What is Oppositional Defiant Disorder and How Can I Help my Child with ODD? A Review of Dr. Gina Antencio-McLean, PsyD Book “Overcoming Oppositional Defiant Disorder: A Two-Part Treatment Plan to Help Parents and Kids Work Together” By: Maria Barcelos, MA, Executive Director The Gatehouse How Can I help My Child when they are diagnosed with Oppositional Defiance Disorder (ODD)? As a parent, being able to help my children feel safe, manage difficult emotions, adapt to life transitions and build self-confidence, and resilience is of utmost importance to me. Many parents struggle with shame-based thinking of not being good enough in general, and intensified shame at not being a good enough parent. These thoughts are further exacerbated when your child presents with additional needs, such as ODD. Having a child with different needs requires us to do some unlearning of unhelpful behaviours and learning of healthier ways to respond to be better able to support our children. This article is a brief review of Dr. Gina Antencio-McLean’s book “Overcoming Oppositional Defiant Disorder: A Two-Part Treatment Plan to Help Parents and Kids Work Together.” As a parent, I highly recommend this resource for any caregiver who is struggling to find other ways to respond and support their child. Ramke (n.d.) noted that all children can be oppositional or defiant at times. However, what distinguishes ODD from normal oppositional behavior is how severe it is, and how long it has been going on for. A child with ODD will have had extreme behavior issues for at least six months. ODD is usually diagnosed around early elementary school ages. Children with ODD have a well-established pattern of behavioural responses, which can include: Being unusually angry and irritable Frequently losing their temper Being easily annoyed Arguing with authority figures Refusing to follow rules Deliberately annoying people Blaming others for mistakes Being vindictive Dr. Antencio-McLean reminds every parent that children with ODD are not bad kids. They are doing the best they can. Children with ODD may have increased challenges being flexible and adaptable to changes in their environment. This is why you might notice that your ODD child behaves differently at school then they do at home.  As a parent, educating yourself on what inspires your child is a critical step in learning valuable life skills. It is important to emulate positive reinforcement for whatever behaviour you are trying to encourage them to change. For example, loading the dishwasher may start with the child taking their plate and placing it on the kitchen counter. Acknowledging them for their help with the dishes is a good start. Many behaviours may be difficult for your child. However, it is important to reinforce for yourself as a parent, that your child is a good kid and has the capacity to learn. They may need more time, positive reinforcement and patience to do so. Opportunities for positively reinforcing favourable behaviours involve recognizing them when they are making small changes. Small changes lead to bigger changes over time. Furthermore, identifying which skills your child needs to help them meet their goals is critical for your child to feel supported, heard and validated. Dr. Antencio-McLean reinforces that children need to learn how to regulate their emotions and how to self-soothe. This is a foundational goal in helping children with ODD to regulate emotional states. Identifying feelings is the first step in the emotional regulation process. We learn to self-soothe from our own parents or other caregivers as children. As survivors of childhood sexual abuse, we may have been further presented with unhelpful modelling behaviours by our parents. For example, not being able to talk about our feelings, being judged or criticized. It is important that we also continue to work on our own responses to trauma to further be able to model healthier responses for our children. Dr. Antencio-McLean reminds us that some children need further help to calm themselves. Children with ODD may be more sensitive and need further support to self-regulate and soothe unhelpful sensations they are experiencing. She highlights behaviour change takes time and practice and that practicing in those times of calm will be most beneficial to helping our children learn to regulate emotions as our brains learn best when we are calm.   For example, identifying a feeling and rating its intensity can be quite helpful for you and your child to identify what is happening for them in the moment. Using deep breathing or identifying some items in the home or school environment to help distract them to these items that are safe may help. E.g., How are you feeling? What level of intensity 1 low to 10 high? Let’s shift our focus to something colourful in our home that we like. How many blue things do you notice in the living room? Name one green item that you can see. Another helpful strategy can be to pass an ice cube from hand to hand to refocus on the cold sensation and minimize the emotional intensity. Regular exercise and socialization with friends help them stay present in the moment, which can be helpful for self-regulation. This is not an exhaustive list. Dr. Antencio-McLean noted that not every tool will be applicable to every person. As survivors of childhood sexual abuse, we can be hard on ourselves and further reinforce the “I am not good enough belief” in times of stress. This is an opportune time for us to redirect our attention to the fact that we are trying to help our child (and sometimes at the same time, our own inner child who is struggling with the very difficult emotions of confusion, grief or sadness that our children struggle with). Be kind to yourself and your child. Changing behaviour is not something that happens overnight. It takes time, patience and repetition. As parents, we have firsthand experience and awareness as to what problematic behaviour our child is displaying. Awareness is key to identifying what behaviours are needing change. Take some time to reflect on