When is it a behavioral health disorder, when is it ADHD, and when is it simply ‘bad behavior’?

The American Academy of Child and Adolescent Psychiatry  says in its ‘Facts for Families’ No.72, that, ‘All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults.

Oppositional behavior is often a normal part of development for two or three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family and academic life.’  

Oppositional defiant disorder may manifest through angry outbursts and resentment, being vengeful and argumentative toward others, and deliberate defiance.  Boys and girls alike exhibit the disorder.  Often the child is in trouble at school or doesn’t have many friends.  In most cases, there are underlying biological or psychological contributing factors.   

Pomegranate Clinical Director, Demetra Taylor, LPCC-S says, ‘A family should talk with a mental health professional or family physician.  When they’ve tried everything else and the behaviors have become unsafe, it may be time to consider residential treatment.  Typically, ODD is coupled with other diagnoses disorders  such as learning disabilities, ADHD (Attention Deficit/hyperactivity disorder), anxiety disorders, bipolar disorder or depression.’

 Taylor says, ‘ An adolescent might be more apt to engage in substance abuse becoming addicted to drugs or alcohol.   Every situation is different.   The value of a diagnostic assessment is that often a youth will come in with family thinking it’s one thing, and it turns out to be something else. That’s the value of working with multi-disciplinary specialists on a team. With a broader range of assessments, the most effective treatment plan can be implemented.’

 The AACAP says the signs the behavior is oppositional defiant disorder, ‘ODD’, is when ‘there is an ongoing pattern of uncooperative, defiant and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning.’ 

AACAP says between 1 to 16% of children and adolescents may have the disorder. A young person caught truant, past curfew, smoking cigarettes, drinking alcohol or engaging in other risky behaviors might simply be labeled as, ‘testing the limits’  or ‘sampling adulthood’.  When they  vandalize property, don’t come home,  behave in a belligerent, hostile, defiant way, or act out in an unsafe manner against a parent, teacher or guardian, there may be a sign something else is wrong. 

 Taylor says, ‘The disorder can be treated with individual therapy, family therapy, and group therapy.  We help them (and their family) understand the symptoms, to look within themselves and find alternative behaviors to replace the inappropriate responses and over time, to lessen and decrease the objectionable actions and bring the person back to balance.’


About Communications

Communications and Social Media @ Sequel-Pomegranate Health Systems
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