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Oppositionality and Oppositional Disorder

Almost all preschool children are noncompliant, at least some of the time--on average, they comply with adult requests about 50% of the

This struggle for autonomy can be viewed as a positive milestone of development, with passivity representing a potential symptom of depression or intimidation. It is the parents' job to provide the structure that will influence the child to comply with our culture's standards for behavior. Research indicates that parents who are authoritative and firm but also warm, encouraging, and rational are more likely to have children who are better adjusted.

Parents need to establish a system of discipline at least by the preschool years that includes three essential components: positive reinforcement for desired behaviors; consequences for undesired behaviors; and, most importantly, interactions that promote the parent-child relationship. Noncompliance as part of conduct disturbances is more common in families whose parenting practices include lax, harsh, or inconsistent rules; unclear, complex, or emotionally charged instructions; lack of warmth; or poor monitoring of the child oppositionality.

One major concern of parents of preschoolers that affects both the relationship and the child's compliance is his activity level. Sturner found that 25.3% of parents of 4-year-olds included "overactive" in a checklist of adjectives about their child. However, poor control of attention is a greater detriment to academic success than high activity level. Multiple factors affect the attentional system, including health (eg, lead levels, anemia, past neurologic insult), current presence of medications, emotional problems such as anxiety or depression, environmental stresses, ability to see and hear adequately, hunger and fatigue, and temperament. Attention deficit disorder with (DSM 314.01) or without hyperactivity (DSM 314.00) is one of the most common mental health diagnoses of preschool children. Two to seven percent of preschoolers are affected, and it may coexist with oppositional defiant disorder.

A preschooler's aggression is said to reach the "problem" level when the negative impact of the behaviors causes people to change their routines, property begins to be damaged seriously, and the aggression is frequent. Symptoms rarely reach the level of a conduct disorder.