Oppositional defiant disorder (ODD) is a psychiatric disorder that typically emerges in childhood, between ages 6 and 8, and can last throughout adulthood.
ODD is more than just normal childhood tantrums, and the frequency and severity of ODD causes difficulty at home and at school. What's more, children with ODD often also struggle with learning problems related to their behavior.
Types of Oppositional Defiant Disorder
There are two types of oppositional defiant disorder:
- Childhood-onset ODD: Present from an early age, and requires early intervention and treatment to prevent it from progressing into a more serious conduct disorder
- Adolescent-onset ODD: Begins suddenly in the middle- and high-school years, causing conflict at home and in school
Symptoms of Oppositional Defiant Disorder
Children with ODD display behaviors that are challenging for parents and educators. For example, they demonstrate aggression and purposeful misbehavior. They usually have difficulty interacting appropriately with peers and adults. Being argumentative and defiant is also a common problem in children with ODD.
Common signs and symptoms of ODD include:
- Being easily annoyed
- Causing conflict
- Frequent temper tantrums
- Low tolerance for frustration
- Moodiness and unprovoked anger
- Noncompliance with even simple requests
- No sense of conscience
- Purposeful irritation of others
It is important to note that with ODD, these symptoms occur in multiple domains and not just at home. Many children engage in oppositional behaviors with their parents but not in any other environment.
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How Is Oppositional Defiant Disorder Diagnosed?
According to the DMS-5, a diagnosis of ODD requires a child to have at least four symptoms from the following categories. The symptoms must occur for at least six months and have a negative impact on social, educational, or occupational functioning:
- Angry/irritable mood: Often loses their temper, is often angry or resentful, is often touchy or easily annoyed
- Argumentative/defiant behavior: Often argues with authority figures or adults, actively defies or refuses to comply with requests from authority figures or with rules, often deliberately annoys others, often blames others for his or her mistakes
- Vindictiveness: Has been spiteful or vindictive at least twice within the past six months
Your healthcare provider may assess the severity of your child's ODD using the following scale from the DSM-5:
- Mild: Symptoms are confined to only one setting.
- Moderate: Some symptoms will be present in at least two settings.
- Severe: Symptoms will be present in three or more settings.
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What Causes Oppositional Defiant Disorder?
While there is no known cause, ODD has been linked to a combination of biological, psychological, and social factors.
Biological factors include:
- A parent with a history of attention-deficit/hyperactivity disorder (ADHD), ODD, or CD
- A parent with a mood disorder (such as depression or bipolar disorder)
- A parent with a substance use disorder
- A mother who smoked during pregnancy
- Abnormal levels ofneurotransmittersin the brain
- Exposure to toxins
- Impairment in the part of the brain responsible for reasoning, judgment, and impulse control
- Poor nutrition
Psychological factors include:
- A neglectful or absent parent
- A poor relationship with one or more parent
- Difficulty or an inability to form social relationships or process social cues
Social factors include:
- Abuse or neglect
- Chaotic environment
- Family instability (such as divorce or frequent moves)
- Inconsistent discipline
- Lack of supervision
- Uninvolved parents
Sometimes ODD occurs in conjunction with other behavior disorders or mental health issues, including attention-deficit/hyperactive disorder (ADHD), anxiety disorders, depression, bipolar disorder, and language disorders.
Treatment for Oppositional Defiant Disorder
It is important that intervention begins as early as possible with children with ODD. Without proper intervention, ODD may develop into a conduct disorder.
Treatment often involves the following:
- Cognitive problem-solving skills therapy: Children will learn to manage specific symptoms of ODD and to identify and solve problems that arise from living with ODD.
- Family therapy:Parents, siblings, and other family members may be invited to attend therapy with the child in order to improve family interactions and relationships.
- Parent training:Parents or caregivers may be taughtbehavior managementstrategies and techniques to reduce misbehavior in the home.
- Psychotherapy:Individual therapycan help a child learn new skills, such as anger management and impulse control.
- Social skills training: Formal social skills training can be effective in helping the child with ODD to interact with peers and adults.
It will be important for the child's therapist to work closely with parents and teachers to ensure the effectiveness of a treatment program because behavior techniques that work with most children may be ineffective with children who have ODD.
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While medication alone is not a recommended treatment for ODD, your child may need medication to treat the symptoms of other coexisting conditions like ADHD, anxiety, and mood disorders.
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How to Reduce Behavioral Issues in Children
Behavior modificationmethods can be effective ways to reduce behavior problems in children. Sometimes a clinician will meet with caregivers separately to provide training on the following parenting techniques that can reduce misbehavior.
