Children often test the limits of their parents and authority figures. Some level of disobedience and rule breaking is a normal and healthy part of childhood.
Sometimes, however, that behavior can be persistent and frequent. This ongoing hostile or defiant behavior could be a sign of oppositional defiant disorder (ODD).
ODD is a type of behavior disorder. Children with ODD often act out. They throw temper tantrums, defy authority figures, or are argumentative with peers or siblings. These behaviors may happen only at home, around parents. They may take place in other settings, too, such as school.
It is estimated between 2 and 16 percent of school-age children and teens have ODD. Symptoms of ODD can appear as early as 2 or 3 years old. However, it’s more likely they’ll show up between ages 6 and 8.
If ODD is not addressed and treated in childhood, the child may develop long-term, chronic problems. These issues can last through their teenage years and into adulthood.
Keep reading to find out what ODD is, how it’s diagnosed, and what can be done to help a child who has it.
Children with ODD will show several of these behavioral symptoms:
- inability or refusal to obey rules
- easily frustrated or quick to lose one’s temper
- repeated and frequent temper tantrums
- fighting with siblings or classmates
- arguing recurrently
- deliberately upsetting or annoying others
- being unwilling to negotiate or compromise
- speaking harshly or unkindly
- defying authority
- seeking revenge
- being vindictive and spiteful
- blaming others for one’s behavior
In addition to behavioral symptoms, a child with ODD may have one or more of these symptoms:
- difficulty concentrating
- difficulty making friends
- low self-esteem
- persistent negativity
Symptoms of ODD may ultimately interfere with learning, making school difficult. Challenges at school may further frustrate the child creating a cycle that could lead to more symptoms or outbursts.
Teens with ODD may be able to internalize their feelings more than younger children. Instead of lashing out or having a tantrum, they may be angry and annoyed all the time. This could lead to antisocial behaviors and depression.
tips for managing a child with odd
Parents can help children manage symptoms of ODD by:
- taking part in family therapy if recommended by the child’s psychiatrist or doctor
- enrolling in training programs that teach parents how to manage their child’s behavior, set clear expectations, and properly provide instruction
- using consistent discipline when warranted
- limiting the child’s exposure to environmental triggers, such as arguments
- encouraging and modeling healthy behaviors, such as getting proper sleep (if lack of sleep is a trigger for your child’s defiant behaviors, for example)
It’s unclear what causes ODD. Researchers and doctors believe a series of issues may play a role. Johns Hopkins Medicine says that can include:
- Developmental stages. All children go through emotional phases from the time they’re born into adulthood. Successful resolution of those stages helps the child grow and develop emotionally. However, children who do not learn to be independent from a parent may be at higher risk of developing ODD. These attachment issues could start as early as toddler years.
- Learned behaviors. Children who are surrounded by a toxic or negative environment may absorb it into their own behaviors. Parents who are excessively strict or negative may reinforce bad behavior that gets them attention. As such, ODD may be born out of a child’s desire for “attention.”
Several other factors may be linked to ODD. These include:
- a permissive parenting style that doesn’t have clear boundaries for appropriate behavior
- personality traits, like a strong will
- stress or turmoil in home life
Risk factors for ODD include:
- Family discord. Children absorb a lot of what happens around them. If they are surrounded by dysfunction and conflict, their behavior may suffer.
- Exposure to violence and substance abuse. Children living in an unsafe environment may be more likely to develop ODD.
- Gender. Before the teen years, boys are more likely to develop ODD than girls. By adolescence, this difference goes away.
- Family history. A history of mental illness may increase a child’s risk for ODD.
- Other conditions. Children with ODD may also have other behavioral disorders or development disorders. For example, about 40 percent of children with attention deficit hyperactivity disorder (ADHD) also have ODD.
when to see your child’s doctor
If you think your child has ODD, these symptoms may indicate you need to see the doctor:
- defiant behavior that makes daily life impossible for your family
- behavior that disrupts school or extracurricular activities
- frequently blaming discipline issues on others
- inability to enforce behavior expectations without temper tantrums or meltdowns
The recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes ODD. Health care providers can use the criteria in the DSM-5 to determine if a child has ODD.
These criteria include:
- a pattern of angry or irritable moods
- argumentative or defiant behavior
- vindictiveness or spiteful reactions
These behaviors must last at least 6 months. They must also involve at least one individual who is not a sibling. Doctors will consider a child’s age, the intensity of symptoms, and how frequently they occur when making a diagnosis.
A child’s pediatrician may prefer to refer your child to a child psychiatrist or mental health expert who can diagnose ODD and develop a proper treatment plan.
how to find help for your child
If you think your child has ODD, these resources can help:
- Your child’s pediatrician. They can refer you to a child psychiatrist or other mental health expert.
- The American Psychological Association’s Psychologist Locator. This tool can search by state, even zip code, to find a provider near you.
- Your local hospital. Patient advocacy or outreach offices frequently help connect individuals with organizations or doctors who can help them with a new diagnosis.
- Your child’s school. The counseling office can also connect you with local services to help diagnose or treat your child.
Early treatment for ODD is imperative. Children who go untreated may develop worse symptoms and future behavior problems, including a conduct disorder.
These behavioral disturbances can and will eventually interfere with many aspects of your child’s life, from finishing high school to holding a job.
treatment options for ODD
Treatments for ODD in children include:
- Cognitive-behavioral therapy (CBT). This type of therapy teaches children to better solve problems, communicate, and control impulses or emotions.
- Family therapy. This strategy provides families, siblings and parents included, a chance to work on their communication skills and interactions together.
- Peer group therapy. This type of therapy helps children learn social skills with people of their own age.
- Parent-child interaction therapy. This approach helps parents and the child with ODD repair their bond and relationship and work to strengthen it through open and improved communication.
- Medicine. Prescription medicine is rarely used for ODD alone. However, drugs may be used to treat a co-occurring disorder, such as ADHD or anxiety disorder.
Treatment, however, is not a one-size-fits-all prescription. Most treatment for ODD is centered around therapy. You and your child may have to try several types of therapy until you all find the one that works best.
Some children with ODD will eventually outgrow the disorder. Symptoms may disappear as they age.
However, as much as 30 percent of children with ODD eventually develop a conduct disorder. About 10 percent of children with ODD may eventually develop a personality disorder, like antisocial personality disorder.
That’s why it’s important you seek help early if you believe your child is showing signs of ODD. Early treatment can go a long way to preventing severe symptoms or long-lasting effects.
In teen years, ODD can lead to problems with authority, frequent relationship conflicts, and difficulty forgiving people. What’s more, teens and with ODD have an increased risk for depression and substance abuse.
Oppositional defiant disorder is a behavior disorder most commonly diagnosed in children and teens. In children, symptoms of ODD can include hostility toward peers, argumentative or confrontational behaviors toward adults, and frequent emotional outbursts or temper tantrums.
If left untreated, ODD can become worse. Severe symptoms may interfere with your child’s ability to participate in school or extracurricular activities. In their teen years, it can lead to a conduct disorder and antisocial behavior.
That’s why early treatment is so important. Therapy can help your child learn to respond better to their emotions and better shape their communications with you, their teachers, their siblings, and other authority figures.