|Oppositional Defiant Disorder
• Are clearly disruptive to the family and home or school environment
• Are persistent
• Have lasted at least six months
The following are behaviors associated with ODD:
• Hostility directed toward authority figures
These behaviors might cause your youngster to regularly and consistently show these symptoms:
• Academic problems
• Acting touchy and easily annoyed
• Aggressiveness toward peers
• Anger and resentment
• Argumentativeness with adults
• Blaming others for mistakes or misbehavior
• Deliberate annoyance of other people
• Difficulty maintaining friendships
• Frequent temper tantrums
• Refusal to comply with adult requests or rules
• Spiteful or vindictive behavior
Related mental health issues—
Oppositional defiant disorder often occurs along with other behavioral or mental health problems such as
attention-deficit/hyperactivity disorder (ADHD), anxiety or depression. The symptoms of ODD may be
difficult to distinguish from those of other behavioral or mental health problems.
It's important to diagnose and treat any co-occurring illnesses because they can create or worsen irritability
and defiance if left untreated. Additionally, it's important to identify and treat any related substance abuse
and dependence. Substance abuse and dependence in kids or adolescents is often associated with irritability
and changes in the youngster or adolescent's usual personality.
There's no clear cause underpinning oppositional defiant disorder. Contributing causes may include:
• A biochemical or neurological factor
• A genetic component that when coupled with certain environmental conditions — such as lack of
supervision, poor quality youngster care or family instability — increases the risk of ODD
• The youngster's inherent temperament
• The youngster's perception that he or she isn't getting enough of the parent's time and attention
• The family's response to the youngster's style
A number of factors play a role in the development of oppositional defiant disorder. ODD is a complex
problem involving a variety of influences, circumstances and genetic components. No single factor causes
ODD. Possible risk factors include:
• Being abused or neglected
• Exposure to violence
• Family instability such as occurs with divorce, multiple moves, or changing schools or youngster care
• Financial problems in the family
• Harsh or inconsistent discipline
• Having a parent with a mood or substance abuse disorder
• Lack of supervision
• Moms & dads with a history of ADHD, oppositional defiant disorder or conduct problems
• Poor relationship with one or both parents
• Substance abuse in the youngster or adolescent
When to seek medical advice—
If you're concerned about your youngster's behavior or your own ability to parent a challenging youngster,
seek help from your doctor, a child psychologist or child behavioral expert. Your primary care doctor or
your youngster's pediatrician can refer you to someone.
The earlier this disorder can be managed, the better the chances of reversing its effects on your youngster
and your family. Treatment can help restore your youngster's self-esteem and rebuild a positive
relationship between you and your youngster.
Tests and diagnosis—
Behavioral and mental health conditions are difficult to diagnose definitively. There's no blood test or
imaging technique that can pinpoint an exact cause of behavioral symptoms, though these tests are
sometimes used to rule out certain conditions. Physicians and other health professionals rely on:
• Information gained from interviewing the youngster
• Information gathered from moms & dads and teachers, who may fill out questionnaires
• Their clinical judgment and experience
Normal child and adolescent behavior and development can be challenging in their own right, but ODD is
distinct due to the frequent and significant disruptions that are caused in the youngster's life at home,
school, or in a job where authority figures have clear limits and expectations for behavior.
It can be difficult for doctors to sort and exclude other associated disorders — for example, attention-
deficit/hyperactivity disorder versus oppositional defiant disorder. These two disorders are commonly
Many kids with oppositional defiant disorder have other treatable conditions, such as:
• Attention-deficit/hyperactivity disorder (ADHD)
If these conditions are left untreated, managing ODD can be very difficult for the moms & dads, and
frustrating for the affected youngster. Kids with oppositional defiant disorder may have trouble in school
with teachers and other authority figures and may struggle to make and keep friends.
ODD may be a precursor to other, more severe behavioral disorders such as conduct disorder, but this is
for a free eBook on Oppositional Defiant Disorder
from the American Academy of Child & Adolescent Psychiatry
Oppositional Defiant Disorder (ODD) --
Even the best-behaved kids can be difficult and challenging at times.
Adolescents are often moody and argumentative. But if your youngster
or teenager has a persistent pattern of tantrums, arguing, and angry or
disruptive behaviors toward you and other authority figures, he or she
may have oppositional defiant disorder (ODD). As many as one in 10
kids may have oppositional defiant disorder in a lifetime.