Treatment will often focus on one or two behavior problems, but the focus should be on reinforcing pro-social behaviors (i.e., keeping hands and feet to self, demonstrating respectful disagreements, etc.).
Form a Positive Relationship
The first step in treatment is building a positive relationship with your child. Most treatments for ODD begin with the parent engaging with the child in child-led play with the parent providing positive reinforcement and engagement.
Children with ODD often have a goal of annoying parents and teachers and will misbehave to provoke a negative response. It is especially important to set clear expectations rules and to apply them consistently.
Establish a Routine
Having a routine can help children with ODD cope with activities at home such as transitioning from dinner to homework to bedtime. Applying rules and following routines consistently and fairly are important for that reason.
Discipline and Rewards
Provide specific, labeled praise and rewards for the prosocial behaviors you want to see. If the child responds to behavior management systems, use stickers, tokens, or a behavior chart to show progress toward behavior goals. Allow the child to identify rewards they would like to earn.
As the child demonstrates success, offer reinforcement such as spending time in a preferred activity, verbal praise, edible rewards, or items from a prize box.
When the child interacts with others, make sure there is adequate supervision to ensure that rules can be enforced, and adults can help them interact appropriately. It can be helpful to have the school's counselor to work with peers to help them learn to respond appropriately to the child's behaviors.
How Can Parents Cope With ODD in Their Children?
Parents can also help their child better cope with ODD by doing their best to:
- Avoid giving direct praise that could result in misbehavior, especially if the child has the tendency to do the opposite of what you want them to do. For example, saying, "I like the way you're keeping your hands to yourself," could provoke the child to become physically aggressive.
- Resist the urge to argue or lecture the child, and try to keep your own temper under control.
- Avoid letting your child see you become angry, as this may be rewarding to them.
- Use a matter-of-fact tone of voice without emotion, simply stating the rule that was broken and what the consequences will be.
- Be consistent and avoid getting into a verbal argument with the child over consequences or what happened.
- Allow the child to have a place to vent their frustrations. Provide a pillow to punch or to yell into.
Support for Parents
Raising a child with ODD can be emotionally taxing and it's important to seek out opportunities to talk with other parents. No matter how thoughtful and understanding your family and friends, there is something special about talking with other parents who understand day-to-day living with a child with ODD.
In addition to emotional support, online support communities or Facebook groups can help ensure that you're educated on the latest findings and approaches to managing ODD.
If your child is struggling with ODD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
Resources for Parents of Kids With ODD
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Riley M, Ahmed S, Locke A. Common questions about oppositional defiant disorder. Am Fam Physician. 2016;93(7):586-91.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington D.C.: 2013. doi:10.1176/appi.books.9780890425596
Ghosh A, Ray A, Basu A.Oppositional defiant disorder: Current insight.Psychol Res Behav Manag. 2017;10:353-367. doi:10.2147/PRBM.S120582
By Ann Logsdon
Ann Logsdon is a school psychologist specializing in helping parents and teachers support students with a range of educational and developmental disabilities.
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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 can oppositional defiant disorder lead to? ›
If not managed promptly, ODD can progress to CD, which could then transition to antisocial personality disorder. Disruptive behavior disorders are psychiatric conditions that are characterized by significant impairments in behavior.What are 3 symptoms of ODD? ›
- 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.
Environmental factors: Having a chaotic family life, childhood maltreatment and inconsistent parenting can all contribute to the development of ODD. In addition, peer rejection, deviant peer groups, poverty, neighborhood violence and other unstable social or economic factors may contribute to the development of ODD.What happens if ODD is left untreated? ›
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.Is ODD a form of autism? ›
Research has suggested that ODD cases are often comorbid to cases of ASD, but due to the difficulty of assessing similar symptoms and attributing the different motivations that underly an ODD diagnosis, it is enormously difficult for clinicians to separate the two.Does ODD ever go away? ›
Does Oppositional Defiant Disorder get better or go away over time? For many children, Oppositional Defiant Disorder does improve over time. Follow up studies have shown that the signs and symptoms of ODD resolve within 3 years in approximately 67% of children diagnosed with the disorder.At what age does ODD develop? ›
ODD behaviours usually surface when the child is at primary school, but the disorder can be found in children as young as 3 years of age. A child with ODD may: become easily angered, annoyed or irritated. have frequent temper tantrums.What is the best treatment for ODD? ›
The preferred ODD treatment is a combination of individual and family behavioral therapy. When therapy alone does not resolve symptoms, medication for ODD can sometimes help. In addition, lifestyle changes can help some people with mild symptoms to control their explosions.Should kids with ODD have consequences? ›
Disciplining a Child with ODD Can Involve Consequences if Done with Caution. Kids with ODD don't respond well to discipline methods like warnings, counting to three, or punishments. If they're used correctly, giving kids with ODD consequences can be effective in helping reduce negative behavior.
