Oppositional Defiant Disorder in Children

Angry little boy looking at puzzles.
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Oppositional defiant disorder (ODD) is a psychiatric disorder that typically emerges in childhood and can last throughout adulthood.


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.

The frequency and severity of their behavior problems cause difficulty at home and at school. These children often suffer from learning problems related to their behavior. Being argumentative and defiant is a common problem in these children.

Other common symptoms of ODD include:

  • Low tolerance for frustration
  • Being easily annoyed
  • Purposeful irritation of others
  • Moodiness and unprovoked anger
  • Noncompliance with even simple requests
  • No sense of conscience
  • Lying
  • Causing conflict

It is important to note that 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. Children with ODD display these behaviors in multiple domains.

Children with persistent, severe symptoms may possibly have ODD and should be evaluated by a pediatric psychiatrist. It is unclear what causes ODD. However, a combination of child temperament and parents' coping responses may be a factor in its development. Difficulties in family functioning may contribute as well.

Managing Oppositional Defiant Disorder

It is important that intervention begin as early as possible with these children. Treatment often involves counseling and therapy. Parent training in behavior management can be helpful.

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.

The Importance of a Routine

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.

Having a routine can help ODD children 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.

Forming 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.

Discipline and Rewards

The next step (and probably the most important) is to provide specific labeled praise and rewards for the pro-social behaviors you want to see. 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.).

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 he 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.

If the child has the tendency to do the opposite of what you want him to do, avoid giving direct praise that could result in misbehavior. For example, saying, "I like the way you're keeping your hands to yourself," could provoke the child to become physically aggressive. Avoid arguing or lecturing the child, and try to keep your own temper under control. Avoid letting the child see you become angry, as this may be rewarding to her.

Using a matter-of-fact tone of voice without emotion, simply state 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 his frustrations. Provide a pillow to punch or to yell into.

Social Interaction

When the child interacts with others, make sure there is adequate supervision to ensure that rules can be enforced, and adults can help him 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.

Formal social skills training can be effective in helping the child with ODD to interact with peers and adults.

Can Children Recover From Oppositional Defiant Disorder?

The prognosis for recovery from ODD is unclear. Some children will mature and symptoms of the disorder will subside into adulthood. Others will carry the disorder into adulthood. Meeting the complex needs of these children will require the cooperation of parents and school personnel as well as mental health professionals.

A cooperative, consistent effort at home and school will improve the likelihood of a positive outcome for these children, especially when intervention begins at an early age.

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