Your child gives a whole new meaning to the word stubborn. He loses his temper over the least little thing, refuses to compromise or listen to reason, and doesn't seem to care how his actions make other people feel. Does this behavior reach the level of oppositional defiant disorder (ODD)? Or are his unreasonable responses an attempt to defend his sensory system from attack?

Making a ODD Diagnosis

To make a diagnosis of ODD, a mental health professional will talk to the child and the parents and use DSM guidelines to identify certain patterns of behavior. ODD is indicated when a child frequently does the following:

• Exhibits an inability to control his temper

• Fights with parents and other grownups

• Disobeys rules

• Refuses to comply with reasonable requests

• Behaves in a way that is annoying to others

• Gets annoyed by others

• Is unwilling to take responsibility for his behavior

• Is in a bad mood

• Behaves in a way that is vengeful and nasty

The mental health professional will expect to see that the behavior has been going on for more than half a year; impairs the child's ability to function in school, at home, and during social activities; and is not due to other psychoses or disorders.

The Sensory Integration Difference

If your child has sensory integration problems that cause her to feel threatened or upset by things that seem absolutely normal to other people, her behavior may appear to be oppositional and defiant. She knows that being tipped back to have her hair washed makes her feel off balance and frightened, and she will resist it the way you might resist being pushed off a building.

As compared to the criteria for ODD, it may appear that your child does the following:

• Exhibits an inability to control her temper if a temper tantrum is the only way she can make unpleasant activities stop

• Fights with parents and other grownups if they don't take her sensory needs into account

• Disobeys rules if she needs to do other things to keep her body comfortable and in control

• Refuses to comply with reasonable requests if those requests don't seem reasonable to her

• Behaves in a way that is annoying to others if she can't modulate her movements and the volume of her voice

• Gets annoyed by others if they do things that feel overwhelming or threatening to her

• Is unwilling to take responsibility for her behavior if she does not understand that the things that seem right to her aren't right to others

• Is in a bad mood if she is constantly overwhelmed by strong sensations and receives no help in adjusting to them

• Behaves in a way that is vengeful and nasty if she reacts too strongly to things that bother her

Understanding your child's sensory integration problems and helping her find socially acceptable ways to deal with them will go a long way toward eliminating oppositional and defiant behavior. Eliminating the source of the problem will help as well. Whereas children with ODD may truly be engaging in their behaviors for no reason, your child with sensory integration disorder has reasons that make good sense to her. If they make sense to you as well, she won't have to fight so hard.