Does My Child Have Oppositional Defiant Disorder?

Know the warning signs that could indicate your child has ODD.
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It’s normal for all kids to be defiant sometimes. But kids with oppositional defiant disorder are defiant almost all the time.  

ODD is a behavior disorder that begins before a child reaches the age of 8 and persists through the teen years. With early intervention and treatment, symptoms can improve. 

Symptoms of ODD

When children have ODD, their behavior problems interfere with their daily lives. They're likely to have educational difficulties.

They may fall behind academically because they're dismissed from class due to misbehavior or they may be failing their classes due to their refusal to do the work.

Children with ODD also tend to have difficulty with their relationships. They may struggle to maintain friendships due to their severity of their behavior problems. Their behavior may also take a serious toll on their relationships with siblings and other family members.

In order to qualify for a diagnosis of ODD, children must exhibit symptoms for at least six months. Misbehavior must be consistent, and above and beyond what’s considered developmentally appropriate.

Here are the symptoms of ODD:

  • Frequent angry outbursts
  • Refusal to follow rules
  • Questioning authority repeatedly
  • Excessive arguing with adults
  • Frequent and intense temper tantrums
  • Deliberate attempts to annoy others
  • Aggressive behavior
  • Spiteful toward others
  • Blames others for mistakes

    Causes of ODD

    There isn’t a single known cause of ODD, but there are several different theories. The developmental theory suggests that children develop ODD when they struggle to develop autonomy during the toddler years. As a result, they continue to exhibit negative attitudes throughout the rest of their childhood years.

    According to the Learning Theory, ODD represents learned behavior that gets reinforced by adults. For example, a child who receives attention for misbehavior may be more inclined to continue misbehaving.

    Studies estimate between 1 and 16% of school-age children may have ODD. It is more common in boys than girls. Sometimes ODD occurs in conjunction with other behavior disorders or mental health issues, like ADHD, depression, and anxiety.

    Diagnosis and Treatment of ODD

    If you have serious concerns about your child's behavior, or teachers have expressed concerns, talk to your child's doctor. If warranted, your child's pediatrician may refer your child to a mental health professional.

    A physician or mental health professional will conduct a thorough assessment of your child. Interviews, questionnaires, and observations of your child may be used to evaluate your child. 

    There are several treatment options available for ODD. A mental health professional will determine which treatments are likely to be most effective based on your child’s needs. Common treatments include:

    • Parent training – Behavior modification methods can be effective ways to reduce behavior problems. Sometimes a clinician will meet with caregivers separately to provide training on specific parenting techniques that can reduce misbehavior.
    • Family therapy – Family therapy may be warranted, depending on a child’s age and the family’s needs. Family therapy may involve step-parents, siblings, or a combination of family members.
    • Group therapy – Children with ODD often lack social skills. Group therapy can be an effective way for them to learn how to interact with peers in a more socially appropriate manner.
    • Medication management – There isn’t a medication that fixes behavior problems. But children may benefit from medication for co-morbid issues such as ADHD or depression that may contribute to behavior problems.

    Parenting a Child With ODD

    Raising a child with ODD can be frustrating and exhausting at times. So it's important to see support for yourself. Consider attending a support group with other parents who have children with ODD.

    Connecting with other parents can provide emotional support as well as practical resources. You may learn which strategies and resources other parents have found most helpful.

    A child with ODD may need special services at school to manage his behavior. Talk to school officials about your options so you can best support your child's education. 

    Sources

    Diagnostic and statistical manual of mental disorders: DSM-5. Washington, Londres: American Psychiatric Association; 2013.

    Jahangard L, Akbarian S, Haghighi M, et al. Children with ADHD and symptoms of oppositional defiant disorder improved in behavior when treated with methylphenidate and adjuvant risperidone, though weight gain was also observed – Results from a randomized, double-blind, placebo-controlled clinical trialPsychiatry Research. 2017;251:182-191. ​