Oppositional Defiant Disorder

A child whose behavior is overly hostile, negative, and puposefully disobedient much of the time for a period of more than 6 months may have oppositional ^* (op-po-ZI-shun-al) defiant ^* (dee-FY-ent) disorder.

What Is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is a type of disruptive behavior problem in children. Children with ODD often lose their temper, act stubborn and willful, argue, and refuse to follow rules, and may annoy others on purpose. Some oppositional behavior is quite common and normal in children. Examples of oppositional behavior are refusing to follow rules, directions, or requests given by adults in charge. While all children may act in these ways occasionally, ODD is diagnosed in those children who act in these ways frequently and whose oppositional behavior seriously interferes with their ability to get along with others in school, on the playground, or at home. ODD can start as early as the preschool years and can be diagnosed in children and adolescents of any age whose defiant behavior is the cause of problems at home, in school, or with peers. Children with ODD have at least 5 of the following problem behaviors to a greater degree than expected for their age for at least 6 months:

• become easily annoyed
• lose temper often
• feel and act angry and resentful
• argue with adults
• refuse to do what adults request
• actively defy the rules of behavior at home or in the classroom
• blame others for mistakes
• deliberately annoy others.

Children with ODD are often set in their ways (inflexible) and stubborn. They may have other problems as well, such as hyperactivity ^* , anxiety ^* , or depression. ODD is sometimes an early sign of another behavioral disorder called conduct disorder. Some, but not all, children with ODD go on to show signs of conduct disorder when they are older. While there are some similarities between ODD and conduct disorder, children and adolescents with ODD do not demonstrate the physical aggression or property destruction that is typical of those with conduct disorder.

What Causes Oppositional Defiant Disorder?

There is no single cause of ODD. Some experts believe that certain children may develop oppositional problems because they are less adaptable and overly sensitive by nature. For example, there seem to be some children who find it especially hard to handle frustration and who become easily upset even by minor things. When they are frustrated, such children have extreme difficulty coping and adapting. They may act very stubborn, defiant, and inflexible. Some children are more irritable and touchy by nature. They may be particularly upset by the way certain clothing feels or by tastes or smells, and they may act even more cranky, oppositional, and defiant when they are tired or hungry.

Family environment also can contribute to oppositional defiant disorder. In families where there is much conflict, harsh discipline, aggressive behavior, or inconsistent rules for behavior, children are more likely to develop oppositional defiant disorder because they are learning to relate to others in hostile, argumentative ways.

How Is Oppositional Defiant Disorder Treated?

Children with oppositional defiant disorder may work with a mental health expert. Often children with ODD are referred by their parents or by school personnel because their behavior is so difficult to manage. Treatment involves helping the child learn to handle frustration, develop more cooperative forms of behavior, and acquire more skills for solving problems and adapting to situations. Parents may be coached to make clear and simple rules for the child's behavior, to reward the child's positive behavior patterns, and to enforce consequences for the oppositional ones. When oppositional defiant disorder is treated early, more serious problems with conduct disorder may be prevented.