Quick Guide to Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a children’s mental health diagnosis that is characterized by a pattern of defiant and uncooperative behavior toward authority figures. All children act out sometimes, but kids who have oppositional defiant disorder struggle with their behavior regularly. They are often angry or irritable. Their behavior problems are also more extreme. For example, a child with ODD might yell at authority figures or throw tantrums if they don’t get their way. 

In order to be diagnosed with ODD, a child’s behavioral challenges need to be present for at least 6 months.

Children with ODD have a pattern of behavior problems. Here are some common symptoms: 

• Being unusually angry and irritable 
• Frequently losing their temper 
• Being easily annoyed 
• Arguing with authority figures 
• Refusing to follow rules 
• Annoying people on purpose 
• Blaming others for mistakes 

ODD can appear in the home, at school, and/or in another setting, such as camp, extracurricular activities, etc. 

For a child to be diagnosed with ODD, they must have a pattern of disruptive behavior including at least four symptoms from this list: 

• Often loses temper 
• Easily annoyed 
• Often angry and resentful 
• Argues with adults 
• Breaks rules 
• Annoys or hurts people on purpose 
• Blames others for behavior 

For a diagnosis, these symptoms also need to last at least six months and involve at least one person who isn’t a sibling. 

ODD is typically diagnosed in kids in elementary school.

ODD is treated with behavioral therapy or a combination of therapy and medication. 

Improving the parent-child relationship is a priority. This means that parents play a big role in treatment. Parent training programs can help parents learn to: 

• Set clear expectations 
• Use effective praise when kids meet expectations 
• Use effective consequences when they don’t 

These techniques can teach children how to manage their emotions and improve their behavior. 

Parent training programs might include sessions with parents and children working together, or just parents alone. Some different programs include: 

• Parent-Child Interaction Therapy (PCIT) 
• Parent Management Training (PMT) 
• Defiant Teens 
• Positive Parenting Program (Triple P) 
• The Incredible Years 

Some children might also benefit from:  

• Social skills training to improve their peer relationships 
• Cognitive behavioral therapy (CBT) if they are struggling with anxiety or depression 
• Dialectical behavior therapy (DBT) if they are struggling with extreme emotions 

There is no FDA-approved medication for ODD. However, medication is sometimes used along with therapy. These include: 

• Antipsychotic medications, if a child is at risk of being removed from school or the home 
• Stimulant medications, if a child also has ADHD or is struggling with impulsivity 
• Antidepressant medications, if a child also has depression or anxiety 

A small percentage of children diagnosed with ODD will go on to develop conduct disorder. Conduct disorder is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting  school consultation and treatment sooner rather than later makes this less likely.