Table of ContentsView AllTable of ContentsWhat Is ODD?SymptomsEffects at SchoolEffects at HomeRisk FactorsCausesHow to Help a Child With ODDSpecialists to SeeDiscipline and ODDSupport
Table of ContentsView All
View All
Table of Contents
What Is ODD?
Symptoms
Effects at School
Effects at Home
Risk Factors
Causes
How to Help a Child With ODD
Specialists to See
Discipline and ODD
Support
Oppositional defiant disorder (ODD) is a clinical behavior disorder. It consists of a characteristic and pervasive pattern of behavior lasting at least six months that includes irritable mood, argumentative or defiant behavior, or vindictiveness.
Children with ODD have difficulty with self-regulation and controlling their temper. Parents may feel incredibly overwhelmed with their children’s behavior. While some controversial research shows there may be a genetic component, this isn’t always the case,
This article will discuss oppositional defiant disorder, its causes, and treatment.
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What Does an Oppositional Defiant Disorder Diagnosis Mean?
A thorough assessment is needed because some behaviors of ODD are common in childhood, especially in very young children and teens. These include frequent temper tantrums, talking back to adults, and questioning authority.
In children with ODD, these symptoms happen more frequently and are significant enough that they negatively impact relationships, school and learning, and social situations.
TheDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5)contains diagnostic criteria for ODD.The first criterion is a pattern of angry or irritable moods, argumentative behavior, or vindictiveness that lasts at least six months, with at least four of the following symptoms from these categories, with at least one person who isn’t a sibling:
The other criteria are:
There is no specific tool made for diagnosing ODD, but several tools for diagnosing other disorders can be used to help make a more accurate diagnosis. These can include:
Symptoms: ODD Behavior in Children
Symptoms of ODD in children can look like general behaviors of childhood, as well as several other mental and/or behavioral disorders. The frequency and intensity of the behaviors and their effect on relationships, learning, and everyday life should be noted. Symptoms can include:
Any possibility of coexisting mental or behavioral disorders should be explored since addressing and treating these disorders can also help with ODD behaviors.
ODD can often overlap with conditions and neurodevelopmental differences such asautismandADHD.They can have symptoms that mimic each other, but these are discrete disorders that should not be confused with one another.
When Children Grow UpAs children with ODD get older, if their ODD is untreated, and especially if they have coexisting mental disorders, they are at higher risk for depression and substance abuse.For some individuals, their diagnosis may change toconduct disorder, which involves much more serious, aggressive, and even violent behavior. A child with ODD will not necessarily evolve into an adult with conduct disorder, but it’s necessary to seek treatment as early as possible and monitor behavior over the years.
When Children Grow Up
As children with ODD get older, if their ODD is untreated, and especially if they have coexisting mental disorders, they are at higher risk for depression and substance abuse.For some individuals, their diagnosis may change toconduct disorder, which involves much more serious, aggressive, and even violent behavior. A child with ODD will not necessarily evolve into an adult with conduct disorder, but it’s necessary to seek treatment as early as possible and monitor behavior over the years.
As children with ODD get older, if their ODD is untreated, and especially if they have coexisting mental disorders, they are at higher risk for depression and substance abuse.
For some individuals, their diagnosis may change toconduct disorder, which involves much more serious, aggressive, and even violent behavior. A child with ODD will not necessarily evolve into an adult with conduct disorder, but it’s necessary to seek treatment as early as possible and monitor behavior over the years.
It’s important to be aware of ableism when evaluating children’s behavior. Children with communication disorders,chronic pain, or learning disabilities, for example, may act in certain ways that appear to be defiant or questioning but are a manifestation of their disability or condition.
Children acting from a trauma response, or developmental trauma disorder (DTD), may also exhibit dysregulation (inability to control emotional responses), lack of attachment, and ODD behavior but may not have ODD.
Oppositional Defiant Disorder: Effects at School
Educators must be cautious when assuming a diagnosis of ODD in school. Society has certain beliefs about how children should act in certain settings and which behaviors are ideal.
Children who question “too much” in school are seen as disruptive and oppositional. But instead, they may be gifted or twice-exceptional (clinically gifted and also have a disability diagnosis) or have a diagnosis like ADHD.