Treatment of oppositional defiant disorder involves therapy and
possibly medications to treat related mental health conditions. As a
parent, you don't have to go it alone in trying to manage a youngster
with oppositional defiant disorder. Doctors, counselors and youngster
development experts can help you learn specific strategies to address
oppositional defiant disorder.
It may be tough at times to recognize the difference between a strong-willed or emotional youngster and
one with oppositional defiant disorder. Certainly there's a range between the normal independence-seeking
behavior of kids and oppositional defiant disorder. It's normal to exhibit oppositional behaviors at certain
stages of a youngster's development.
However, your youngster's issue may be oppositional defiant disorder if your youngster's oppositional
Treatments and drugs—
Ideally, treatment for oppositional defiant disorder involves your primary care doctor
and a qualified mental health professional or youngster development professional. It
may also help to seek the services of a psychologist specializing in family therapy.
These health professionals can screen for and treat other mental health problems that
may be interfering with oppositional defiant disorder, such as ADHD, anxiety or
depression. Successful treatment of the often-coexisting conditions will improve the
effectiveness of treatment for ODD. In some cases, the symptoms of ODD disappear entirely.
Successful treatment of oppositional defiant disorder requires commitment and follow-through by you as a
parent and by others involved in your youngster's care. Most important in treatment is for you to show
consistent, unconditional love and acceptance of your youngster — even during difficult and disruptive
situations. Doing so can be tough for even the most patient moms & dads.
To learn more about defiant behavior, consider looking into parent education programs for a higher
education on the subject matter.
Learning or improving parental skills—
Mental health professionals can help you learn or strengthen specific skills and parenting techniques to help
improve your youngster's behavior and strengthen your relationship with him or her. For example, you can
learn how to:
• Avoid power struggles
• Establish a schedule for the family that includes specific meals that will be eaten at home together, and
specific activities one or both moms & dads will do with the youngster
• Give effective timeouts
• Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount
• Offer acceptable choices to your youngster, giving him or her a certain amount of control
• Recognize and praise your youngster's good behaviors and positive characteristics
• Remain calm and unemotional in the face of opposition
Success requires perseverance, hard work—
Although some parent management techniques may seem like common sense, learning to use them in the
face of opposition isn't easy, especially if there are other stressors at home. Learning these skills may
require counseling, parenting classes or other forms of education, and consistent practice and patience.
At first, your youngster is not likely to be cooperative or to appreciate your changed response to his or her
behavior. Expect that you'll have setbacks and relapses, and be prepared with a plan to manage those times.
In fact, behavior often temporarily worsens when new limits and expectations are set. However, with
perseverance and consistency, the initial hard work often pays off with improved behavior and relationships.
Individual and family counseling—
Individual counseling for your youngster may help him or her learn to manage anger. Family counseling
may help improve communication and relationships and help family members learn how to work together.
Lifestyle and home remedies—
At home, you can begin chipping away at problem behaviors by practicing the following:
• Assign your youngster a household chore that's essential and that won't get done unless the youngster
does it. Initially, it's important to set your youngster up for success with tasks that are relatively easy to
achieve and gradually blend in more important and challenging expectations.
• Build in time together. Develop a consistent weekly schedule that involves moms & dads and youngster
• Model the behavior you want your youngster to have.
• Pick your battles. Avoid power struggles.
• Recognize and praise your youngster's positive behaviors.
• Set limits and enforce consistent reasonable consequences.
• Set up a routine. Develop a consistent daily schedule for your youngster.
• Work with your spouse or others in your household to assure consistent and appropriate discipline
Coping and support—
For yourself, counseling can provide an outlet for your own mental health concerns that could interfere with
the successful treatment of your youngster's symptoms. If you're depressed or anxious, that could lead to
disengagement from your youngster — and that can trigger or worsen oppositional behaviors.
Here are some tips:
• Be forgiving. Let go of things that you or your youngster did in the past. Start each day with a fresh
outlook and a clean slate.
• Learn ways to calm yourself. Keeping your own cool models the behavior you want from your youngster.
• Take time for yourself. Develop outside interests, get some exercise and spend some time away from
your youngster to restore your energy.
Final note: Parenting strategies often include a home rules contract
(i.e., a written set of expectations that moms & dads have of their
adolescents and pre-adolescents). The contract includes basic rules,
consequences and privileges. The primary purpose of a home rules
contract is for adolescents to be held accountable for their behavior
while allowing moms & dads to maintain a reasonable amount of control
(i.e., teaching adolescents that there are consequences for breaking rules, the knowledge of which hopefully
will transfer in the teenager's mind to school rules as well as the legal system).