Oppositional defiant disorder (ODD) impacts between 1 and 16 percent of children and adolescents in the general population. However, it is far more prevalent in patients with attention deficit hyperactivity disorder (ADHD or ADD).
“Many kids with ADHD who are diagnosed with ODD are showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.”
The symptoms of ODD may look different in girls and boys, for whom the condition is more common. Boys with ODD tend to be more physically aggressive and have explosive anger while girls often lie, refuse to cooperate, and express symptoms in other indirect ways. ODD is usually diagnosed in childhood; some children outgrow the condition in elementary school, some carry it with them into adolescence, and still others continue experiencing symptoms of ODD in adulthood.
Children with ODD thwart, obstruct, frustrate, demean, and resist anyone in a position of authority (parents, teachers, coaches, police, etc.). They purposefully bother and irritate others. Between ages two and three, and in the teen years, most children exhibit aggressive and irritating behavior from time to time. At least four of the following symptoms must be present consistently for six months or longer to merit an ODD diagnosis:
- Loses temper
- Argues with adults
- Actively defies or refuses to comply with adults’ requests or rules
- Deliberately annoys people
- Blames others for his or her mistakes or misbehavior
- Easily annoyed by others
- Angry and resentful
- Spiteful or vindictive
[Self-Test: Oppositional Defiant Disorder in Children]
ODD manifests in two ways. The pediatric version is present from an early age, and can make a child very difficult to raise. The second type is adolescent-onset ODD, which makes once-loving children almost impossible to live with. About half of all preschoolers diagnosed with ODD outgrow the problem by age 8, while older kids with ODD are less likely to do so. Home and school become places of almost constant conflict.
What Do ODD Symptoms Look Like at Home?
As the list of symptoms above demonstrates, symptoms of ODD in children can look a lot like certain symptoms of ADHD, anxiety, or hormonal moodiness. To determine whether your perpetually angry child may be showing signs of ODD, look for the following warning signs at home:
- Your child throws huge tantrums when he gets home from school, and the consequences for acting out only make him more agitated.
- Simple reminders, like to put socks in the hamper and not on the floor, trigger aggression or meltdowns.
- Consequences don’t work, nor do they seem to have any impact on behavior. Your child just doesn’t take rules seriously.
- You’re like a broken record. Your child hears, but ignores you over and over.
- Your child tells little lies, even after you’ve stressed the importance of telling the truth.
- Public tantrums in restaurants and check-out lines are keeping you and your family homebound.
- It’s like your child is seeking conflict, purposely trying to ignite your anger.
- Your child refuses to accept blame when he has done something wrong.
What Do ODD Symptoms Look Like at School?
A student with ODD does more than just act out in class. He may have repeated meltdowns at school, and display aggressive behavior toward classmates or staff. Some signs of ODD at school include:
- Your child was sent to the principal’s office (again) for shoving a classmate.
- The teacher complains that he is throwing things in class again.
- The teacher notes that your child is baiting classmates, picking fights with them by purposely doing things he knows annoy them.
- When given detention for acting out, your child has an explosion so extreme she is sent home for the day.
- A reminder to pick up paintbrushes after art class triggered aggression with the art teacher.
Any child who shows symptoms of oppositional behavior needs appropriate ODD treatment by a psychiatrist, psychologist, or therapist who is familiar with the disorder. Counseling should involve both the child and the parents, and focus on ways to cope with such behavior. Parent management training — in which parents learn to change the way they react to their child’s behavior — is often highly effective in treating ODD. If the child becomes dangerous to himself or others, hospitalization may be necessary.
[Free Resource: Why Is My Child So Defiant?]
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