Even the best-behaved children can be difficult and challenging at times. But oppositional defiant disorder (ODD) includes a frequent and ongoing pattern of anger, irritability, arguing, and defiance toward parents and other authority figures. ODD also includes being spiteful and seeking revenge, a behavior called vindictiveness.
These emotional and behavioral issues cause serious problems with family life, social activities, school, and work. But as a parent, you don’t have to try to manage a child with ODD alone. Your health care provider, a mental health professional, and a child development expert can help.
Treatment of ODD involves learning skills to help build positive family interactions and to manage problem behaviors. Other therapy, and possibly medicines, may be needed to treat related mental health conditions.
Sometimes it’s difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It’s common for children to show oppositional behavior at certain stages of development.
Symptoms of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. Oppositional and defiant behaviors are frequent and ongoing. They cause severe problems with relationships, social activities, school, and work, for both the child and the family.
Emotional and behavioral symptoms of ODD generally last at least six months. They include:
Angry and irritable mood:
Argumentative and defiant behavior:
Hurtful and revengeful behavior:
Severity: ODD can be mild, moderate, or severe:
For some children, symptoms may first be seen only at home. But with time, problem behavior also may happen in other settings, such as school, social activities, and with friends.
Your child isn’t likely to see their own behavior as a problem. Instead, your child will probably complain about unreasonable demands or blame others for problems.
If you think your child may have ODD or other problem behavior, or you’re concerned about your ability to parent a challenging child, seek help from a child psychologist or a child psychiatrist with expertise in behavior problems. Ask your child’s pediatrician or other health care provider for a referral to a mental health provider.
There’s no known clear cause of oppositional defiant disorder. Causes may include a combination of genetic and environmental factors:
Oppositional defiant disorder is a complex problem. Possible risk factors for ODD include:
Children and teenagers with oppositional defiant disorder may have trouble at home with parents and siblings, in school with teachers, and at work with supervisors and other authority figures. Children and teens with ODD may struggle to make and keep friends and relationships.
ODD also may lead to other problems, such as:
Many children and teens with ODD also have other mental health conditions, such as:
Treating these other mental health conditions may help reduce ODD symptoms. It may be difficult to treat ODD if these other conditions are not evaluated and treated appropriately.
There’s no sure way to prevent oppositional defiant disorder. But positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better.
Treatment can help restore your child’s self-esteem and rebuild a positive relationship between you and your child. Your child’s relationships with other important adults in their life — such as teachers and care providers — also will benefit from early treatment.
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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.
Your child’s exam will likely include an assessment of:
Treatment for oppositional defiant disorder primarily involves family-based interventions. But treatment may include other types of talk therapy and training for your child — as well as for parents. Treatment often lasts several months or longer. It’s important to also treat any other problems, such as a mental health condition or learning disorder, because they can cause or worsen ODD symptoms if left untreated.
Medicines alone generally aren’t used for ODD unless your child also has another mental health condition. If your child also has other conditions, such as ADHD, anxiety disorders, or depression, medicines may help improve these symptoms.
Treatment for ODD usually includes:
As part of parent training, you may learn how to manage your child’s behavior by:
Although some parenting techniques may seem like common sense, learning to use them consistently in the face of opposition isn’t easy. It’s especially hard if there are other stressors at home. Learning these skills requires routine practice and patience.
Most importantly, during treatment, show consistent, unconditional love and acceptance of your child — even during difficult and disruptive situations. Don’t be too hard on yourself. This process can be tough for even the most patient parents.
At home, you can work on improving problem behaviors of oppositional defiant disorder by practicing these strategies:
With regular and consistent effort, using these methods can result in improved behavior and relationships.
It’s challenging to be the parent of a child with oppositional defiant disorder. Ask questions and tell your treatment team about your concerns and needs. Consider getting counseling for yourself and your family to learn coping strategies to help manage your own needs. Also seek and build supportive relationships and learn stress management skills to help get through difficult times.
Learning coping and support strategies can lead to better outcomes for you and your child because you’ll be more prepared to deal with problem behaviors.
You may start by seeing your child’s health care provider. Or you may choose to make an appointment directly with a mental health provider. A mental health provider can make a diagnosis and create a treatment plan that meets your child’s needs.
When possible, both parents or caregivers should be present with the child. Or take a trusted family member or friend along to support you and help you remember information.
Before your appointment, make a list of:
Some questions to ask your child’s mental health provider include:
Feel free to ask other questions during your appointment.
Here are examples of questions that your mental health provider may ask:
Be ready to answer your mental health provider’s questions. That way you’ll have more time to go over any other information that’s important to you.