- Know your boundaries. In a calm moment, think about what your boundaries are. ...
- Set your boundaries. ...
- Make clear how you will respond if your boundaries are violated. ...
- Enforce your boundaries. ...
- Model positive boundaries. ...
- Know your emotional buttons.
Oppositional defiant disorder (ODD) is a type of behavior disorder. Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures. Developmental problems may cause ODD.Does ODD get worse with age? ›
The condition may persist for a lifetime just as often as it spontaneously disappears. In about 40 percent of cases, adults with ODD become progressively worse and end up developing antisocial personality disorder.What are the 4 types of ODD? ›
The typology consists of three types: Stimulus Dependent ODD, Cognitive Overload ODD and Fearful ODD. Youth with Stimulus Dependent type ODD have noticeably impairing attention deficit/hyperactivity disorder (ADHD) and have ODD behaviours in multiple settings.Is ODD linked to trauma? ›
Factors such as a chaotic home life, inconsistent discipline by parents, and being exposed to abuse, neglect, or trauma at an early age can all lead to the onset of ODD symptoms.Can kids with ODD grow up to be normal? ›
Some children with ODD will eventually outgrow the disorder. Symptoms may disappear as they age. However, as much as 30 percent of children with ODD eventually develop a conduct disorder. About 10 percent of children with ODD may eventually develop a personality disorder, like antisocial personality disorder.Can kids with ODD live normal lives? ›
It is possible for children with oppositional defiant disorder to live normal lives. Treatment for this condition may include parent training and family therapy. We help you develop parenting skills that focus on recognizing and praising good behavior, while helping you learn how to deal with bad behavior.What is the most common cause of ODD? ›
There's no known clear cause of oppositional defiant disorder. Causes may include a combination of genetic and environmental factors: Genetics. A child's natural personality or character — also called temperament — may contribute to developing ODD .What are the three dimensions of ODD? ›
In autism spectrum disorder (ASD), symptoms of oppositional defiant disorder (ODD) are common but poorly understood. DSM-5 has adopted a tripartite model of ODD, parsing its features into 'angry and irritable symptoms' (AIS), 'argumentative and defiant behavior' (ADB) and 'vindictiveness'.Is ODD a type of ADHD? ›
The key difference is that with ADHD, your child usually has trouble paying attention and they're hyperactive. With ODD, your child is defiant, cranky, and angry. ADHD symptoms tend to show up when your child is 12 or younger.
Children with ODD typically have a persistent pattern of irritable, angry outbursts, arguments, and disobedience. While this behavior is usually directed at authority figures like parents and teachers, it can also target siblings, classmates, and other children.What does ODD look like in the classroom? ›
These students can appear defiant, disobedient, angry and irritable. They might argue with parents, teachers and other students. They may find it hard to follow teachers' instructions. They may lose their temper if they feel like something isn't going their way.What is the first line treatment for ODD? ›
Therapy. Therapy is the first-line treatment for oppositional behavior. When a child has an ODD diagnosis, it's helpful for parents to participate in therapy to learn supportive behavior management strategies.Do kids with ODD show remorse? ›
Often, oppositional children do not display any signs of remorse. Some children with ODD seem to have no regard for the consequences of their behavior, for themselves or for other people, and they may report emotional numbness and unhappiness.How do you deal with ODD in school? ›
Be sensitive to self-esteem issues. Provide feedback to your student with ODD in private, and avoid asking the student to perform difficult tasks in front of classmates. It can be helpful to praise positive behaviors, such as staying seated, not calling out, taking turns, and being respectful.Can ODD be just with parents? ›
ODD may occur only in certain settings.
More recently, medical professionals have recongized that certain children with ODD may behave well at school, and only show symptoms at home. In addition, a child may be oppositional with only one parent, though this occurs less frequently.
- Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation. ...
- Learn to control yourself. ...
- Pick your battles. ...
- Set up reasonable, age-appropriate limits with consequences that can be enforced consistently. ...
- Don't go it alone.
- Prepare, Prepare, Prepare. There is no stronger classroom management technique than preparation. ...
