Identifying Oppositional Defiant Disorder in Children & Adults

Children have many moods, and some of these moods lead to behaviors that are trying for parents. Temper tantrums, tears, and defiance of rules can happen with any child – it’s part of growing up, learning about emotions and what to do with them, and developing a sense of self in relation to other people. 

But sometimes a child becomes so resistant to any form of authority and so violent in their behaviors that they cause much distress to themselves and to those who interact with them at home, school, or in their community. Such a child may be diagnosed with an oppositional defiant disorder or ODD. 

While most cases of ODD begin when children are quite young, from preschool through early elementary school, untreated ODD can last throughout high school and into adulthood. There may be cases in which the disorder is not even diagnosed until a person is older. 

Identifying Oppositional Defiant Disorder

So how do you know if your child’s defiance is within the range of normal or if it could benefit from professional intervention? Let’s look at the behaviors associated with ODD, which fall into three main categories:

• Angry and irritable mood
• Argumentative and defiant behavior
• Hurtful and vindictive behavior

A child with ODD is often angry and has frequent temper tantrums. They argue with authority figures, question rules, and refuse to comply with them. They are touchy, easily annoyed by others, and also purposely try to upset others. They speak harshly and unkindly, and seek revenge for anything they perceive as a personal slight. For example, if another child accidentally runs into them during play, the ODD child will purposely hurt them in return. 

A child with ODD can quickly become violent, striking out at those who oppose them. For this reason, parents are often reluctant to set boundaries for fear of upsetting the child and triggering them to act out. 

For ODD to be diagnosed, the child must display the above mood and behavior symptoms consistently for at least 6 months. 

But wait, you might say. My child is only like this at home–he behaves much better when we’re in public. Could he still have ODD?

The answer is yes, ODD may still be diagnosed, although it may be considered mild. Generally, ODD symptoms are evident in multiple environments, although some environments may trigger symptoms more than others. If you suspect your child or adolescent may be showing signs of ODD, consult with your pediatrician. 

Oppositional Defiant Disorder Diagnosis and Treatment

A pediatrician will likely examine the child and potentially run neuroimaging or blood tests to rule out medical causes for the behavior. They may then look for signs of other disorders that can accompany ODD, like anxiety, depression, or ADHD, before recommending a child psychiatrist or psychologist for evaluation and diagnosis. 

While there is no cure for ODD, treatment can help and may include a three-pronged approach:

• Parent management therapy – in which the parents of the child are taught to identify problematic behavior and use positive reinforcement to decrease those behaviors and encourage healthy behavior 
• Psychotherapy – in which the child works with a therapist (alone and/or with the family) to understand how their thoughts and emotions affect their behavior and how to think and behave in a more positive way
• School-based interventions – in which the child’s teacher/s are given tools to help improve the child’s behavior in the classroom

There is currently no medication for ODD, although children with accompanying anxiety, depression, ADHD, or another mental health disorder may be prescribed medication for those disorders. Some children with more severe ODD may be prescribed light doses of antipsychotic medication to reduce their aggression.

Untreated ODD may go away on its own as the child ages; however, it may also develop into conduct disorder or antisocial personality disorder as the child enters their teen and adult years. 

Here at Eagle View Behavioral Health in Bettendorf, Iowa, we offer treatment services for people ages 12 and older. If your adolescent has struggled with especially aggressive and angry behavior since childhood or has already been diagnosed with ODD, we can help. 

A consultation with our treatment team can help you determine whether your teen needs inpatient or outpatient treatment. Generally, adolescents are not admitted for inpatient treatment unless their behaviors threaten their own or others’ safety. In any situation, however, our compassionate and knowledgeable caregivers can provide the support your family needs to ease the symptoms of ODD and give you hope for the future.