For those with a clinical diagnosis of ODD, this can impact school because they refuse to comply with their teachers’ requests or refuse to do work, lash out at other students, defy authority and rules, and may be mean to other children.
Oppositional Defiant Disorder: Effects at Home
At home, a child with ODD might challenge everything, from what’s for breakfast to getting dressed for the day to doing homework after school. They may be quick to anger, hostile toward parents and siblings, and aggressive with or mean to family members. This can lead to difficult family relationships and a feeling of uneasiness in the home.
Risk Factors for Oppositional Defiant Disorder
There are a variety of risk factors for ODD. Having risk factors does not necessarily mean a person will develop a disorder, but it simply increases the chance for the condition. Risk factors for ODD can include:
It should be noted that supportive environments have been found to be a protective factor for ODD.A parenting style that results in an unstable home, unstable parent-child relationships, and weak attachments can be a risk factor for ODD.
If a parent is not responsive or supportive, is aggressive and inconsistent with discipline, or is overly harsh with discipline, the child is less likely to be positively attached or feel supported.
Underlying Causes of Oppositional Defiant Disorder
There is no known cause for ODD. Many experts suspect that there is a cumulative effect of a variety of risk factors from biological, psychological, and social issues.There are some things that can be protective and reduce the risk or severity of ODD, which illustrates that this is not as clear-cut as some would like to think.
There have been familial clusters of ODD, which could point to a possible genetic component, but this is variable and not certain.
How to Help Children With Oppositional Defiant Disorder
If the behavior is a pattern that’s causing significant impairment in one or more areas of a child’s life, see a professional for an evaluation. A child with ODD is not intentionally trying to be challenging. This is a clinical behavior disorder that requires treatment and understanding. Without disorder-specific treatment, “help” won’t do much.
Treatment for ODD usually includes:
Appropriate treatment is essential, and this includes social support for them as well. Knowing they have a safe space and are supported can have a positive effect.
At home, having a strong relationship with your child is important, as are things like setting clear household rules, praising positive behaviors, and being consistent with consequences (like loss of privileges if rules are broken or negative behaviors occur).
Specialists to See for Suspected Oppositional Defiant Disorder
While a qualified child mental health professional can provide a diagnosis, specialists to see can depend on the kind of treatment you pursue. Cognitive behavioral therapy (CBT) andfamily therapyrequire CBT and family therapists, respectively.
Medication is not typically a first-line treatment for ODD, but if coexisting mental or behavioral disorders require medication, a psychiatrist should prescribe it.
In a school setting, let the teachers and any other associated staff, like the child study team, know about your child’s diagnosis so that you can work with them to create a supportive educational plan for your child.
Discipline and ODD: What to Avoid
Children with ODD also often have ananxiety disorder, and so they may feel a need for control.This can result in power struggles with authority figures, which is something to be avoided.
Don’t make complicated rules or create too many rules for the home or classroom. Pick the rules you prioritize the most, outline them clearly, and what the consequences are for breaking them.
Avoid an overly relaxed household. Structure is important because a chaotic environment contributes to a lack of self-regulation, making ODD worse. Have structured bedtimes, meal times, healthy foods, and physical activity.
Children with ODD want to engage in conflict. Speak calmly with the child and do not participate in an argument with them.Let them know about any expectations or consequences, and then end the discussion. If you are in the wrong or have broken a household or classroom rule, admit that to them and apologize.
Don’t reduce them to negative pathology. Celebrate any positive behaviors, especially prolonged positive behavior.Recognize successes and acknowledge their hard work. It’s also important to connect with the child during times of calm and to work toward establishing a stable relationship.
Support for Parents of Children With ODD
Because of the misconceptions about ODD, as well as societal assumptions of what children should be like and how they should behave, parenting a child with suspected ODD can be challenging. Talk with your pediatrician or counselor about support groups for you and your partner, or find online support groups.
Managing your own stress can also help with emotions and parenting choices. Get exercise, eat a healthy diet, get outside, and utilizerelaxation techniques.
Summary
While there is no cure, treatment is necessary for any progress to be made. This includes behavioral therapy, parent training and parenting modification, social skills training, and support. If there are coexisting disorders like depression, anxiety, or ADHD, medication for those disorders may be prescribed.
