Oppositional Defiant Disorder Basics

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

ODD: What Is It?

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

Oppositional defiant disorder (ODD) is a persistent behavioral pattern of angry or irritable mood; argumentative, defiant behavior towards authority figures; and vindictiveness. In some children with ODD, these behaviors are only in evidence in one setting—usually at home. In more severe cases they occur in multiple settings. For a diagnosis of ODD, the frequency and intensity of these behaviors must be outside the typical range for a child’s developmental level, gender and culture.

Read More: An in-depth look at what is oppositional defiant disorder.

ODD: What to Look For

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

Children and adolescents with ODD are very quick to lose their tempers, often disobedient at home or at school, apt to ignore or rebel against rules, quick to blame others for mistakes or misbehavior, and prone to annoy others and be easily annoyed. Within limits, every one of these behaviors is typical in children, but those with ODD have problems containing these impulses, and act out so often that it compromises their ability to get along with others. The extraordinary level of oppositional behavior means children with ODD are sometimes described as having a “reflexive ‘No!’”—they will refuse to cooperate even before they know what is being asked of them. Symptoms of ODD can become apparent as early as pre-school or much later, in adolescence.

ODD: Diagnosis

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

To distinguish symptoms of ODD from normal childhood or adolescent rebellion, professionals depend on a detailed history of behaviors in various situations. For children younger then 5, the behaviors should occur on most days for at least 6 months; for those who are 5 or older, they should occur once a week for 6 months. Since children with ODD may show symptoms only in one setting—usually at home—and are more likely to be defiant in interactions with adults and peers they know well, the symptoms may not be in evidence in the clinician’s office.

ODD: Treatment

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

ODD is treatable, usually with behavioral therapy or a combination of behavioral intervention and medication.

Psychotherapeutic: A popular evidence-based treatment is a type of behavior therapy called parent-child interaction therapy. The parent and child work together through a set of exercises while a therapist coaches parents through an ear bud. Parents learn to increase positive interactions with the child and to set consistent consequences for undesirable behavior. Children learn to rein in behavior and enjoy a more supportive relationship with parents.

Pharmacological: Medicines are not specifically indicated for ODD. However, as many children with ODD have co-occurring conditions such as ADHD, they may be on medications for those other disorders. In addition, some children are so troubled by their own aggression, and their difficulties managing their painfully low frustration tolerance, that a clinician may recommend medication—like psychostimulants used to treat ADHD to help them control those responses and benefit more from behavioral therapy.

ODD: Risk For Other Disorders

Children with oppositional defiant disorder (ODD) display extreme resistance to authority, conflict with parents, outbursts of temper and spitefulness with peers. This guide outlines the signs a child might have ODD, how it is diagnosed in children and treatment options.

ODD is often diagnosed alongside ADHD. Children with ODD often have co-occurring mood disorders like depression, anxiety disorders, or learning or communication disorders. Professionals warn that ODD that goes untreated early in life is often linked to more severe disorders later, including conduct disorder and substance use disorder.