships. I think it is beneficial to children to have friends out of all walks of life.  A child does not have to only have friends in their class at school, there should also be friends at extra-mural activities and other social groupings. You can use your child’s interests to help her meet other children with similar interests.
• Teach your child how to effectively express herself. When a child knows how to convey her feelings and thoughts effectively, she is able to be open and honest in her friendships.  Point out to her how her attitude and even appearance can either promote social interaction or prevent it.
• Be a good listener. Listening to your child’s conversations gives you the opportunity to pick up when she is experiencing difficulties in her friendships.
• Model good friendship behavior. Our children are always watching us.  When we have good friendships and maintain those friendships our children learn from us and copy our behavior. Hospitality is such an important skill to learn and we as parents should strive to always be hospitable – it is not only beneficial to our own friendships, but children learn how to make their friends feel at home and act in a friendly manner.

How can you help your shy child to form friendships?

• Use every opportunity to build friendships based on what your child finds interesting.
• Include brothers, sisters, cousins and other potential friends in your child’s daily routine.
• Organize playdates, but keep them small and short.  Plan ahead and have activities which your child enjoys and is good at.
• Embrace the latest fad, whether it is silkworms or stickers.  The fad is something that the children will have in common.
• Be a play date to your child.  This gives you the chance to see how your child plays with other children and also gives you the opportunity to model correct behavior.

Good friendships will boost your child’s confidence and self-esteem, whilst a bad friendship will leave her feeling belittled and down.  As parents we cannot choose our childrens’ friends or interfere with all the fights, but we have to monitor and guide our children for their own benefit.

As I explained, oppositional behavior is expected at certain times during a child’s development. But many parents ask the question: “When is my child’s behavior not just a symptom of growing up? When should I worry about this behavior that is making the family’s life unbearable?”

Oppositional behavior becomes a problem when he is frequently and consistently defiant of authority and his behavior is worse that that of his peers.  It becomes a problem when his behavior affects his social, family and academic life. Children who suffer from Oppositional Defiant Disorder have an ongoing pattern of uncooperative, defiant and hostile behavior when it comes to authority figures.

Symptoms of Oppositional Defiant Disorder:

• Frequent tantrums
• Excessive arguing with adults
• Always questioning the rules
• Active defiance and refusal to comply with requests and rules
• Deliberate attempts to annoy and upset others
• Blaming others for their mistakes or misbehavior
• “Touchy”, over sensitive and easily annoyed by others
• Frequent anger and resentment
• Mean and hateful speech when they are upset
• Spiteful attitude
• Seeking revenge.

These symptoms have to be present in multiple setting in order for your child to be diagnosed as Oppositional Defiant.

Will my child become Oppositional Defiant?

Early signs of oppositional defiant behavior is when infants are very fussy, colicky and difficult to soothe.  Power struggles ensue over eating, sleeping and potty training. These children throw many temper tantrums in an attempt to change their parents’ behavior.

When they get older you will find that the child consistently dawdle and procrastinate when it comes to tasks and requests.  They often claim to not have heard your request. Older children will turn homework, keeping their room clean, picking toys up and bathing into a battle field, and they will do almost anything to end up as the winner. You will find that this child talks back and interrupts conversations.

What causes Oppositional Defiant Disorder?

The jury is still out on this issue, but we generally agree that it is a combination of genetics and environment.

1. A circular family dynamic is common in the households from which children with ODD comes. These children who are temperamentally inclined to be difficult and easily angered cause frustration for the parents. Being frustrated with their child they start expecting certain reactions when they request things. Anticipating a negative response from their child they become unresponsive parents, leaving the child feeling helpless, needy and frustrated.
2. These children find that negative attention is better than no attention at all.  They annoy their parents on purpose just to get a reaction from them.
3. Parents with children with ODD are often inconsistent when disciplining their child. Today he is allowed to put his feet on the table, but tomorrow it is unacceptable.  Inconsistent parenting leads to a child feeling unsafe and unsure of rules.

How can I help my child with Oppositional Defiant Disorder?

There is no medication that can change oppositional defiant behavior.  Medication can, though be given to children with ODD to help them cope with the co-morbid  conditions of Attention Deficit Hyperactivity Disorder and Learning Disorders. Many children with ODD also suffer from debilitating Depression that can be effectively treated with medication.

