Some kids are just “bad kids.” You know the ones. They run down the aisle screaming at church. They have meltdowns in the supermarket. They don’t listen, they talk back, and they laugh in the face of authority. They can’t be controlled by their parents or teachers.

In short, they’re a menace with a capital M.

Except… there’s no such thing as a “bad kid,” is there? There are good kids who need help… Kids who start to believe the worst about themselves because they’ve come to expect negative reinforcement from their parents, other adults, or their peers…

Believe it or not, that kid yelling obscenities at his mother in the school parking lot probably doesn’t want to be doing that. But children with oppositional defiant disorder, or ODD for short, have difficulty controlling their impulses and making healthy, developmentally appropriate choices.

What is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is a behavior disorder that’s typically diagnosed in childhood between the ages of 6 and 8 (3). Children with ODD can be defiant, hostile, exceptionally uncooperative, and argumentative.(1)

ODD Symptoms(2)

If your child has ODD, you may notice they frequently have an angry and irritable mood and are:

Easily annoyed by other people
Resentful
Often losing their temper

If your child has ODD, you may notice defiant, argumentative behavior where they:

Argue with authority figures frequently
Defy adults and refuse to follow rules
Deliberately annoy and upset other people
Blame others for their own mistakes, misbehaviors, or wrongdoings

If your child as ODD, you may notice vindictive behavior where they:

Behave spitefully
Try to “get back at” someone they feel has wronged them

But children with ODD aren’t having your typical toddler tantrum or teenage rebellion. Just because your toddler learned the word “no” and loves saying it to everyone and everything, for example, does not mean they have oppositional defiant disorder.(2) For a parent of a child with ODD, things like screaming matches, angry or aggressive behavior, expulsions from school, or daily rule breaking are the norm.(4) And it can be really hard on families.

In children with ODD, the oppositional and defiant behavior is persistent, extreme, and significantly interferes with their ability to function in school or have relationships with others.(1) It also has to be going on for at least 6 months in order to be diagnosed as ODD.(2)

Is ODD Genetic?

Biological, genetic, and environmental factors may all play a role in a child developing oppositional defiant disorder.(5) Unbalanced neurotransmitters may play a role too, as many children with ODD also have other mental health disorders, such as ADHD or mood disorders.(5)

Risk Factors for ODD:

Lack of supervision(11)
Poverty(11)
An unstable or dysfunctional home life(11)
Exposure to violence or aggressive behavior(8)
A family history of substance abuse(8)
Abuse or neglect(8)
Inconsistent parenting and disciplining(7)
A parent or close relative with mental illness(7)

You may be thinking, “Now, wait a minute. I’ve given my child everything! Nothing you’ve described sounds like our family. There’s no violence, no drugs. The rules are clear, easy to follow, and my child still has these out-of-control outburst and anger issues.”

A chaotic, stressful home life can contribute to mental health problems, there’s just no way around that. But even in a stable home, some children will develop oppositional defiant disorder.

Genetics may also be a factor. If a child has a close relative with mental illness, they are more likely to develop ODD.(7) Oppositional defiant disorder occurs more commonly among children whose family members have a history of ADHD, mood disorders like depression or bipolar disorder, and substance use disorders.(8)

Comorbidity

Children with ODD may struggle with one or more of the following:(9)

ADHD
Conduct disorder
Mood disorders (anxiety and depression)

ODD Diagnosis

You love your child desperately… You’d do anything for them. You’d die for them! But at this rate, you’re finding it very difficult to like them.

You know the angry outbursts, temper tantrums, spiteful behavior and arguments are, well… not exactly normal. So what’s a parent to do?

A medical doctor or mental health professional like a child psychologist or psychiatrist can diagnose oppositional defiant disorder. It’s likely they’ll want to talk to you, the parent or caregiver, and your child to conduct an assessment. They may also want to speak to your child’s teachers and conduct an assessment at school, depending on where your child exhibits their ODD symptoms.

What’s the Outlook for Kids with ODD?

About two thirds of children diagnosed with ODD overcome the disorder and don’t show behavioral symptoms anymore by the time they’re 18. (7) Amazing news, right?

It’s so important that your child get help if you think they do have ODD. Left untreated, severe oppositional defiant disorder can become conduct disorder, which is a more serious, delinquency version of ODD. But when treated early, prognosis is much better. Studies have shown that ODD symptoms resolve within 3 years in about 67% of children with the diagnosis.(14)

Treatment

There are many treatment options for children with ODD, and they will likely involve the whole family!

Family Therapy

ODD can be very taxing for parents and difficult on siblings. Family therapy can help improve communication skills, suggest systemic changes that need to be made within the family unit, and provide support for the entire family.(1) Being involved in your child’s treatment plan is important. Share your concerns, goals, and hopes with your child’s care team.

Parent-Management Training

Want to learn how to manage your child’s behavior? There’s a class for that! In parent-management training, you’ll be taught positive reinforcement techniques and how to discipline effectively.(14) Ask your child’s therapist or doctor for information on where to sign up.

Cognitive Behavioral Therapy

Often, children with ODD don’t understand that their defiant and aggressive behavior is wrong or unjustified. When asked why they behave the way they do, they might say, “because my parents are always on case.” In therapy, your child will master social skills and learn that he’s capable of making different, healthier choices.

Cognitive Behavioral Therapy (CBT) helps tackle unhelpful patterns of thinking and replaces them with healthier patterns.(10) In therapy, your child may role play scenarios he might encounter with family or friends and practice more adaptive, appropriate behaviors.

Peer Group Therapy

This can be a great resource if your child struggles to interact and socialize with peers. ODD can be hard on friendships. Peer group therapy provides a safe space for children with ODD to practice getting their social interactions right so they feel safe to try things out in the real world.

Medication

Typically, medication is not recommended to treat ODD unless another underlying condition like ADHD needs to be addressed.

Interested in Learning More?

Check out this podcast episode on ODD. You’ll learn five surprising questions you should ask yourself if you think your child has oppositional defiant disorder… and you’ll learn more about the parent-child relationship and how it can impact your child’s mental health. This is an episode you won’t want to miss!

Equip yourself with knowledge and tools to help your child thrive. Subscribe here to the Genius Little Minds podcast so you never miss an episode!

References