Oppositional Defiant Disorder (ODD) is a psychiatric condition that typically arises in childhood, characterized by defiant and disruptive behaviors that can affect a child's relationships and learning. Diagnosis requires displaying specific symptoms for at least six months, and treatment may involve therapy, parent training, and in some cases, medication for co-existing conditions. Early intervention and a consistent support system from parents and educators are crucial for improving outcomes in affected children.

1. Oppositional Defiant Disorder (ODD)
Ref- Psychology Today
Compiled by Col Mukteshwar Prasad(Retd),
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for book ”Decoding Services Selection Board” and SSB ON line guidance and training
at Shivnandani Edu and Defence Academy

2. Introduction
Oppositional defiant disorder (ODD) is a psychiatric disorder that typically emerges
in childhood, between ages 6 and 8, and can last throughout adulthood.
ODD is more than just normal childhood tantrums
Frequency and severity of ODD causes difficulty at home and at school.
Children with ODD also struggle with learning problems related to their
behavior.
Two types of oppositional defiant disorder:
Childhood-onset ODD:
Present from an early age
Requires early intervention and treatment to prevent it from progressing
into a more serious conduct disorder
Adolescent-onset ODD:
Begins suddenly in the middle- and high-school years, causing conflict at
home and in school

3. Symptoms
Display behaviors that are challenging for parents and educators. For example,
 Demonstrate aggression and purposeful misbehavior.
Have difficulty interacting appropriately with peers and adults.
Tend to be argumentative and defiant
Common signs and symptoms(occur in multiple domains and not just at home)of ODD include:
Being easily annoyed
Causing conflict
Frequent temper tantrums
Low tolerance for frustration
Lying
Moodiness and unprovoked anger
Noncompliance with even simple requests
No sense of conscience
Purposeful irritation of others
Many children engage in oppositional behaviors with their parents but not in any other environment.

4. Diagnosis
 Diagnosis of ODD requires a child to have at least four symptoms from the following categories.
 It must occur for min six months with negative impact on social/educational/ occupational functioning:
Angry/irritable mood:
Often loses their temper,
Is often angry or resentful,
Is often touchy or easily annoyed
Argumentative/defiant behavior:
Often argues with authority figures or adults,
Actively defies or refuses to comply with requests from authority figures or with rules,
Often deliberately annoys others,
Often blames others for his or her mistakes
Vindictiveness: -Has been spiteful or vindictive at least twice within the past six months
Severity of child's ODD may be assessed using the following scale :
Mild: Symptoms are confined to only one setting.
Moderate: Some symptoms will be present in at least two settings.
Severe: Symptoms will be present in three or more settings.

5. Causes
 Probably linked to a combination of biological, psychological, and social factors.
Biological factors include:
A parent with a history of attention-deficit/hyperactivity disorder (ADHD), ODD, or CD
A parent with a mood disorder (such as depression or bipolar disorder)
A parent with a substance use disorder
A mother who smoked during pregnancy
Abnormal levels of neurotransmitters in the brain
Exposure to toxins
Impairment in the part of the brain responsible for reasoning, judgment, and impulse control
Poor nutrition
Psychological factors include:
A neglectful or absent parent
A poor relationship with one or more parent
Difficulty or an inability to form social relationships or process social cues

6. Causes…..
Social factors include:
Abuse or neglect
Chaotic environment
Family instability (such as divorce or frequent moves)
Inconsistent discipline
Lack of supervision
Poverty
Uninvolved parents
Sometimes ODD occurs in conjunction with other behavior disorders or mental health
issues, including
Attention-deficit/hyperactive disorder (ADHD),
Anxiety disorders,
Depression,
Bipolar disorder, and
Language disorders.

7. Treatment
Intervention must begins as early as possible with children with ODD and may
develop into a conduct disorder.
Therapy
Treatment often involves the following:
Cognitive problem-solving skills therapy: Children will learn to manage specific
symptoms of ODD and to identify and solve problems that arise from living with ODD.
Family therapy: Parents, siblings, and other family members may be invited to attend
therapy with the child in order to improve family interactions and relationships.
Parent training: Parents or caregivers may be taught behavior management strategies
and techniques to reduce misbehavior in the home.
Psychotherapy: Individual therapy can help a child learn new skills, such as anger
management and impulse control.
Social skills training: Formal social skills training can be effective in helping the child
with ODD to interact with peers and adults.

8. Medication
While medication alone is not a recommended treatment for ODD but child may need
medication to treat the symptoms of other coexisting conditions like ADHD, anxiety,
and mood
Training
Behavior modification methods can be effective ways to reduce behavior problems in
children.
Better parenting techniques that can reduce misbehavior.
Focus is on reinforcing pro-social behaviors (i.e., keeping hands and feet to self,
demonstrating respectful disagreements, etc.).
Form a Positive Relationship
Building a positive relationship with your child.
Engaging with the child in child-led play with the parent providing positive
reinforcement and engagement.
Set Expectations
Children with ODD misbehave to with a goal of annoying parents/teachers
 Hence set a clear expectations rules and to apply them consistently.

9. Establish a Routine
Having a routine can help children with ODD cope with activities at home
 Apply rules and follow routines consistently and fairly
Discipline and Rewards
Provide specific, labeled praise and rewards for the prosocial behaviors
May use stickers, tokens, or a behavior chart to show progress
Allow the child to identify rewards they would like to earn.
As the child demonstrates success,
Offer reinforcement such as spending time in a preferred activity,
Verbal praise,
Edible rewards, or items from a prize box.
Social Interaction
While interacting with others, ensure there is adequate supervision
Work with peers for appropriate response to the ODD child's behaviors.

10. Coping
Parents can also help their child better cope with ODD by doing their best to:
Avoid giving direct praise that could result in misbehavior
Resist the urge to argue /lecture the child keeping own temper under control.
Avoid being angry which may be rewarding to the child
Use a matter-of-fact tone of voice without emotion, simply stating the rule that was
broken and what the consequences will be.
Be consistent and avoid getting into a verbal argument with the child over
consequences or what happened.
Allow the child to have a place to vent their frustrations.
 Provide a pillow to punch or to yell into.
Support for Parents
Do talk to other parents who understand day-to-day living with a child with ODD.
Look for additional emotional support online and ensure education on latest findings
and approaches to managing ODD.

11. A Word From Verywell
The prognosis for recovery from ODD is unclear.
Some children will mature and symptoms of the disorder will subside into adulthood.
Others will carry the disorder into adulthood.
Meeting the complex needs of these children will require the cooperation of parents
and school personnel as well as mental health professionals.
A cooperative, consistent effort at home and school will improve the likelihood of a
positive outcome for these children, especially when intervention begins at an early age.