ODD – What is Oppositional Defiant Disorder?

Oppositional Defiant Disorder (ODD), is a childhood behaviour problem that can continue into adulthood. This article will address the causes, symptoms, and treatment of ODD.

Introduction

ODD, or Oppositional Defiant Disorder is a childhood behaviour problem that involves anger, defiant behavior, and resistance toward adults. This isn’t your normal toddler tantrums or the occasional hit as your child learns to regulate their anger. ODD is a continuous feeling of resentment toward adults, annoyance toward peers, and just a general obstinance toward authority. If this type of behaviour continues for 6 months or longer, chances are your child has ODD and you should seek professional help from a paediatrician or child psychiatrist, and consider some family therapy. In this article, we’ll discuss signs to look for, treatment, and what it means for a child to have ODD.

What is ODD?

ODD stands for Oppositional Defiant Disorder. The American Academy of Child and Adolescent Psychiatry (AACAP) defines ODD as an “an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child’s day to day functioning.” https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-With-Oppositional-Defiant-Disorder-072.aspx

“ODD is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child’s day to day functioning.”

AACAP.org
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“There is a very high overlap in kids who have ADHD who are also diagnosed with ODD” – Emke

What behaviours are associated with ODD?

According to research, the behavioral symptoms can include:

  • Unusually angry and irritable mood
  • Frequently losing their temper
  • Being easily annoyed
  • Arguing with adults or other authority figures
  • Disruptive behavior
  • Refusing to follow rules
  • Deliberately annoying people
  • Blaming others for mistakes
  • Purposely vindictive behaviour
  • Physical aggression
  • Is often nasty or unkind

https://childmind.org/article/what-is-odd-oppositional-defiant-disorder/

https://raisingchildren.net.au/guides/a-z-health-reference/odd

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Children that have this disorder will have displayed ODD behaviors for at least six months and will have them continuously to the point where it affects their daily lives and those around them. 

How is it different from ADHD?

Oftentimes a child with ODD has a coexisting condition, such as ADHD (Attention Deficit Hyperactivity Disorder). Emke writes, “There is a very high overlap in kids who have ADHD who are also diagnosed with ODD. Depending on the study, the overlap could be 30 to 50 percent of kids with ADHD also have ODD.” Whereas ADHD is more about kids being unable to focus on one task for long periods of time and becoming easily distracted, ODD is a step beyond where kids feel the need to defy authority and rules set in place. https://childmind.org/article/what-is-odd-oppositional-defiant-disorder/ Psychology Today also lists “mood disorders and anxiety disorders… but also learning disorders or language disorders” as possible coinciding conditions. https://www.psychologytoday.com/us/conditions/oppositional-defiant-disorder

How do I know if my child has ODD?

Again, it needs to be reiterated that ODD is not the same as your toddler learning the word “no”, having frequent temper tantrums, and when he/she can push boundaries. However, ODD can begin during the toddler years, it’s just harder to identify. A sign that your child may have ODD is if their behaviour is angry, temperamental, or defiant and is continuous to where it affects their home and school life. If your child displays several of the symptoms mentioned above, for an extended period, it may be time to talk to your child’s paediatrician and seek out a referral for a child therapist or child’s psychologist. Hopkins Medicine advises that you should seek medical help if your child hears or sees things that others don’t, can’t sleep or eat for three days in a row, has extreme anxiety, fear, or depression, or shows any other behaviour that is concerning to friends and family. https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder

What are the main causes?

The causes of ODD are unknown but some risk factors seem like they may influence it. The Mayo Clinic identifies two possible factors as: “genetics – a child’s natural disposition or temperament and possibly neurobiological differences in the way nerves and the brain function” and “environmental factors – problems with parenting that may involve a lack of supervision, inconsistent discipline or harsh discipline, or abuse or neglect.” https://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/symptoms-causes/syc-20375831

Further risk factors may also be if their temperament is highly reactive and they struggle to control their emotions (inability to self-regulate), their home life is stressful and lacking supervision, and if their peer environment is lacking in attention and friendships, or if they’ve experienced peer rejection or bullying.

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There are several risk factors, some of which may be environmental or biological.

At what age is ODD diagnosed?

ODD may manifest during the toddler years but will continue into childhood and even adolescence. During the toddler years, it is hard to distinguish whether your child is simply experiencing normal defiance or if it is an actual behaviour disorder. Continue to monitor behaviour for at least 6 months and talk to your child’s healthcare provider if you are concerned.

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Are there treatments and strategies for dealing with ODD?

Treatments and strategies include the child receiving help from a licensed psychiatrist, your family attending therapy together, parent management training on how to manage challenging behaviours, and training for the child in regards to social situations and how to self-regulate and manage emotions. There may also need to be school-based interventions to ensure strategies are consistent across all environments.

Personally, I have experience educating and caring for several children who were diagnosed with ODD and it was vital for all family members, educators, health professionals and everyone involved in the child’s life to be on board with common strategies and behaviour management plans, for the best chance at successful outcomes.

As of now, there is no medication approved for ODD, but certain medicines can be helpful if the child has a coexisting condition like Attention Deficit Hyperactivity Disorder (ADHD).

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It’s so important that all family members, educators, healthcare professionals and anyone caring for the child is on board with agreed strategies and behaviour management

“Children with ODD need professional diagnosis and treatment early on. This will help your child develop skills to make and keep friends, get and keep a job, and build a support network later in life.”

raisingchildren.net.au

What happens when ODD is not treated?

If ODD is not addressed, problems at home and school could not only continue to occur but also escalate. These issues could include: poor school and work performance, antisocial behavior, impulse control problems, substance use disorder, further mental disorders and even suicide. https://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/symptoms-causes/syc-20375831 The Child Mind Institute also warns that “A small percentage of kids with ODD go on to develop something called conduct disorder, which is a more severe behavior disorder that includes criminal acts like stealing, setting fires and hurting people. Getting treatment sooner rather than later improves a child’s trajectory.” https://childmind.org/article/what-is-odd-oppositional-defiant-disorder/

Does it run in families?

Though genetics is sighted as a possible cause for ODD, there isn’t sufficient research that can verify whether it is a factor or not. In fact, some children may have an older or younger sibling that doesn’t have a behavioural disorder at all.

Can ODD just be at home?

According to AACAP, “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.” Though the disorder may occur at either home or school, the consensus seems to be that it will eventually flow into the other. A stressful home life can lead to antisocial behaviour at school. Struggles with schoolwork or peer groups can lead to irritability and defiance at home. Attempting to understand your child’s struggles at home and school will help manage expectations and possibly lessen the effects of ODD.

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With early identification and diagnosis, ODD can be managed and overcome, rather than getting out of control and developing into further disorders such as conduct disorder.

Does ODD improve with age?

Good news, parents! ODD can improve with age. If an ODD diagnosis occurs early and steps are taken to learn, understand, and address ODD, your child can learn how to not only manage their ODD, but thrive. Gia Miller, author for Parents.com, reminds us, “[Children] all want to be good, even though they might behave poorly. When you teach them the skills they need, it will help them throughout their lives.” https://www.parents.com/kids/development/behavioral/i-thought-my-child-was-just-misbehaving-but-it-was-really-odd/

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Conclusion

ODD, or oppositional defiant disorder, is a serious condition that should be treated as early in a child’s life as possible. As parents, we want to see the best in our children, but managing Oppositional Defiant Disorder can be extremely challenging.

There should never be any shame in helping your child be their best self. If that means seeking out an evaluation and then continuing with family therapy and training, so be it. In order for your child to overcome the obstacles brought about by ODD, you and your child must both work together for the most positive outcomes.

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