Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. To be diagnosed with ODD, a child's behavior must be worse than their peers and meet criteria in the DSM. ODD is usually diagnosed by age 8 and affects 1-6% of children, more commonly boys. It can be caused by inconsistent parenting, learning difficulties, family factors and may co-exist with other disorders like ADHD. Treatment involves therapy, parenting programs, and in some cases medication, with the goal of developing coping skills to reduce frustration and defiance.

1. BY CHRISTINE SCHMITT

2.  Oppositional Defiant Disorder is a relatively
new diagnosis.
 It is classified as a disruptive behavior disorder
and is defined as a pattern of negative,
disobedient, defiant or hostile behavior
directed toward authority.

3.  Periods of difficult
behavior are normal.
 Toddlers and teens go
through periods of
difficult behavior as
they strive for
autonomy and
independence.
 ODD children display
negative or defiant
behavior over time that
is more often or worse
than normal for their
age.

4.  Diagnosis for Oppositional Defiant Disorder
must meet certain criteria specified in the
Diagnostic and Statistical Manual of Mental
Disorders.
 A physical exam is performed.
 A mental health professional can then
determine whether a child or adolescent has
ODD.

5.  Often loses temper/ temper tantrums

6.  Argumentativeness with adults
 Refuses to comply with adults’ rules
 Deliberately annoys other people
 Often blames others for his/her misbehavior or
mistakes
 Is touchy or easily annoyed
 Often angry or resentful
 May be spiteful or vindictive

7.  Anthony Kane, MD believes there are a few
key questions whose answers may be
indicative of ODD.
 Oppositional Defiant Disorder usually appears
by age 8, and usually not later than early
adolescence.

8.  Oppositional Defiant Disorder in younger
children is more common among boys.

9.  Among school aged children and adolescents,
ODD occurs almost equally in boys and girls.

10.  1% to as high as 6% of children and adolescents
have oppositional defiant disorder to some
degree.

11.  ODD affects all types of families, but it seems
to occur more in lower socioeconomic families.

12. DEVELOPMENTAL
THEORY
LEARNING THEORY
 There may be
limitations or delays in
a child’s ability to
process thoughts or
feelings.
 This suggests that ODD
is the result of negative
experiences.

13. Temperament Theory
 Many children who are in therapy have higher
maintenance temperaments.
 Dr. David Rice worked for non-profit
organization…The Preventive Ounce

14.  Adaptability: not being able to quit an activity or be
flexible
 Persistence: because frustration tolerance is low, the
child or adolescent wants problems solved for him/her

15.  Mood: reacts to the world negatively

16.  Inconsistent or harsh discipline
 Abuse or neglect
 Lack of supervision
 Chemical imbalance, i.e. serotonin

17.  ADD, ADHD: found in 50 to 65% of ODD
children
 Affective Disorders: 35% (of the above)
 Personality Disorders: 15% (of the above)
 Learning Disorders

18.  A parent with a history of a disorder or abuse
 Brain impairment
 Exposure to toxins
 Poor relationship with parent(s)
 Neglectful or absent parent(s)
 Poverty
 Instability at home

19.  Therapy is the usual treatment for individuals
and families.

20.  Cognitive problem solving training

21.  Parent training: a therapist helps parents
develop skills for more positive and less
frustration outcomes, especially in regard to
temperament

22.  Ritalin: if ODD
co-exists with
ADHD
 Strattera
 Risperdal
 Divalproex
 Vitamins and
Supplements
 Medication alone
is not a
recommended
treatment for
ODD

23.  For teachers:
remember that
the ODD student
has deficits when
it comes to
dealing with
frustration.
 Teachers need to
help identify
frustrating
activities and help
develop coping
skills.
 Clearly state
behavioral goals.

24.  With treatment, some will outgrow their ODD.

25.  In older children, 75% will retain ODD traits.

26.  The ODD may become something else.
 The child or adolescent may develop a conduct
disorder.
 In very few cases, the child may continue to
have only ODD.

27.  Boot camps
 Clinics
 Ranches

28.  Good parenting
 Early intervention

29.  Early diagnosis and treatment are very
important.
 For those who receive treatment, many can
become symptom free and can lead rewarding,
happy lives.

30.  “If you work with kids, but you are not a
mental health professional, maybe it’s time to
at least learn some of the basics about
children’s mental health. And, no matter what
your role with children, please consider it your
obligation to train your kids to be peaceful.
That may be the most important contribution
you could make in a world that so thoroughly
ensures that every child knows so much about
extreme violence, and so little about anything
peaceful.”