What's the Matter with Kids Today?

Disrespectful children and adolescents, normal adolescent behavior/development, lousy parenting, criminal behavior, or mental illness? It is usually a law enforcement officer to make that initial assessment.

It is a familiar call to a familiar address. The dispatcher puts in out on the air as a family disturbance; 123 Problem Street, premise history for same. 15 year old WMJ versus father. Verbal only, no weapons, unknown alcohol or drugs. RP is the adolescent's mother; she is crying and states she is afraid the situation will escalate. She reports her son is out of control. You brief your new beat partner on scene. Jason (the subject) frequently has verbal arguments with Dad. Dad is as much of a hot head as Jason. Mom is simply wishy-washy and always tearful. She consistently wants Jason to be taken to a behavioral health hospital; Dad insists that he needs to be at juvenile hall. You enter the home, and it is the same story. Jason is calm, smirking at this father. Dad is beat red and immediately demands that you do something now. Mom is a shrinking violet on a corner love seat.

This time the fight is over Jason's violation of the behavioral contract he had established with his therapist and parents. He did not do his homework right after school; which meant he was grounded. Jason decided it was his choice and right to attend the high school basketball game this evening anyway. Jason threatened to pound Dad if he stopped him from leaving the house. Dad wanted him arrested for terrorist threats. Mom wanted him go to back to the hospital (previously a voluntary admission) because Jason was obviously a danger to others. She again tells you that Jason has been diagnosed with oppositional defiant disorder. Jason states that his father should be arrested because he used force (held his wrists) when Jason tried to leave the house. You send your partner back in service, and try to deal with this mini crisis at the Williams household solo.

What is Oppositional Defiant Disorder?

Everyone has heard the buzz acronym ODD, but what does that mean, and how many kids have it? It is important to remember that all children, even the best behaved, will be oppositional at times. This is especially true if they are tired, hungry or upset. They may talk back, disobey, or defy parents or other authoritarians. This is not abnormal. Being able to question and stand up for oneself is essential for everyday living.

On the other side, are kids who show a consistent pattern of angry and verbally aggressive behaviors. Their wrath is usually aimed at parents and other authority figures, most frequently at school. At this extreme, mental health professionals frequently give the child or adolescent the diagnosis of oppositional defiant disorder (ODD). The diagnosis is only given if the behavior substantially affects the social, family and academic life of the child or adolescent. It is one of the most common mental health disorders found in kids.

Signs and Symptoms of ODD

  • frequent temper tantrums
  • excessive arguing with adults
  • often questioning rules
  • active defiance and refusal to comply with adult requests and rules
  • deliberate attempts to annoy or upset people
  • blaming others for his or her mistakes or misbehavior
  • often being touchy or easily annoyed by others
  • frequent anger and resentment
  • mean and hateful talking when upset
  • spiteful attitude and revenge seeking
  • possible drugs and alcohol abuse
  • the symptoms are usually seen in multiple settings, but may be more noticeable at home or at school.

The exact rate of ODD is unknown, as most kids display some of the above symptoms at times. It is estimated that up to 16% of the child/adolescent population meet the diagnostic criterion for oppositional defiant disorder. For many children, ODD does improve over time. Follow-up studies have demonstrated that approximately two out of three children diagnosed with ODD, who received treatment, will be symptom-free after three years. Children presenting with ODD symptoms should be evaluated for possible other psychiatric disorders including: attention-deficit hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. Treatment usually consists of a combination of parenting classes, family therapy, and behavioral therapy for the child or adolescent, and school based programs. Medication alone is not effective; however, it may be helpful if the kid is also experiencing symptoms of ADHD or a mood disorder.

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