Oppositional Defiant Disorder (ODD) is a common clinical disorder among children and teens. ODD refers to a recurring pattern of disobedient behavior directed towards an authority figure, typically a parent or primary caregiver. These children are usually stubborn, unable to compromise, and often push the envelope with most issues. Children with ODD also tend to have a difficult time controlling their temper, behave in a manner that annoys people, refuse to follow rules imposed by adults, blame others for their mischievous actions, seem malicious, are easily annoyed by other people, are angry, and are argumentative with adults. They do not, however, engage in the recurrent pattern of significant violation of the rights of others or of societal norms that typifies Conduct Disorder. This means that a child with ODD is not making plans to burglarize the neighbor’s home, rather they are refusing to follow any rules at home. ODD behaviors are not the occasional brief negative phase many children exhibit nor are they explained away as “boys being boys”; the diagnosis is made after a period of at least six months of significant behavioral problems. Further, to meet criteria for this diagnosis, the ODD must not only occur during a psychotic episode or during a worsening of a Mood Disorder.

Children and teens with ODD may act quite differently in school or with peers than at home with parents. They also tend to engage in ODD behaviors when they are interacting with familiar people, rather than strangers. This fact makes it difficult to initially observe the ODD behaviors in the doctor’s office (not to mention adding to parental frustration). ODD behaviors are typically evident before age 8 and, before puberty, ODD is more common among boys than girls. However, over time, the behavior both male and female children with ODD engage in begins to cause problems in their relationships and/or in school. Over the course of time, children with ODD are at increased risk for substance abuse, underachievement, and Conduct Disorder. It should be noted that many children with Attention Deficit (Hyperactivity) Disorder (ADHD) are prone to an additional problem of ODD.

Treatment for ODD usually involves parent management training and individual Cognitive Behavioral Therapy. Parent management training involves instructing parents on how to appropriately implement contingency management strategies. In general, this strategy includes removing positive reinforcement of ODD behaviors, increasing reinforcement of good behavior, and applying consequences for ODD behaviors. Of utmost importance is the consistent and timely application of each of these components. Also essential is learning how to avoid pointless and repetitive power struggles. Individual CBT typically involves problem-solving skills, assertiveness, anger/stress management, and communication skills training.

Tips: 1.When your child acts in a way that is compliant and appropriate, let them know by providing them with verbal praise (“Thanks. I appreciated it when you helped clear the table.”).
2.Hold your child accountable for their actions in a calm, non-critical manner (even if they make a big fuss or try to make you feel guilty).