Parent Management Training helps parents change their own behavior which in turn can alter their child’s negative behavior.  Parents often need training to rather focus on their child’s pro-social behavior instead of giving negative attention. Ineffective harsh punishment and poor parent modeling should be replaced by the use of effective brief non-aversive punishment.

How can I help myself as a parent of a child with Oppositional Defiant Disorder?

• Organize a baby sitter at least once a week to give you and your partner the opportunity to go out.
• Give yourself some time to vent and moan about your difficulties with your child.
• Get regular exercise.
• Make sure you get enough sleep.
• Follow a balanced diet and avoid drastic diets.
• Try to not take too many things on at the same time.
• Avoid alcohol.
• Get a hobby to distract yourself.
• Limit the amount of TV, video and computer games in the house.

The prognosis for children with ODD is not all bad.  Some children simply out of it, whilst others’ diagnosis change to ADHD or Conduct Disorder. Unfortunately other disorders are common with children with ODD, it is unusual but about 5% of these children retain their diagnosis.

Conduct Disorder is often only the result of ODD when Opposition Defiant Disorder is already present when the child is 3 or 4 years old and the defiant behavior is severe.  It has been found that children with Conduct Disorder usually have a biological parent who is a career criminal.

Children do not necessarily present with the signs of depression that we notice in adults. The following can be possible signs that your child is depressed:

• Crying, sadness, feelings of hopelessness and helplessness
• Feelings of being discouraged or worthless
• Loss of interest in the activities she enjoyed previously
• Constant tiredness, low energy levels and boredom
• Temper tantrums, irritability and being easily annoyed
• Feelings of rejection
• Drop in achievement levels at school
• Constant fidgeting or feeling restless
• Emotional outbursts, shouting or complaining
• Inability to communicate
• Physical complaints without a sound medical reason behind it. Children often complain of headache, stomachache or pain in their limbs.
• Parents might notice an increase or decrease in their child’s appetite
• Children who are depressed might show changes in their sleeping pattern – either sleeping more or struggling to sleep.
• Problems with concentration.

We have to realize that depression is different from just having the “blues ”. Depression lasts longer and is more intense, leaving a child immobilized and broken down with no self-esteem. It affects interpersonal relationships and school performance. A child that once was popular may become withdrawn, lonely and an academic under-achiever.

What causes a child to become depressed?

There are different things that can contribute to depression. We distinguish between underlying factors that predispose a child to having depression and events that can trigger a depressive episode.

Some children are genetically predisposed to becoming depressed. Often there is a family history of depression. Developmental events can also play a role – for instance severe separation anxiety can predispose a child to depression. Physiological stressors for instance an illness or handicap and psychological stressors like grieving or an adult with depression in the house can contribute to depression.

The type of events that can trigger depression is prolonged separation from parents, divorce, death of a person or pet, moving or academic and sport failure can trigger a depressive episode. Failure to live up to perceived expectations play a more important role than parents often realize. Any kind of abuse, whether physical, emotional or verbal can lead to severe depression, breaking the child down up to the point where they feel like an empty shell.

What to do if you suspect your child is depressed:

• Get professional medical and mental health advice as soon as possible.
• In older children, make sure there are no concurrent alcohol or drug abuse.
• Check that any medication your child is taking does not have depression or any symptoms of depression as side-effects.
• Know that normal grieving and reactions to stressful life events should have a short life span and pass over time. Depression tends to be more permeating and longer lasting.
• Make sure that your child’s diet is healthy and complete.
• Monitor your child’s sleeping pattern.
• Stay involved in your child’s life. Try to prevent your child from isolating herself and cutting her off from peer interaction.
• It is important that your child gets regular exercise and stays active.
• Spend time with her and give her the opportunity to communicate to you in a safe environment.
• Try to schedule pleasurable activities on a one-to-one basis, but also as a family.

Children with depression often end up being adults with depression. Stop the cycle as soon as possible. Psychotherapy at a young age can prevent medication use at a later stage. Children do very well in play therapy and family therapy. Family therapy helps to recognize roles in the family and enable children to voice their problems and concerns appropriately.