Oppositional Defiant Disorder (ODD)

What Is ODD?
Children and adolescents with oppositional defiant disorder (ODD) are frequently and consistently negative, defiant, disobedient and hostile toward adults. Their behavior can impair learning and performance in school as well as their ability to get along in social situations. Symptoms usually appear between ages 1 and 3.

As many as 5% to 15% of school-age children in the U.S. have ODD. It's the number-one reason for referring children and teens to mental health programs.

Signs & Symptoms
Children with ODD often will act out at home but not necessarily at school or with other adults. You'll see most or all of these behaviors in kids with ODD more than you will in other children of the same age:

• Losing his or her temper
• Arguing with adults
• Defying or refusing to comply requests or rules
• Annoying others deliberately deliberately annoys people
• Blaming others for his or her mistakes or misbehavior
• Touchiness or easily annoyed by others
• Anger and resentment
• Spitefulness or vindictiveness

Who's at Risk?
No one knows what causes ODD. In younger children it is more common in boys, but after puberty the rate is the same for both sexes. Other risk factors:

• Family history of alcoholism and run-ins with the law
• Presence of learning disabilities or mental health conditions such as ADHD

Professional Help
Living with a child who has ODD can be difficult and disruptive for the whole family. Don't wait for the child to "grow out of it." Get treatment as early as possible. The longer that patterns of oppositional behavior are in place, the harder they are to change.

ODD is diagnosed when the negative, hostile and defiant behavior has lasted at least 6 months and where at least four ODD symptoms (above) are observed. To diagnose ODD, a doctor will:

• Examine the child and if needed, order tests to rule out any medical problems
• Talk with the child and parents
• Review the child's medical history
• Check for other mental health disorders, since ODD almost always occurs with other conditions  

Treatment for ODD can include:

• Parent training to help you learn how to manage your child's behavior
• Individual psychotherapy to help your child learn how to manage anger
• Family psychotherapy for improving overall communication the family and with others who interact with your child.
• Behavioral therapy to teach your child how to solve problems and overcome negative attitudes
• Social skills training to help the child learn to be more flexibile and less frustrated with people and situations
• Medications such as the stimulants prescribed for ADHD

What You Can Do

• Praise postive behaviors when you see them. For example, if your child cooperates with you instead of digging in his heels, let him know you notice and appreciate it.
• Don't let conflicts between you escalate. If your words and actions are making a conflict worse, take a time-out or a break. If your child wants to take a time-out to prevent her own overreacting, support her decision.
• Pick your battles. A child with ODD will mount a power struggle over almost anything and it's easy for parents to get worn down. Prioritize and enforce the things you think are important and let the rest go. 
• Set limits and enforce them consistently. Make sure these are reasonable and appropriate for your child's age.
• Get support. Work with other adults in your child's life, like teachers and coaches, to help deal with your child. Join a support group with other parents of children with ODD.
• Take care of yourself. To manage your own stress, make sure you exercise and take time to relax. Get enough sleep.

Priority Health members can check here for information on getting mental health assistance.