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Young girl shouting defiantly at mother iStockphotos.com/Mark Bowden

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  • Around one in 10 children under the age of 12 years is thought to have ODD. 
  • Twice as many boys than girls have ODD.
 

Oppositional defiant disorder (ODD) is more than just ‘bad’ behaviour. It’s when a child’s thoughts, feelings and behaviour are out of balance, and the child just can’t cooperate. A child with ODD needs a professional diagnosis and management plan.

What is oppositional defiant disorder (ODD)?

Oppositional defiant disorder (ODD) is a childhood behaviour problem. A child with ODD won’t do what people ask, thinks that what she’s being asked to do is unreasonable, and gets angry and aggressive about being asked to do things.

All children are disobedient and cranky sometimes, especially if they’re tired, upset or frustrated. But a child with ODD behaves like this a lot, and the ODD behaviour is so severe that the child has trouble doing ordinary, everyday things.

Diagnosing oppositional defiant disorder (ODD) 

A diagnosis of oppositional defiant disorder (ODD) can be made only by a health professional like a paediatrician, psychiatrist or psychologist.

To be diagnosed with ODD, a child must have constant angry and cranky moods, along with negative, defiant behaviour that upsets other people. A child must also have at least four symptoms from the following list.

The child:

  • loses his temper
  • argues with adults
  • actively refuses to do what adults ask and disobeys rules
  • often deliberately annoys people
  • often blames others for mistakes or challenging behaviour
  • is easily annoyed by others
  • is often nasty or unkind.

A child with ODD shows the symptoms very often, in a way that interferes with usual daily activities, and for at least six months

If you think your child might have ODD, it’s best to speak with your GP or school counsellor for a referral to the right health professional. 

It’s normal to hope that your child will grow out of ODD, but ODD won’t go away by itself. Your child needs professional diagnosis and treatment early on. This will help your child develop the skills she needs to make and keep friends, get and keep a job, and build a support network later in life. 

Managing oppositional defiant disorder (ODD)

Managing oppositional defiant disorder (ODD) in children is about first accepting that your child will behave in challenging ways.

The next step is working with health professionals to develop a behaviour management plan, which can make the behaviour easier to handle – for you and your child.

A good plan will help your child:

  • learn how to improve his behaviour and understand how it affects other people
  • manage strong emotions like anger and anxiety
  • improve the way he solves problems, communicates and gets on with other children.

These things will help your child with making and keeping friends, saying what she thinks without getting angry, accepting no for an answer and playing well with others.

A good behaviour management plan will also help you cope with your child’s challenging behaviour by helping you:

  • understand the causes of your child’s challenging behaviour
  • work out how you can increase your child’s positive behaviour and manage his challenging behaviour
  • support your child in managing strong emotions and improving social skills
  • work on strengthening your family relationships.

Helping your child with oppositional defiant disorder (ODD)

Working on your relationship  
Your child needs to know that she’s important to you. 

One of the best ways you can send your child this message is by spending positive time together doing things your child enjoys. This will help to strengthen your relationship with your child.

Changing your child’s behaviour
Here are some strategies for changing your child’s behaviour:

  • Use praise to encourage positive behaviour, and try to avoid using negative consequences. A good rule of thumb is to try to give your child six positive comments for every negative comment or consequence.
  • Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
  • Give short, brief, direct instructions, telling your child exactly what you want by offering your child specific choices – for example, ‘Would you like to do your homework now, or after the next TV show?’
  • Follow up on uncooperative behaviour straight away. For example, give your instruction. If your child doesn’t do what you ask, ask again and say, ‘This is the last time I am going to tell you’. Be ready with a consequence like withdrawal of a privilege if your child doesn’t cooperate.

Working with your child’s school
You can also work with your child’s school to improve your child’s classroom and playground behaviour. For example, you could talk to staff about:

  • classroom behaviour management programs – for example, seating your child at the front of the classroom away from distractions
  • structured classroom activities – for example, having a daily planner on the wall that everyone can see and telling children when activities are about to change
  • alternative thinking strategies – for example, allowing children to offer their own ideas about ways to solve problems
  • emotional regulation programs that teach children how to manage strong emotions like anger and frustration
  • resilience, wellbeing and bullying intervention programs
  • rewards for good behaviour, so that your child doesn’t feel that he’s always being punished for unacceptable behaviour.

Looking after yourself

It can be challenging to balance looking after yourself with looking after your child with oppositional defiant disorder (ODD) and other children in the family. 

Here are some tips on how you can care for yourself:

  • Make some time every day to be on your own to read a book, watch a TV show or go for a walk. Start with five minutes at the end of the day if that’s all you have.
  • Ask family, friends or members of your support network to look after your child for a little while so you can have some time to yourself.
  • Make time for some physical activity – for example, walking, yoga or swimming. A bit of exercise can give you more energy to work with your child.
  • Make some time to do fun activities with your partner if you have one. Your child’s difficult behaviour can be stressful on your relationship, especially if you and your partner don’t agree about how to handle your child’s behaviour. Seek professional help if you can’t sort out these differences.
Sharing support, advice and experiences with other parents can be a big help. You could try starting a conversation in our online forum for parents of school-age children.

Risk factors for oppositional defiant disorder (ODD)

It’s hard to say why any child develops ODD. It’s probably not because of any one thing. But there are some risk factors that are linked to ODD:

  • temperament – for example, whether a child is easygoing or like rules a lot
  • the relationship a child has with her parents – for example, if the child and her parents haven’t been able to bond or respond to each other in consistently loving ways
  • low academic performance at school – for example, if a child has learning difficulties
  • speech and language problems in everyday life
  • poor social skills, poor problem-solving skills and memory problems
  • parenting and family factors – for example, inconsistent and harsh discipline, and a lot of family stress
  • school environmental factors – for example, schools with harsh punishment or unclear rules, expectations and consequences
  • community factors – for example, negative influences from peers, neighbourhood violence and a lack of positive things to do with free time.

Children with ODD often have other difficulties like learning disabilities, attention deficit hyperactivity disorder, anxiety disorders, mood disorders or language impairment. 

Because so many factors can play a part in ODD, a child who might have it needs a full assessment from a health professional. This lets the health professional pick up any other conditions that the child has and helps to set goals for treatment.

 
 
 
  • Last updated or reviewed 02-08-2016
  • Acknowledgements This article was developed in collaboration with Jo Winther, Child and Adolescent Mental Health Service, Royal Children’s Hospital, Melbourne.