What is Oppositional Defiant Disorder (ODD)

Oppositional defiant disorder is a mental health disorder that affects children. Children who have this disorder have a pattern of being angry, disobedient, and spiteful. Most children behave this way some of the time, but children with ODD behave this way much of the time. Most of the time, there is no reason for it.

Starting early with treatment for this condition is important. Untreated ODD can lead to problems at home and school. It can also lead to other mental health problems later in life.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:

• Children who have a parent who has mental health problems.
• Children who have a parent who has alcohol or drug problems.
• Children who live in homes where relationships are unpredictable or stressful.
• Children whose home situation is unstable.
• Children who have been neglected or abused.
• Children who have another mental health disorder, especially attention deficit hyperactivity disorder (ADHD).
• Children who have a hard time managing emotions and frustration.

What are the signs or symptoms?

Symptoms of this condition include:

• Temper tantrums.
• Anger and irritability.
• Excessive arguing.
• Refusing to follow rules or requests.
• Being spiteful or seeking revenge.
• Blaming others.
• Trying to upset or annoy others.

Symptoms may start at home. Over time, they may happen at school or other places outside of the home. Symptoms usually develop before 8 years of age.

How is this diagnosed?

This condition may be diagnosed based on the child’s behavior. Your child may need to see a child mental health care provider (child psychiatrist or child psychologist) for a full evaluation. The psychiatrist or psychologist will look for symptoms of other mental health disorders that are common with ODD. These include:

• Depression.
• Learning disabilities.
• Anxiety.
• Hyperactivity.

Your child may be diagnosed with this condition if:

• Your child is younger than 5 years of age and has at least four symptoms of ODD on most days of the week for at least six months.
• Your child is 5 years of age or older and has four or more symptoms of ODD at least once per week for at least six months.

How is this treated?

This condition may be treated with:

• Parent management training (PMT). This teaches parents how to manage and help children who have this condition. PMT is the most effective treatment for children who are younger than 5 years of age.
• Cognitive problem-solving skills training. This teaches children with this condition how to respond to their emotions in better ways.
• Social skills programs. These teach children how to get along with other children. These programs usually take place in group sessions.
• Medicine. Medicine may be prescribed if your child has another mental health disorder along with ODD.

Follow these instructions at home:

• Learn as much as you can about your child’s condition.
• Work closely with your child’s health care providers and teachers.
• Teach your child positive ways of dealing with stressful situations.
• Provide consistent, predictable, and immediate punishment for disruptive behavior.
• Do not treat your child with strict discipline or tough love. These parenting styles tend to make the condition worse.
• Do not stop your child’s treatment. Treatment may take months to be effective.
• Try to develop your child’s social skills to improve interactions with peers.
• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child’s symptoms are not getting better after several months of treatment.
• You child’s symptoms are getting worse.
• Your child is developing new and troubling symptoms.
• You feel that you cannot manage your child at home.

Get help right away if:

• You think that the situation at home is dangerously out of control.
• You think that your child may be a danger to himself or herself or to other people.