Oppositional Defiant Disorder

Even the best-behaved children can be difficult and challenging at times, but oppositional defiant disorder (ODD) includes a frequent and ongoing pattern of anger, irritability, arguing and defiance toward parents and other authority figures. ODD also includes being spiteful and seeking revenge, a behaviour called vindictiveness.

These emotional and behavioral issues cause serious problems with family life, social activities, school and work. But as a parent, you don't have to try to manage a child with ODD alone. Your health care provider, a mental health professional and a child development expert can help.

Treatment of ODD involves learning skills to help build positive family interactions and to manage problem behaviours. Other therapy, and possibly medicines, may be needed to treat related mental health conditions.

Symptoms

Sometimes it's difficult to recognise the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's common for children to show oppositional behaviour at certain stages of development.

Symptoms of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. Oppositional and defiant behaviors are frequent and ongoing. They cause severe problems with relationships, social activities, school and work, for both the child and the family.

Emotional and behavioral symptoms of ODD generally last at least six months. They include angry and irritable mood, argumentative and defiant behaviour, and hurtful and revengeful behaviour.

Angry and irritable mood

• Often and easily loses temper.
• Is frequently touchy and easily annoyed by others.
• Is often angry and resentful.

Argumentative and defiant behavior

• Often argues with adults or people in authority.
• Often actively defies or refuses to follow adults' requests or rules.
• Often annoys or upsets people on purpose.
• Often blames others for their own mistakes or behaviour.

Hurtful and revengeful behavior

• Says mean and hateful things when upset.
• Tries to hurt the feelings of others and seeks revenge, also called being vindictive.
• Has shown vindictive behaviour at least twice in the past six months.

Severity

ODD can be mild, moderate or severe:

• Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.
• Moderate. Some symptoms occur in at least two settings.
• Severe. Some symptoms occur in three or more settings.

For some children, symptoms may first be seen only at home. But with time, problem behaviour also may happen in other settings, such as school, social activities and with friends.

Your GP can help if you have concerns about your child displaying ODD characteristics.