Oppositional Defiant Disorder

What is it?

Oppositional Defiant Disorder (ODD) is a childhood disorder characterized by persistent negative, defiant, disobedient and often hostile behavior toward adults and authority figures. In some cases, these behaviors only happen at home; in more severe cases, they occur in multiple settings.

Signs and Symptoms

Children and adolescents with ODD lose their tempers quickly, are often disobedient at home or at school, may ignore rules, blame others for mistakes or misbehavior, and are prone to annoy others and be easily annoyed. Each of these behaviors is typical in children, but children with ODD act out so often that it compromises their ability to get along with others. They will refuse to cooperate even before they know what is being asked of them. Symptoms of ODD can appear as early as preschool or in adolescence.

Diagnosis and Treatment

To distinguish symptoms of ODD from normal childhood or adolescent rebellion, professionals look at a detailed history of behaviors in various situations. For children younger then 5, the behaviors should occur almost daily for at least 6 months; for those older than 5, the behaviors should occur weekly 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 evident in the professional’s office. To be diagnosed, behaviors must occur for at least 6 months.

ODD is treatable with behavioral therapy or a combination of behavioral intervention and medication.
A type of behavior therapy that’s especially successful is called parent-child interaction therapy. Parents learn to increase their positive interactions with their child and set consistent consequences for undesirable behavior. Children learn to control their behavior and enjoy a more supportive relationship with parents.

Many children with ODD have co-occurring conditions such as ADHD and may be on medications for those other disorders. Some children may be prescribed medication to help them manage their low tolerance for frustration and aggression.

What are the risk factors for children?

Children with ODD have often experienced harsh, inconsistent or neglectful parenting. ODD is often diagnosed along with ADHD and children with ODD may have co-occurring mood disorders like depression, anxiety, 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 abuse.