- Remain Calm. ...
- Your Words Matter. ...
- Praise Positive Behavior. ...
- Let Them Know You Care. ...
- Give Them an Incentive. ...
- Ask for Help. ...
- Dealing With Defiant Students.
To determine whether your child has oppositional defiant disorder, a mental health provider does a thorough psychological exam. ODD often occurs along with other behavioral or mental health problems. So it may be difficult to tell which symptoms are from ODD and which ones are linked to other problems.What is the severity of ODD? ›
Severity: ODD is considered mild if symptoms are confined to only one setting, moderate if at least two settings and severe if symptoms are present in three or more settings.
A child (or adult) can be given an ODD diagnosis without an autism diagnosis; however every child/adult diagnosed with PDA is autistic.How rare is ODD? ›
ODD is a fairly common problem faced by children and teens. At any given point in time, about 1% to 16% of children and teens are struggling with this behavior problem. Boys are much more likely to have ODD than girls.What are 5 examples of ODD? ›
An odd number always ends in 1, 3, 5, 7, or 9. Examples of odd numbers: 51 , − 543 , 8765 , − 97 , 9 , etc. An odd number is always 1 more than (or 1 less than) an even number.What is ODD called in adults? ›
Adults with oppositional defiant disorder (ODD) display a pattern of negative, hostile, and defiant behavior that lasts at least six months and includes four (or more) of the following symptoms: Often loses temper. Often argues with family and coworkers. Actively defies or refuses to comply with rules and laws.Is ODD linked with anxiety? ›
Many children and teens with ODD also have other behavioral problems, like attention deficit disorder, learning disabilities, mood disorders (such as depression), and anxiety disorders. Some children with ODD go on to have a more serious behavior disorder called conduct disorder.Is ODD related to schizophrenia? ›
Many children with oppositional defiant disorder but not autism nevertheless exhibit elevated symptoms of autism spectrum disorder as well as schizophrenia spectrum disorder.Does ODD lead to BPD? ›
Longitudinal research indicates that both ADHD and ODD symptoms in childhood predict higher levels of BPF later in development (Belsky et al., 2012; Stepp et al., 2012; Vaillancourt et al., 2014), implicating ADHD and ODD as potential risk factors for the development of BPD.What does ODD turn into in adults? ›
Some children with ODD outgrow the condition by age eight or nine. But about half of them continue to experience symptoms of ODD through adulthood. People with ODD report feeling angry all of the time, and about 40 percent of them become progressively worse and develop antisocial personality disorder.Can ODD lead to ADHD? ›
Attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are often closely linked, with many people experiencing both disorders at the same time. Doctors usually diagnose these disorders in children. According to a 2017 study, more than half of people with ADHD also have ODD.Does oppositional defiant disorder go away? ›
Does Oppositional Defiant Disorder get better or go away over time? For many children, Oppositional Defiant Disorder does improve over time. Follow up studies have shown that the signs and symptoms of ODD resolve within 3 years in approximately 67% of children diagnosed with the disorder.
ODD is genetic.
Oppositional defiant behavior tends to run in families. Studies show that the development of the condition is more heavily influenced by genes than it is by environmental factors. A child diagnosed with ODD quite frequently has a first-degree relative with ODD.
No medications are FDA-approved for the treatment of ODD in the U.S. Nonetheless, clinical experience has shown that the majority of children and adolescents with ODD do show signs of improvement with a low dose of atypical neuroleptics – arippirazole (Abilify) and risperidone (Risperidal), for example.Does ODD involve anxiety? ›
Many children and teens with ODD also have other behavioral problems, like attention deficit disorder, learning disabilities, mood disorders (such as depression), and anxiety disorders. Some children with ODD go on to have a more serious behavior disorder called conduct disorder.What does ODD look like in girls? ›
Symptoms of oppositional defiant disorder (ODD) include regular temper tantrums, excessive arguments with adults, and uncooperative, deliberately annoying, or mean and spiteful behavior. If you recognize these extreme symptoms in your child, consider seeking an ODD diagnosis and behavioral parent training.How to help someone with ODD? ›
- Recognize and praise your child's positive behaviors as close to the time you see them as possible. ...
- Model the behavior you want your child to have. ...
- Pick your battles and avoid power struggles. ...
- Set limits by giving clear instructions and using consistent reasonable consequences.
Factors such as a chaotic home life, inconsistent discipline by parents, and being exposed to abuse, neglect, or trauma at an early age can all lead to the onset of ODD symptoms.