When Parenting Doesn't Work - The Oppositional Child

-->

The Oppositional Child

     Some children don’t respond to normal parenting.. They don’t respond to rewards or punishment and they don’t learn from good discipline.  Repeated negative experiences often cause them to be angry and withdrawn. They are often aggressive and have a history of being kicked out of both daycares and schools.  They have low frustration tolerance, poor emotional regulation and hate to adapt to new situations. These children are diagnosed as having Oppositional-Defiant Disorder.

     Oppositional children can benefit greatly from individual therapy that emphasizes social skills training, behavioral therapy and anger control. Both the parents and the child benefit when the parents learn more effective parenting strategies such as collaborative problem solving.  This is s system that teaches parents how to initiate joint adult-child problem solving to resolve conflicts. The goal is to minimize negative interactions, strengthen parent-child relationships and help the child develop self-control.  “Think:Kids” is a web-based program at www.thinkkids.org that helps aggressive children. The American Academy of Pediatrics offers the “Connected Kids” program. Other resources are “The Explosive Child” by RW Green and “Helping the Noncompliant child” by RJ McMahon. Some schools also offer therapy programs to increase social skills and decrease aggressiveness.

     After therapy and skills training, there is the option of medication. As with ADHD, parents often react negatively to using medication for oppositional children – “I don’t want to drug my kid” – but medication often allows the child to get the most benefit from the behavioral therapy.  Medication can help the child be less frustrated, less angry, and more receptive to the therapy. Children with ADHD often have some oppositional – defiant problems and stimulant ADHD medications improve both problems with minimal side-effects. Non-stimulant AHD medications such as clonidine and guanfacine also improve aggression.  If the child is being seen by a psychiatrist, antipsychotic medications like risperidone can be used to diminish aggression and anger but these drugs have side effects that need to be explained fully to parents.