Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a type of disruptive behavior disorder in which children frequently defy authority with hostility, leading to serious disturbances in their daily life.

What is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is a type of disruptive behavior disorder, a condition in which children show ongoing patterns of uncooperative and defiant behavior.

Although all children have moments when they’re not willing to do as they are told, children with ODD do this more frequently and with more hostility than their peers.

The American Academy of Child & Adolescent Psychiatry estimates that 1 to 16 percent of all school-age children and adolescents have ODD. The prevalence of ODD is somewhat higher for boys than girls.

What Causes ODD?

It’s not known what causes oppositional defiant disorder, but doctors believe several factors may play a role. These factors include:

  • Parent/Child Relationships. Parents of children with ODD may be found to provide inconsistent or overly harsh discipline. At times, parents’ actions may reinforce inappropriate behaviors.
  • Genetics. Some children with ODD have parents with mental health disorders, such as substance abuse, attention deficit hyperactivity disorder (ADHD) and mood disorders.
  • Environment. Children who are rejected, abused or neglected are at an increased risk for ODD.
  • Psychological health. Children who have been diagnosed with ADHD are at an increased risk. Children with ODD often appear to have underlying temperamental factors, such as being easily frustrated or emotionally reactive, that increase their risk for meeting ODD criteria.

What Are The Signs & Symptoms of ODD?

Children with oppositional defiant disorder:

  • Lose their temper often
  • Are quick to argue with adults over rules, requests or even small, unimportant things
  • Are uncooperative
  • Are unwilling to follow rules
  • Annoy others deliberately and become annoyed by others easily
  • Blame others for their misconduct or mistakes
  • Are spiteful and vindictive
  • Get in frequent arguments with their peers
  • Are disciplined at school frequently

It’s important to remember that all children behave this way sometimes. These behaviors can be developmentally appropriate, depending on the intensity, frequency and age of the child.

The difference between normal behavior and ODD is that, with ODD, a child behaves this way more frequently and with more hostility than other children his or her age. Your child’s care team will take frequency, level of impairment and developmental appropriateness into consideration when a child has behavioral issues.

How is it Diagnosed?

Oppositional defiant disorder is diagnosed by a behavioral health specialist with experience in treating children with ODD.

The behavioral health specialist will complete a thorough evaluation of the child’s symptoms to rule out other disorders that are similar to ODD or may coexist with ODD, such as ADHD, depression, anxiety or learning disabilities. An accurate diagnosis is vital to ensure the child receives the right treatment.

How is ODD Treated?

Oppositional defiant disorder is best managed with the help of a behavioral health professional. Parents must also educate themselves and play an active role in the treatment process.

Parent behavior management plays a crucial role in ODD treatment. During parent management training, a behavioral health specialist teaches the parent ways to more effectively manage the child’s behavior.

Treatment for ODD may also include:

  • Psychotherapy. The behavioral health specialist talks to the child about his or her thoughts and feelings and helps the child learn how to recognize his or her anger cues and use coping strategies to manage anger. Therapy may be conducted individually or with the child’s parent present.
  • Medicine. ADHD medications or an antidepressant may be prescribed if the child is also diagnosed with ADHD, depression or anxiety.
With the right treatment and consistent support from family and school professionals, children with oppositional defiant disorder can improve their behavior and social and academic life.

What Are The Potential Complications?

A small percent of children with oppositional defiant disorder eventually develop conduct disorder, another type of disruptive behavior disorder that involves no regard for others’ rights or social rules. A child with ODD may also have a greater likelihood of an ADHD diagnosis or other mental health conditions such as mood disorders or anxiety.

When Should I Seek Help For My Child?

If you think your child has oppositional defiant disorder, make an appointment with your family doctor or pediatrician to discuss your concerns. He or she will assess your child’s symptoms and conduct a physical exam to ensure another condition isn’t causing the symptoms.

If the doctor suspects ODD, he or she will refer you to a behavioral health specialist with experience in diagnosing and treating the condition.