How can I help my six-year-old cousin with oppositional defiant disorder?

By Patrick J. McGrath, OC, PhD, FRSC

Dr. Pat

Question:

My six-year-old cousin was diagnosed with Oppositional Defiant Disorder several years ago and has been on medication ever since. Although the medication has toned down some of his behaviours, I wonder if there isn’t more we can do. The family dynamic has not been considered.

Dr. Pat responds:

Children with Oppositional Defiant Disorder have tantrums, aggression, and disobedience. Many may grow out of it. But almost all the 16-year-olds who are in the news as delinquents began this way. It is important to help him NOW.

Parent training works well with these kids. The best things for parents and aunts and uncles to do are:

1. Pay attention to his good behaviour.
2. Have firm consequences for “bad” behaviour.
3. Monitor the child so that good and bad behaviour get consequences.
4. Create situations where good behaviour will occur.

Psychologists often teach these parenting skills. Sometimes there are courses in the community.

Talk therapy with these children doesn’t work. Sometimes it makes them worse.

But you are not his parent. If advice isn’t asked for, it is not worth giving. Don’t tell his parents what to do.

He is probably obnoxious. Don’t avoid him. Be positive with him. Have fun with him. Don’t let him get away with things when he is with you.

No use blaming his parents. Don’t badmouth your nephew to his parents. You will only alienate them.

It is not easy to raise a child with problems. It takes a whole family to help. Don’t give up on him. You can be a very positive influence.

Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. Read more "Ask Dr. Pat" columns Ask Dr. Pat a question