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Topic: Axis I : Child Disorders

Low Frustration Tolerance in Children and ODD (Opposition Defiant Behavior)


Just as the influence of substance use and abuse on clients' behavior problems was often minimized by psychotherapists before the 1970's, the importance of temperament in children's behavior problems is becoming an increasingly essential part of child and family therapy.
Some parents are unable to effectively deal with certain children who try their patience despite having no such difficulty with their other children. Let us focus on one aspect of childhood temperament, frustration tolerance, its relationship with Oppositional Defiant Disorder (ODD), and how such concerns can be worked on in therapy with children and their parents.
Opposition defiant behavior (ODD)
It is noticed that children with low frustration tolerance are at risk for becoming oppositional. Also, parents often responded to these kids in ways that exacerbated their problematic behavior. ODD has now related to the child's temperament and the family's response to that temperament.
ODD according to DSM IV TR (2000) ·  
ODD... is a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months.
In males, the disorder has been shown to be more prevalent among those who, in the preschool years, have problematic temperaments (e.g. high reactivity, difficulty being soothed.).
ODD... usually becomes evident before age 8 years and usually not later than in early adolescence.
The oppositional symptoms often emerge in the home setting but over time may appear in other settings as well. Onset is typically gradual, usually occurring over the course of months or years.
Often loses temper, often argues with adults, often actively defies or refuses to comply with adults' requests or rules, often deliberately annoys people, often blames others for his or her mistakes or misbehaviors, is often touchy or easily annoyed by others, is often angry and resentful, and is often spiteful or vindictive.
According to Barkley
He states "children who are easily prone to emotional responses (high emotionality) are often irritable, have poor habit regulation, are highly active, and/or are more inattentive and impulsive and appear more likely ... to demonstrate defiant and coercive behavior than are children not having such negative temperamental characteristics." He also notes that "immature, inexperienced, impulsive, inattentive, depressed, hostile, rejecting, or otherwise negatively temperamental parents are more likely to have defiant and aggressive children."
ODD and Low Frustration Tolerance

Children with low frustration tolerance are adamant in wanting to end the cause of their frustration as quickly as possible. When they are having a hard time with a task (e.g., homework, some tasks they don't immediately understand, or a toy or game that they can't make work the way they want), they find that the best way to eliminate their frustration is to stop trying and do something else instead. If they want to do something and their parent (or another adult) won't let them do it, the best way to eliminate their frustration is to act in ways that might get the adult to change their mind and leave them to their own desires and interests.
How Parents Make it Better or Worse
Indeed, a key task of parenting is to help children gradually take on more difficult tasks so they learn how to tolerate frustration as well as regulate emotional reactions. But clearly, parents make the situation better or worse by how they interact with their child. Parents make things better by setting appropriate limits, managing their own anxiety, reinforcing positive behaviors, and understanding the motivations of the child. Certainly, parents can behave in ways that make matters worse via what can be called as the Argument Trap and the Overly Helpful Parent.
The Argument Trap!
Here, the parent, after setting a limit for their child, keeps responding to the child's objections in an effort to have the child understand the parent's logic. This attempt to explain the limit and convince the child of its necessity often results in the child becoming more upset. The parent may then even punish the child for not complying with the limit. But since the child's goal is to remove the frustrating limit, as long as the parent and child are arguing, the child can hope that the parent changes their mind. If the parent gives in, the child is being taught to argue again next time. If the parent punishes the child, then the child has an additional reason to blame their parent for not removing their frustration.
So what to do in these situation?
To help a child with low frustration tolerance accept limits, the parent needs to let the child complain about the limit and have the last word, even if the last word is provocative. The parent needs to stick to the limit (unless there is good reason to give in) and not try to convince the child to agree with the limit. The child is less likely to keep arguing if the parent is not responding in kind. The parent ideally needs to set a limit, repeat the limit in as calm a voice as possible, suggest alternatives for the child, and then stop talking about the limit.
The Overly Helpful Parent
Another way that parents inadvertently increase their children's low frustration tolerance is by helping their children too much when their children are faced with challenging tasks. Parents naturally help their children countless times each day. But low frustration tolerance children will often ask for help without trying enough on their own before seeking help. They tend to give up too soon without really testing themselves, and want the adult to jump in and solve the problem or complete the task at hand.
The parent's role is to help the child learn how to handle frustrating situations, not to quickly solve the frustrating situation for the child. For example, when a parent has been helping a low frustration tolerance child too much with his homework, backing off from helping may lead to the child receiving worse grades for a while.
Does Your Child Have Low Frustration Tolerance?
There is no valid and reliable test that can definitively determine whether a child has low frustration tolerance. Temperament questionnaires, observation and reflection, comparison with other children's behavior in the same situation, and parents' willingness to examine their own feelings about a child can help parents and therapists reach an informed opinion about a child's level of frustration tolerance. Here are some questions for parents to consider:

What is your child's temperament? Energetic-positive, energetic-difficult, passive-low energy, easy going?
Does your child get frustrated more easily than other children the same age?
Does your child get easily frustrated when you set limits? Or, does your child get easily frustrated when you want your child to stop doing what they are doing and do something else instead? (Note: Some children are slow to adapt to transitions, changes and intrusions, and are likely to get frustrated when asked to stop what they are doing and do something else. Their response should not be confused with that of children with low frustration tolerance, who will complain when a limit is set but may generally not complain when a family routine is changed, the day's schedule is changed, or if you interrupt them when they are doing something. Of course, a child can be slow to adapt to changes and also have low frustration tolerance.)
Do you give in more often than you think you should when your child complains about a limit? Do you find yourself getting annoyed because your child keeps testing limits?
Is your child able to play alone or with friends in their own room or do they always have to be with you? Do you often tell your child to "go play" while you try to finish a task?
Has your child's frustration tolerance decreased suddenly? Has something happened recently (e.g., the birth of a sibling, a change in teachers, a death, a divorce, an illness) that could have upset your child and made your child more easily frustrated about things than previously so? If so, your child's frustration tolerance should improve as you both deal with the feelings associated with the event or change that has occurred.

Summarized from the article written by David Rice, PhD

David Rice, PhD is a licensed clinical psychologist in private practice in Vallejo, CA. He worked for twenty years with the Preventive Ounce, a non-profit organization in Oakland, CA that develops anticipatory guidance materials for temperament-related behavioral issues for parents and healthcare professionals. He can be reached at eMail('drice2','comcast','net') . Dr. Rice thanks members of the Benicia Therapy Group (particularly Ann Steiner, Micah Altman, and Polly Lytle and Ira Polonsky) who read earlier versions of this paper.

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