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Brain, Nervous System and Mental Conditions

Oppositional Defiant Disorder (ODD)

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What is ODD?

It is common for children to be defiant toward adults sometimes. For example, they may argue, refuse to do what they are told or talk back.

However, if your child has negative, hostile and defiant behavior that lasts more than six months and is worse than behavior normally seen in children of the same age, your child may have oppositional defiant disorder (ODD). ODD is a behavior disorder that often co-occurs along with other disorders, such as attention disorder, learning problems, conduct disorders and anxiety and mood disorders. 

What are the symptoms of ODD?

The signs and symptoms of ODD in children and teens include frequent:

  • Loss of temper
  • Arguing with adults
  • Refusing to do what adults ask or to follow rules
  • Annoying other people on purpose
  • Blaming others for their own mistakes
  • Being touchy or easily annoyed by others
  • Anger and resentment
  • Spitefulness or vindictiveness (being unkind or mean)

How common is ODD? 

ODD is a fairly common problem faced by children and teens. At any given point in time, about 1% to 16% of children and teens are struggling with this behavior problem. Boys are much more likely to have ODD than girls. ODD and other behavior problems are the most common reason children are referred to mental healthcare.

What causes ODD?

It is not known exactly what causes ODD. It may develop from a combination of biological, psychological and environmental factors, including: 

  • The disposition or temperament your child inherited, or was born with
  • Inconsistent discipline (overly harsh or overly lax)
  • Abuse, neglect or exposure to violence 

Family stress can worsen ODD symptoms.

What is the impact of ODD? 

ODD can cause social and academic difficulties and family problems. It is likely that your child’s ODD will improve over time, but it does put them at a greater risk for more serious disorders, including conduct disorder (PDF). Due to the long-term consequences of ODD, it should be taken seriously and treated.

How is ODD diagnosed?

ODD is diagnosed during an evaluation, which includes taking a history from the parent and interviewing the child. Often, there are other psychiatric or learning problems that should be screened for, such as attention deficit hyperactivity disorder (ADHD) or reading disabilities.

How is ODD treated?

Children with ODD often benefit when their parents and teachers are trained in behavior modification.

Because ODD often occurs along with other disorders such as attention disorder, learning problems, conduct disorders and anxiety and mood disorders, it is important to have a comprehensive evaluation and treatment plan. Medicine may help treat related disorders, such as attention or mood disorders.

Is treatment helpful for ODD?

Teaching parents how to use effective discipline strategies has been shown to greatly reduce behavior problems in their children.

Medicines may be helpful for treating your child’s ODD symptoms if they also have ADHD.

What should I do if I think my child has ODD? 

If you’re concerned about your child’s behavior, talk to your pediatrician. Treatment is more effective with younger children, and children with persistent ODD are at higher risk for severe behavior disorders and substance abuse as they get older.

Who Treats This at Seattle Children's?

Should your child see a doctor?

Find out by selecting your child’s symptom or health condition in the list below:

Spring 2014: Good Growing Newsletter

In This Issue

  • Cold Water Shock Can Quickly Cause Drowning
  • E-Cigs Are Addictive and Harmful
  • Bystanders Can Intervene to Stop Bullying

Download Spring 2014 (PDF)

In Crisis?

If your child or family is in a crisis situation and needs help right away, please call your county’s mental health crisis number. In King County, call 866-427-4747.