Oppositional Defiant Disorder

No.
72 March 2011
Children with Oppositional Defiant

Disorder
All children are oppositional from time to time, particularly when tired, hungry, stressed
or upset. They may argue, talk back, disobey, and defy parents, teachers, and other
adults. Oppositional behavior is often a normal part of development for two to three year
olds and early adolescents. However, openly uncooperative and hostile behavior
becomes a serious concern when it is so frequent and consistent that it stands out when
compared with other children of the same age and developmental level and when it
affects the child’s social, family and academic life.
In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of

uncooperative, defiant, and hostile behavior toward authority figures that seriously
interferes with the youngster’s day to day functioning. Symptoms of ODD may include:
• Frequent temper tantrums

• Excessive arguing with adults
• Often questioning rules
• Active defiance and refusal to comply with adult requests and rules
• Deliberate attempts to annoy or upset people
• Blaming others for his or her mistakes or misbehavior
• Often being touchy or easily annoyed by others
• Frequent anger and resentment
• Mean and hateful talking when upset
• Spiteful attitude and revenge seeking
The symptoms are usually seen in multiple settings, but may be more noticeable at home
or at school. One to sixteen percent of all school-age children and adolescents have
ODD. The causes of ODD are unknown, but many parents report that their child with
ODD was more rigid and demanding that the child’s siblings from an early age.
Biological, psychological and social factors may have a role.
A child presenting with ODD symptoms should have a comprehensive evaluation. It is

important to look for other disorders which may be present; such as, attention-deficit
hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar
disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD
without treating the coexisting disorder. Some children with ODD may go on to develop
conduct disorder.
Children with ODD, “Facts for Families,” No. 72 (3/11)
Treatment of ODD may include: Parent Management Training Programs to help parents
and others manage the child’s behavior. Individual Psychotherapy to develop more
effective anger management. Family Psychotherapy to improve communication and
mutual understanding. Cognitive Problem-Solving Skills Training and Therapies to
assist with problem solving and decrease negativity. Social Skills Training to increase
flexibility and improve social skills and frustration tolerance with peers.
Medication may be helpful in controlling some of the more distressing symptoms of

ODD as well as the symptoms related to coexistent conditions such as ADHD, anxiety
and mood disorders.
A child with ODD can be very difficult for parents. These parents need support and
understanding. Parents can help their child with ODD in the following ways:
• Always build on the positives, give the child praise and positive reinforcement
when he shows flexibility or cooperation.
• Take a time-out or break if you are about to make the conflict with your child
worse, not better. This is good modeling for your child. Support your child if he
decides to take a time-out to prevent overreacting.
• Pick your battles. Since the child with ODD has trouble avoiding power
struggles, prioritize the things you want your child to do. If you give your child a
time-out in his room for misbehavior, don’t add time for arguing. Say “your time
will start when you go to your room.”
• Set up reasonable, age appropriate limits with consequences that can be enforced
consistently.
• Maintain interests other than your child with ODD, so that managing your child
doesn’t take all your time and energy. Try to work with and obtain support from
the other adults (teachers, coaches, and spouse) dealing with your child.
• Manage your own stress with healthy life choices such as exercise and relaxation.
Use respite care and other breaks as needed
Many children with ODD will respond to the positive parenting techniques. Parents may
ask their pediatrician or family physician to refer them to a child and adolescent
psychiatrist or qualified mental health professional who can diagnose and treat ODD and
any coexisting psychiatric condition.
See also:
Oppositional Defiant Disorder Resource Center
This resource center offers a definition of the disorder, answers to

frequently asked questions, and information on getting help.
For additional information see other Facts for Families:

#6 Children Who Can't Pay Attention/ADHD
#16 Learning Disabilities
#4 The Depressed Child
Children with ODD, “Facts for Families,” No. 72 (3/11)
#38 Manic-Depressive Illness in Teens

#52 Comprehensive Psychiatric Evaluation
#33 Conduct Disorder
#65 Children's Threats
#66 Helping Teenagers with Stress
#00 Definition of a Child and Adolescent Psychiatrist
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Children with Oppositional Defiant

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of

• Frequent temper tantrums

A child presenting with ODD symptoms should have a comprehensive evaluation. It is

Medication may be helpful in controlling some of the more distressing symptoms of

This resource center offers a definition of the disorder, answers to

For additional information see other Facts for Families:

#38 Manic-Depressive Illness in Teens

Copyright © 2011 by the American Academy of Child and Adolescent Psychiatry.

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