After reading a concern that children in the States were being pacified through a combination of spurious diagnoses and subsequent medication we started asking around about the use of Oppositional Defiant Disorder as a diagnosis in the UK.

ODD is characterised by ‘an ongoing pattern of anger-guided disobedience, hostility, and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behaviour’ and it is clear that the word ‘normal’ in that definition from the controversial Diagnostic and Statistical Manual of Mental Disorders is the moot point.

The message we received is that it has been in use in the UK for at least a decade but that not everyone was happy with it. We then turned to Dave Whitaker, head of the wonderful Springwell Special School in Barnsley for his expert, profesional point of view. This is what he said when asked the question to the effect, ‘So, ODD, real disorder or made-up problem to quieten kids down and sell drugs?’:

“The million dollar question! We have a number of pupils with ODD at Springwell. Some have comorbidity so they have ODD along with conditions such as ADHD. My own view, and therefore not a medical view, is that ODD is a social problem that stems from developmental gaps in early childhood. This can be tackled through Nurture principles and effective profiling (see Marjorie Boxall who first developed Nurture Groups).

There is a really powerful concept that I use in training called ‘The Circle of Influence’ that explores why pupils behave in a certain way based on their own developmental influences. This includes the concept of ‘received behaviour’, where schools and other people in authority have to deal with oppositional behaviour traits that have been developed in children from a very early age due to their social circumstances.

Here at Springwell we focus on ‘locus of control’ with children with ODD. For example, if a child is up a tree and refusing to get down I would tell them that its ok to stay up the tree and therefore I take the locus of control from the pupil. Nine times out of ten the pupil will then get down from the tree. Another technique is to ask a question that the pupil will answer in the way you want them to. “Are you going to do five maths questions or ten?” The pupil chooses five because he thinks it’s easier and you actually only wanted him to do five anyway! Locus of control is with the teacher. Use language cleverly to take away the option of defiance.”

One thing we particularly like about the work of Dave and his staff at Springwell is that it is always about seeing the child and his or her potential not his or her behaviour, diagnoses or disorders. He is also always honest.

“That said, the ODD kids are probably the hardest kids to deal with on a day to day basis and the ones that require the most resilience from staff.”

What do you think about ODD – label for social control, illness that needs medicating, consequence of poor parenting and unfortunate life experiences, something else or all of the above?