Oppositional Defiance Disorder (ODD)

As many parents know, a child can be argumentative or strong-willed when a limit is set. Preschoolers, for example, commonly exhibit temper tantrums when they are asked to stop playing with a favorite toy or get ready for bed. But if a child has frequent temper tantrums and consistently refuses to follow requests day after day, he or she may have a deeper problem. Defiance and aggressiveness that repeatedly impacts family, social, or school activities, could be a sign of oppositional defiant disorder (ODD).

What is oppositional defiant disorder?

Before puberty, ODD is more common in boys. After puberty, it occurs almost equally among boys and girls. ODD has no clear cause. The behaviors appear to arise from a combination of genetics and poor parent-child interactions. It may also involve environmental factors that begin in early childhood. Children with ODD often have difficulty making friends. This is because they view other children’s behavior as hostile and respond aggressively.

What causes oppositional defiant disorder?

Before puberty, ODD is more common in boys. After puberty, it occurs almost equally among boys and girls. ODD has no clear cause. The causes of ODD behaviors appear to be a combination of genetics, trauma, or disrupted parent-child attachment. It may also involve environmental factors that begin in early childhood.

What are the signs and symptoms of oppositional defiant disorder?

Children with ODD may refuse to follow commands or requests made by parents, teachers or other adults. They may also overreact to life events. They frequently fail to take responsibility for their actions, and at times show little remorse. Signs and symptoms of ODD are commonly linked with these behaviors:

• Frequent temper tantrums that are outside of what one would expect for a child’s age, gender and culture
• Is often angry or easily annoyed
• Argumentative toward adults or others
• Deliberately annoying others
• Blaming others for mistakes or misbehavior, even when caught in the act
• Being resentful, spiteful or vindictive
• Being aggressive toward peers, and angry or disruptive toward adults.

ODD Behavior

ODD behavior is different from normal behavior because it persists and impacts social relationships. Children with ODD typically display irritable mood, argue with adults, or blame others for their mistakes for at least 6 months. In these cases, children do not consider themselves argumentative. Instead, they perceive that unreasonable demands are being placed on them. While these behaviors often occur exclusively in the home, they can also occur in the classroom or other settings. According to the National Institute of Mental Health, children are diagnosed with ODD only if their behavior goes beyond what is considered normal for children of the same age, gender, race and culture.

How is oppositional defiant disorder treated?

Treatment for ODD is important because a child’s development, relationships and education are at risk if the disorder is not treated. There is a strong body of research that supports Parent-Child Interaction Therapy for children with ODD (Eyeberg, S. M. and Banger, D. M., 2007) and co-occurring conditions such as ADHD (Forehand, R., Parent, J., Sonuga-Barke, E., Peisch, V. D., Long, N., and Aibkoff, H. B., 2016). If untreated, ODD may lead to anxiety, depression, or a more serious disorder called conduct disorder. A child or teen with conduct disorder may harm or threaten people or animals, damage property or engage in serious violations of rules.

Parents who think their child may have ODD should seek help from their child’s doctor or a child psychologist to get appropriate treatment. Diagnosing ODD can be difficult and should be handled by a provider who has experience with the disorder.

Reviewed by Amy Morse, PsyD, June 4, 2021.