Oppositional defiant disorder (ODD) & kids

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 irritable, especially if they’re tired, upset or frustrated. This is a typical part of child development.

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.

ODD isn’t common.

Signs and diagnosis of oppositional defiant disorder (ODD)

To be diagnosed with oppositional defiant disorder (ODD), children must have a pattern of angry and irritable moods, along with argumentative, defiant or mean behaviour that upsets other people and gets children in constant trouble with their parents, teachers and others.

Children with ODD have at least 4 symptoms that negatively affect their daily activities for at least 6 months. They:

often lose their temper
are often touchy or easily annoyed
are often angry and resentful
often 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 often nasty or unkind.

ODD symptoms can vary in severity. They can be:

mild, which means they occur in only one setting– for example, 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 ODD and help your child develop the social, emotional, behavioural and thinking skills they need to thrive.

Your child might be able to get Medicare rebates for up to 10 sessions with a mental health professional each calendar year. To get these rebates, your child will need a mental health treatment plan from a GP or a referral from a paediatrician or psychiatrist.

Behaviour support plans for oppositional defiant disorder (ODD)

If your child is diagnosed with oppositional defiant disorder (ODD), support starts with 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 support plan, which can make the behaviour easier to handle – for you and your child.

A good plan will help your child:

understand how their behaviour affects other people
learn to behave in more positive ways
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 support plan will also help you:

understand the causes of your child’s behaviour
work out how to encourage positive behaviour in your child
support your child to manage strong emotions and improve social skills
work on strengthening your family relationships.

Children with ODD need early professional diagnosis and treatment. 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

You play an important role in supporting your child to behave in positive ways. 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 positive 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?’
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.
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.
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 enjoying time together. 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 support plan and any other recommendations from your child’s paediatrician, psychiatrist or psychologist.

Your child’s school might be able to help with things like:

classroom behaviour and learning strategies – 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 your child know what’s happening and when
alternative thinking strategies – for example, letting your child suggest ways to solve problems
emotional regulation programs that teach your child how to manage strong emotions like anger and frustration
resilience, wellbeing and bullying intervention programs
rewards for positive 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 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 and other 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.
Get support for your own mental health from a counsellor or other professional. When you get support, you’ll be better able to encourage positive behaviour in your child and stay connected to them.
Share support, advice and experiences with other parents. You could try starting a conversation in an online forum or joining a parent support group.

Risk factors for oppositional defiant disorder (ODD)

ODD might be caused by a combination of genes and environmental factors.

Risk factors linked to ODD include:

a family history of mental health conditions like ODD, conduct disorder or attention deficit hyperactivity disorder (ADHD).
a parent who uses harsh discipline
exposure to family violence
experience of physical abuse.

Children with ODD often have other mental health conditions. These include learning difficulties or specific learning disorders, ADHD, anxiety disorders, mood disorders and communication disorders.