Both parents and children need support, training, and guidance in treating ODD.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Riley M, Ahmed S, Locke A.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.Johns Hopkins Medicine.Oppositional defiant disorder (ODD) in children.Mandy W, Roughan L, Skuse D.Three dimensions of oppositionality in autism spectrum disorder.J Abnorm Child Psychol. 2014;42(2):291-300. doi:10.1007/s10802-013-9778-0Boston Children’s Hospital.Oppositional defiant disorder.Spinazzola J, van der Kolk B, Ford JD.Developmental trauma disorder: a legacy of attachment trauma in victimized children.J Trauma Stress. 2021;34(4):711-720. doi:10.1002/jts.22697Child Mind Institute.Quick guide to oppositional defiant disorder.Ollendick TH, Greene RW, Austin KE, Fraire MG, Halldorsdottir T, et al.Parent management training (PMT) and Collaborative & Proactive Solutions (CPS): a randomized controlled trial for oppositional youth.J Clin Child Adolesc Psychol. 2016;45(5):591-604. doi:10.1080/15374416.2015.1004681
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Riley M, Ahmed S, Locke A.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.Johns Hopkins Medicine.Oppositional defiant disorder (ODD) in children.Mandy W, Roughan L, Skuse D.Three dimensions of oppositionality in autism spectrum disorder.J Abnorm Child Psychol. 2014;42(2):291-300. doi:10.1007/s10802-013-9778-0Boston Children’s Hospital.Oppositional defiant disorder.Spinazzola J, van der Kolk B, Ford JD.Developmental trauma disorder: a legacy of attachment trauma in victimized children.J Trauma Stress. 2021;34(4):711-720. doi:10.1002/jts.22697Child Mind Institute.Quick guide to oppositional defiant disorder.Ollendick TH, Greene RW, Austin KE, Fraire MG, Halldorsdottir T, et al.Parent management training (PMT) and Collaborative & Proactive Solutions (CPS): a randomized controlled trial for oppositional youth.J Clin Child Adolesc Psychol. 2016;45(5):591-604. doi:10.1080/15374416.2015.1004681
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Riley M, Ahmed S, Locke A.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.Johns Hopkins Medicine.Oppositional defiant disorder (ODD) in children.Mandy W, Roughan L, Skuse D.Three dimensions of oppositionality in autism spectrum disorder.J Abnorm Child Psychol. 2014;42(2):291-300. doi:10.1007/s10802-013-9778-0Boston Children’s Hospital.Oppositional defiant disorder.Spinazzola J, van der Kolk B, Ford JD.Developmental trauma disorder: a legacy of attachment trauma in victimized children.J Trauma Stress. 2021;34(4):711-720. doi:10.1002/jts.22697Child Mind Institute.Quick guide to oppositional defiant disorder.Ollendick TH, Greene RW, Austin KE, Fraire MG, Halldorsdottir T, et al.Parent management training (PMT) and Collaborative & Proactive Solutions (CPS): a randomized controlled trial for oppositional youth.J Clin Child Adolesc Psychol. 2016;45(5):591-604. doi:10.1080/15374416.2015.1004681
Riley M, Ahmed S, Locke A.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.
Johns Hopkins Medicine.Oppositional defiant disorder (ODD) in children.
Mandy W, Roughan L, Skuse D.Three dimensions of oppositionality in autism spectrum disorder.J Abnorm Child Psychol. 2014;42(2):291-300. doi:10.1007/s10802-013-9778-0
Boston Children’s Hospital.Oppositional defiant disorder.
Spinazzola J, van der Kolk B, Ford JD.Developmental trauma disorder: a legacy of attachment trauma in victimized children.J Trauma Stress. 2021;34(4):711-720. doi:10.1002/jts.22697
Child Mind Institute.Quick guide to oppositional defiant disorder.
Ollendick TH, Greene RW, Austin KE, Fraire MG, Halldorsdottir T, et al.Parent management training (PMT) and Collaborative & Proactive Solutions (CPS): a randomized controlled trial for oppositional youth.J Clin Child Adolesc Psychol. 2016;45(5):591-604. doi:10.1080/15374416.2015.1004681
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