What is oppositional defiant disorder (ODD)?
Oppositional defiant disorder (ODD) is a childhood behaviour disorder.
Children with ODD:
- won’t do what people ask
- think that what they’re being asked to do is unreasonable
- get angry and aggressive about being asked to do things.
It’s common for children to refuse to do what others ask them to do and get cranky, especially if they’re tired, upset or frustrated. But children with ODD behave like this a lot, and the behaviour interferes with their ability to do everyday things, like learn and communicate, manage emotions and get along with others.
ODD often begins during the preschool years. Sometimes ODD begins later, but it almost always begins before the early teenage years.
Signs and symptoms of oppositional defiant disorder (ODD)
To be diagnosed with oppositional defiant disorder (ODD), a child must have a pattern of angry and cranky moods, along with negative, defiant behaviour that upsets other people.
The child must also have at least 4 symptoms from the following list. They:
- lose their temper
- argue with adults
- actively refuse to do what adults ask and disobey rules
- often deliberately annoy people
- often blame others for mistakes or challenging behaviour
- are easily annoyed by others
- are often nasty or unkind.
A child with ODD shows symptoms:
- very often
- in a way that interferes with daily activities
- for at least 6 months.
ODD symptoms can vary in severity. They can be:
- mild, which means they occur in only one setting, like only at home, at school or with peers
- moderate, which means they occur in at least 2 settings
- severe, which means that some symptoms occur in 3 or more settings.
If you think your child might have ODD, start by talking with your GP about a referral to a paediatrician, psychiatrist or psychologist. These health professionals can diagnose oppositional defiant disorder (ODD) and help your child develop the social, emotional, behavioural and thinking skills they need to thrive.
Your GP will probably talk with you about a Mental Health Treatment Plan for your child. If you have a plan, you can get Medicare rebates for up to 10 sessions with a psychologist. If your child is referred to a paediatrician or psychiatrist, you can get Medicare rebates for these appointments.
Behaviour management plans for oppositional defiant disorder (ODD)
Managing oppositional defiant disorder (ODD) in children is about first accepting that your child behaves in challenging ways more often than other children their age.
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 their behaviour and understand its effects on other people
- manage strong emotions like anger and anxiety
- improve the way they solve problems, communicate and get on with other children.
These things will help your child make and keep friends, say what they think without getting angry, accept no for an answer, and play well with others.
A good behaviour management plan will also help you cope with your child’s challenging behaviour. It will help you:
- understand the causes of your child’s behaviour
- work out how you can increase your child’s positive behaviour and manage their challenging behaviour
- support your child in managing strong emotions and improving social skills
- work on strengthening your family relationships.
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.
Working on oppositional defiant disorder (ODD) at home
Here are strategies for working on your child’s ODD behaviour at home:
- Use specific praise to encourage positive behaviour – for example, ‘It was really helpful when you put your plate on the bench’.
- Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
- Give short, clear and specific instructions – for example, ‘Please put the dishes in the sink’.
- Give choices about when your child can do tasks, not whether your child will do them – for example, ‘Would you like to do your homework now, or after the next TV show?’
- Follow up on challenging behaviour straight away. For example, if your child doesn’t do what you ask, ask again and say, ‘This is the last time I am going to ask you’. If your child still doesn’t cooperate, you could use a consequence like loss of privilege.
- Use consequences in the same way and for the same behaviour every time. This means your child knows what to expect. For example, you might always use a time-out for hitting.
- Acknowledge your child’s strong emotions and let them know you’re there to listen and help. For example, ‘I understand you’re feeling angry. Do you want to talk about it?’
For these strategies to help your child, it’s important to use them consistently. But this can take patience and practice, and it can be challenging if your child opposes them. You can ask your child’s psychologist for help or for other strategies you can try.
Your child needs to know that they’re important to you. One of the best ways you can send this message is by spending positive time together doing things your child enjoys. This will help to strengthen your relationship with your child.
Working with schools on oppositional defiant disorder (ODD)
It can help to talk to staff at your child’s school about your child’s diagnosis and behaviour management plan and any other recommendations from your child’s psychologist, psychiatrist or paediatrician. Your child’s school might be able to help with things like:
- strategies to support classroom behaviour and learning – 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 lets children know what’s happening and when
- 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 positive behaviour, so that your child doesn’t feel that they’re always being punished for challenging behaviour.
Your child will get the most benefit from treatment when you, your child’s mental health professionals and your child’s teachers work together.
Looking after yourself when your child has oppositional defiant disorder (ODD)
Looking after yourself gives you the energy you need to help your child with oppositional defiant disorder (ODD) grow and thrive.
Here are tips on how to care for yourself when you have a child with ODD:
- Make some time every day to be on your own to read a book, watch a TV show, go for a walk, or do something you enjoy. Start with 5 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 time to do things for yourself.
- Make time for physical activity – for example, walking, yoga or swimming. Exercise can give you more energy to help your child.
- Make time to do fun activities with your partner, if you have one. Your child’s challenging behaviour can be stressful for your relationship, especially if you and your partner don’t agree about how to handle it.
- Consider seeking help from a counsellor if you’re finding it hard to cope. A counsellor can help you learn coping strategies.
Sharing support, advice and experiences with other parents can be a big help. You could try starting a conversation in an online forum or joining a parent support group.
Risk factors for oppositional defiant disorder (ODD)
We don’t know why children develop oppositional defiant disorder (ODD). But it might be a combination of genes and environmental factors. For example, there are risk factors that are linked to ODD. These include your child’s temperament and stress in your child’s life that affects their relationship with family or community.
Children with ODD often have other conditions like learning difficulties or disorders, attention deficit hyperactivity disorder (ADHD), anxiety disorders, mood disorders or communication disorders.