ODD symptoms in girls most often disputed

“Disagreement about whether children show symptoms of behavioural disorders can make complicate efforts to help and increase the risk of drop-outs from treatment.”

So says child psychologist Linda Helen Munkvold, who is a specialist in child and adolescent psychology at Haukeland University Hospital in Bergen.

Today she is presenting her doctoral dissertation about the behavioural problem known as oppositional defiance disorder, or ODD.

Parents and teachers very rarely agree when young school children (aged 7-9) have symptoms of ODD.

But it’s hardest for them to see eye to eye when children involved are daughters, according to her research.

Fewer frustrations to interpret

Munkvold thinks part of the reason for this is that girls have a developmental head start on boys when they begin school. 

The child psychologists explains that young girls are generally better equipped for tackling school and they will tend to encounter fewer frustrations there which educators could interpret as conduct disorders.

Munkvold adds that international studies indicate teachers are less likely to perceive conduct disorders among girls as serious.

She says teachers are also more consistent about correcting such behaviour among girls in a constructive way.

Munkvold adds that parents are better than educators when it comes to detecting rarer and more obscure forms of behavioural disorders, because they see the children in more situations.

“Girls let it out more at home, and to an extent that explains why there’s more disagreement between parents and teachers when it comes to girls.”

Impacts

Such disagreement between parents and teachers can be quite consequential. One possible outcome is animosity between a child’s guardians and the school.

Another is that children who are perceived by either parents or the school as having problems requiring special attention and follow-ups can fly under the radar.

“As professionals who provide treatment we encounter opposing descriptions of a child’s behaviour and this can make it hard to detect the less obvious cases, where preventive measures could yield very beneficial effects,” says Munkvold.

“To put it simply, it’s harder to find out whether the child has a behaviour disorder, or whether the gist of the problem is the inconsistent way in which parents and teachers deal with the child.”

Attempts to minimize disagreement

The child psychologist says a goal of treatment is often to reduce such disagreement through meetings with parents, the child and teachers. All three parties rarely participate at the same time in such meetings.

She says this means that helpful treatment often requires cooperation among different local authorities such as the Children’s and Young People’s Psychiatric Outpatient Clinic, the Educational Psychological Service and the Child Protective Services.

It’s useful to challenge the parents and teachers regarding their perception of the child. Professionals try to help adults to see things from the child’s perspective.

“In other words, when he or she is doing this or that, try to imagine what the child is attempting to say through its behaviour − something that he or she needs help with,” explains Munkvold.

Can the child simply opt for a change?

According to the child psychologist parents and educators have different ways of interpreting behaviour and explaining its roots.

If a child has difficulties abiding by rules and obeying messages, teachers might have a tendency to say the child can alter its behaviour if he or she wants to – as if the child’s negative conduct is a matter of will.

“From the child’s perspective it might be a form of self-protection, for instance in cases where they feel they can’t come to grips with an assignment at school,” says Munkvold.

At home the child doesn’t have to sit still as much as at school. There are fewer rules to follow and the child’s interplay with others can shift character.

“Parents will thus have a different perception and interpretation. Sometimes the behaviour is determined by or linked to particular situations. Then we aren’t talking about behaviour disorders,” explains Munkvold.

Losing a temper − pestering others

The fact that parents and teachers almost never concur on whether a child has symptoms of  ODD is an observation from the research that Munkvold and colleagues published in 2009 in Journal of Child Psychology and Psychiatry.

As with the aforementioned study, the doctoral dissertation is based on data from the Bergen Child Study, which surveyed the mental health of children aged 7-9.

Signs of ODD can be that the child loses its temper, refuses to follow instructions or intentionally hassles others, but the presence of such factors doesn’t mean that child has the disorder.

A child doesn’t get diagnosed with ODD unless an array of such symptoms is observed over a longer period, and these symptoms have to be more extensive than among normal children.

ODD can develop into more serious variations during adolescence and adulthood.

Reference:

Linda Helen Munkvold. Oppositional Defiant Disorder: Informant discrepancies, sex differences, co-occurring mental health problems and neurocognitive function. Doktoral thesis, University of Bergen.

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Read the article in Norwegian at forskning.no

Translated by: Glenn Ostling

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