Quick Guide to Oppositional Defiant Disorder
Understanding Oppositional Defiant Disorder in Children
Children with Oppositional Defiant Disorder (ODD) exhibit a pattern of defiant behavior and they often argue with adults, refuse to comply with rules, and are easily annoyed by others. ODD can be difficult for parents, caregivers, and teachers to manage and it can have a significant impact on a child's social and academic functioning.
Signs and Symptoms
Children with ODD exhibit a range of behaviors that are persistent and disruptive to their daily functioning. The symptoms of ODD typically start to emerge in early childhood and can worsen over time if left untreated. These behaviors can be extremely challenging for parents to manage and can lead to conflict, frustration, and stress for all involved. Some common signs and symptoms of ODD include:
Frequent temper tantrums
Easily agitated or annoyed
Arguing with adults
Refusing to comply with rules or requests
Blaming others for their mistakes
Deliberately annoying others
Being spiteful or vindictive
Causes
The exact causes of ODD are not fully understood, but research suggests that a range of factors contribute to its development. These factors include biological, genetic, and environmental influences. Some of the known risk factors for ODD include:
Family history of mental health conditions
Parenting styles that are harsh, inconsistent, or neglectful
Trauma and abuse
Exposure to toxins and pollutants
Learning and language difficulties
Evaluation
Behaviors that go along with ODD are difficult to change; therefore, early identification of ODD give children and adolescents the best chance for success.
There is no single test that can diagnose ODD. The first step is to complete a comprehensive assessment including a thorough history of your child’s functioning since early childhood. Standardized behavior checklists and symptom rating scales help us pinpoint problematic behaviors. Ratings from others who have observed your child’s behaviors in different settings also are used.
Open communication between you and our providers can help overcome the difficulties diagnosing this disorder. We will ask questions that help clarify whether a child’s behavior is a response to a short-lived situation or transition, ODD, or another serious behavioral condition, such as conduct disorder or a mood disorder. We will also look for signs of other conditions that often occur along with ODD, such as ADHD, anxiety, and mood disorders.
Treatment
There are a range of treatments available for children with ODD. These treatments are typically tailored to meet the individual needs of the child and may involve behavioral therapy, medication, or a combination of the two.
Parent Management Training and Parent-Child Interaction Therapy are two parent training programs that have proven effective in treating ODD among all age groups. These programs teach parents how to develop a more confident, secure relationship with their child and how to set boundaries for unacceptable behavior. Studies have shown that intervening with parents is one of the most effective ways to reduce the behavioral symptoms of ODD, in all age groups.
Medication may be necessary to help control some of the more distressing symptoms of ODD as well as the symptoms of coexisting conditions, such as ADHD, anxiety, and mood disorders; however, medication alone is not a treatment for ODD. Successful treatment of coexisting conditions often makes ODD treatment more effective. For example, medication used to treat children with ADHD has been shown to lessen behavioral symptoms when ODD and ADHD coexist. If medication is recommended, your initial evaluation report can be sent to one of our psychiatry referrals to further sort through the need for medications, any potential contraindications, and problem-solving with each person to determine the correct approach for them.
For preschool-age children, treatment often concentrates on parent management training and education. School-age children perform best with a combination of school-based intervention, parent management training, and individual therapy. For adolescents, individual therapy along with parent management training has been shown to be the most effective form of treatment.
Experts agree that therapies given in a one-time or short-lived fashion, such as boot camps, tough-love camps, or scare tactics, are not effective for children and adolescents with ODD. In fact, these approaches may do more harm than good. Trying to scare or forcibly coerce children and adolescents into behaving may only reinforce aggressive behavior. Children respond best to treatment that rewards positive behavior and teaches them skills to manage negative behavior. Read more about our parent training consultations here.
