Oppositional Defiant Disorder (ODD) in Children
What is oppositional defiant disorder (ODD) in children?
Oppositional defiant disorder (ODD) is a type of behavior disorder. It is mostly diagnosed
in childhood. Children with ODD are uncooperative, defiant, and hostile toward peers,
parents, teachers, and other authority figures. They are more troubling to others
than they are to themselves.
What causes ODD in a child?
Experts don’t know what causes ODD. But there are 2 main theories for why it occurs:
Developmental theory. This theory suggests that the problems start when children are toddlers. Children
and teens with ODD may have had trouble learning to become independent from a parent
or other main person to whom they were emotionally attached. Their behavior may be
normal developmental issues that are lasting beyond the toddler years.
Learning theory. This theory suggests that the negative symptoms of ODD are learned attitudes. They
mirror the effects of negative reinforcement methods used by parents and others in
power. The use of negative reinforcement increases the child’s ODD behaviors. That’s
because these behaviors allow the child to get what he or she wants: attention and
reaction from parents or others.
Which children are at risk for ODD?
ODD is more common in boys than in girls. Children with these mental health problems
are also more likely to have ODD:
What are the symptoms of ODD in a child?
Most symptoms seen in children and teens with ODD also happen at times in other children
without it. This is very true for children around ages 2 or 3, or during the teen
years. Many children tend to disobey, argue with parents, or defy authority. They
may often behave this way when they are tired, hungry, or upset. But in children and
teens with ODD, these symptoms happen more often. They also interfere with learning
and school adjustment. And in some cases, they disrupt the child’s relationships with
Symptoms of ODD may include:
Having frequent temper tantrums
Arguing a lot with adults
Refusing to do what an adult asks
Always questioning rules and refusing to follow rules
Doing things to annoy or upset others, including adults
Blaming others for the child’s own misbehaviors or mistakes
Being easily annoyed by others
Often having an angry attitude
Speaking harshly or unkindly
Seeking revenge or being vindictive
These symptoms may seem like other mental health problems. Make sure your child sees
his or her healthcare provider for a diagnosis.
How is ODD diagnosed in a child?
If you see symptoms of ODD in your child or teen, get a diagnosis right away. Early
treatment can often prevent future problems.
Before a mental health referral is made, your child's healthcare provider will want
to rule out any other health problems. Once this is done, a child psychiatrist or
qualified mental health expert can diagnose ODD. He or she will talk with you and
your child's teachers about your child’s behavior. He or she may also watch your child.
In some cases, your child may need mental health testing.
How is ODD treated in a child?
Early treatment can often prevent future problems. Treatment will depend on your child’s
symptoms, age, and health. It will also depend on how bad the ODD is.
Children with ODD may need to try different therapists and types of therapies before
they find what works for them. Treatment may include:
Cognitive-behavioral therapy. A child learns to better solve problems and communicate. He or she also learns how
to control impulses and anger.
Family therapy. This therapy helps make changes in the family. It improves communication skills and
family interactions. Having a child with ODD can be very hard for parents. It can
also cause problems for siblings. Parents and siblings need support and understanding.
Peer group therapy. A child learns better social skills.
Medicines. These are not often used to treat ODD. But a child may need them for other symptoms
or disorders, such as ADHD or anxiety disorders.
How can I help prevent ODD in my child?
Experts don’t know what causes ODD. But certain approaches can help prevent the disorder.
Young children may be helped by early intervention programs. These can teach them
social skills and how to deal with anger. For teens, talk therapy (psychotherapy),
learning social skills, and getting help with schoolwork can all help reduce problem
behaviors. School-based programs can also help to stop bullying and improve relationships
Parent-management training programs are also important. These programs teach parents
how to manage their child’s behavior. Parents learn positive reinforcement methods,
and also how to discipline their child.
How can I help my child live with ODD?
Early treatment for your child can often prevent future problems. Here are things
you can do to help:
Keep all appointments with your child’s healthcare provider.
Take part in family therapy as needed.
Talk with your child’s healthcare provider about other providers who will be included
in your child’s care. Your child may get care from a team that may include counselors,
therapists, social workers, psychologists, school psychologists, school counselors,
and psychiatrists. Your child’s care team will depend on his or her needs and how
serious the disorder is.
Tell others about your child’s conduct disorder. Work with your child’s healthcare
provider and school to create a treatment plan.
If ODD greatly interferes with your child’s ability to succeed in school, he or she
may be eligible for certain protections and reasonable accommodations under the Americans
with Disabilities Act (ADA) or Section 504 of the Civil Rights Act. Talk with your
your child’s teacher and school principal about how to get more information.
Reach out for support. Being in touch with other parents who have a child with ODD
may be helpful. If you feel overwhelmed or stressed out, talk with your child’s healthcare
provider. He or she may direct you to a support group for caregivers of children with
When should I call my child’s healthcare provider?
Call your child’s healthcare provider right away if your child:
Feels extreme depression, fear, anxiety, or anger toward him or herself or others
Feels out of control
Hears voices that others don’t hear
Sees things that others don’t see
Can’t sleep or eat for 3 days in a row
Shows behavior that concerns friends, family, or teachers, and others express concern
about this behavior and ask you to seek help
Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the
Key points about ODD in children
Oppositional defiant disorder (ODD) is a type of behavior disorder. Children with
ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other
Developmental problems may cause ODD. Or the behaviors may be learned.
A child with ODD may argue a lot with adults or refuse to do what they ask. He or
she may also be unkind to others.
A mental health expert often diagnoses ODD.
Therapy that helps the child get along better with others is the main treatment. Medicines
may be needed for other problems, such as ADHD.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.