No. 72; March 2011
Click here to download and print a PDF version of this document.
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.
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.
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
#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
Oppositional Defiant Disorder
|Oppositional Defiant Disorder
Melvin Oatis, M.D.
Excerpts from Your Child on Oppositional Defiant Disorders
All children are oppositional from time to time. There are also times in normal development when oppositional behavior is expected. This is especially true when the thrust towards separation is most intense, around the ages of two and three, and again in early adolescence.
However, openly uncooperative and hostile behavior becomes a serious concern when it is so incessant and fierce that it stands out when compared with other children’s behavior and when it affects the child's social, family, and academic life.
The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,500 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.
Facts for Families© information sheets are developed, owned and distributed by AACAP. Hard copies of Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale or profit. All Facts can be viewed and printed from the AACAP website (www.aacap.org). Facts sheets may not be reproduced, duplicated or posted on any other website without written consent from AACAP. Organizations are permitted to create links to AACAP's website and specific Facts sheets. For all questions please contact the AACAP Communications & Marketing Coordinator, ext. 154.
If you need immediate assistance, please dial 911.
Copyright © 2012 by the American Academy of Child and Adolescent Psychiatry.