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Raising a child comes with many challenges. Whether you’re trying to soothe their latest case of strep throat or doing what you can to prevent summer injuries, it can be a lot of work. And lest we forget the occasional misbehavior or crankiness that appears in even the most docile of children when they become overtired or frustrated. Challenging for sure, but manageable, right?  

But what happens when a child’s behavior becomes unmanageable or so severe that it interferes with their ability to function? Is it just a temper tantrum, or is there a larger concern that needs professional attention?  

What is Oppositional Defiant Disorder? 

Oppositional defiant disorder (ODD) is a behavior disorder found in some children and adolescents. Children with an ODD diagnosis exhibit a clinically significant level of anger, frustration, and defiance towards authority figures like teachers and even their parents. 

Oppositional Defiant Disorder Symptoms 

Common symptoms in a child with ODD are: 

  • Arguing with adults 
  • Aggressive and vindictive behavior 
  • Disruptive behavior in school and at home 
  • Low frustration tolerance 
  • Lack of impulse control 
  • Refusing to do what they're told 
  • Blaming others for mistakes 
  • Deliberately breaking rules 
  • Purposefully annoying others (not just siblings) 

Any child or adolescent can exhibit the above behaviors from time to time. What qualifies as an ODD diagnosis is the significant impact on the individual and their family.  

ODD does not stand alone and generally has a high comorbidity rate with other mental health conditions. Common co-occurring mental health conditions in children and adolescents with ODD are: 

  • Depression 
  • Anxiety disorders 
  • Mood disorders 
  • Attention-deficit/hyperactivity disorder (ADHD) 

How Does a Mental Health Professional Diagnose Oppositional Defiant Disorder?  

The diagnosis needs to come from a professional, like a psychiatrist, psychologist, licensed professional counselor, or a licensed clinical social worker. In order to be diagnosed, your child must exhibit a pattern of behavior problems that cause clinically significant distress for a duration of at least six months. If these behaviors are isolated to sibling interaction, the criteria of ODD would not be met.   

A mental health professional will take a detailed history of the child’s behaviors in various settings and situations. They will evaluate the frequency, intensity, and duration of symptoms, as well as the child’s ability to function during the episodes.  

ODD is often misdiagnosed and wrongly credited for some of the unexplainable challenges of child rearing. In order to truly identify it, a clinician will work to rule out any other possible mental health conditions that may be causing behavioral issues. “Children are more than just their behaviors,” says Summit Health behaviorist Janna Hodge, LPC. “All behavior means something. Since children can’t always tell us what is bothering them, they show us, and it’s up to their care givers and professionals to figure out what that is.” 

What Causes Oppositional Defiant Disorder? 

It's not clear what causes ODD in children and adolescents. It is believed that ODD could be influenced by several things such as environmental factors, developmental factors, and possibly learned behaviors.   

Oppositional Defiant Disorder Treatment Options 

Treatment for ODD symptoms include: 

  • Cognitive-behavioral therapy (CBT) 
  • Family therapy 
  • Parenting models of therapy  
  • Peer/Group therapy 
  • Parent-Child Interaction Therapy (P-CIT) 
  • Medication therapy 

These therapies, especially P-CIT and family therapy, allow children and parents to recognize problems, issues, and negative feelings in a controlled professional setting. 

My Child Does Not Want Therapy. What Do I Do?   

Unfortunately, it is not uncommon for children and adolescents with ODD to be uncooperative in treatment. Remember, they blame everyone else for their problems, so coming to therapy is usually a challenge for them. Thankfully, parenting models of treatment have been clinically proven to be effective. The purpose of parent training models is to give parents the skills to effectively manage their child’s emotional and behavioral issues when they cannot do it themselves. 

Is My Child Going to Be Okay? 

The outcomes for children diagnosed with ODD vary. With the proper treatment and behavior management training, children and adolescents with ODD can thrive in adulthood.  

Final Thoughts on Oppositional Defiant Disorder 

ODD is a complex behavior disorder that can impact many areas of a child’s life, including family dynamics, academic, social, and emotional functioning. Intervention is key.  

If you think your child may have ODD or any other mental health condition, contact Summit Health's Behavioral Health and Cognitive Therapy Center (BHCTC) and request to schedule an appointment. Parents who identify behavioral issues as their main concern are scheduled for a 15-minute phone consultation to speak to a therapist to gain a better understanding of their needs. Based on this screening, the therapist can make a recommendation about the best next steps. Pediatric therapists at our center are well versed in the mental health challenges of children and adolescents and can help you navigate the treatment of ODD.  

For more information on behavioral disorders like oppositional defiant disorder, book an appointment online