Oppositional Defiant Disorder (ODD) in Children: Symptoms, Treatment & More

Oppositional Defiant Disorder (ODD) is a mental health condition that is prevalent in children. Kids who experience this condition display uncooperative and sometimes hostile behaviour. They tend to lose their temper and have frequent outbursts and other reactions. Since they behave in a certain way, they might face inconveniences in their daily life.

Interested in knowing more about this condition? Keep reading.

ODD is a type of disruptive behavioural disorder. This is a condition where children show patterns of uncooperative manners. This disorder is common for children of ages two or three and those in their early teens. Although kids of this age often act rebellious, those who have this condition do this more frequently. As per an estimate by the American Academy of Child & Adolescent Psychiatry, 1-16% of all school-going children have this disorder. In addition, boys are more prone to this condition than girls.

Sources suggest symptoms of Oppositional Defiant Disorder start by the age of 8. Even though in some cases, the signs remain stable for up to 10 years, they do not always decline. The symptoms of ODD can be put together into three categories:

1. Anger and Irritability

Signs under this category are as follows:

• Losing temper easily
• Frequent outbursts of resentment
• Getting annoyed by others 
• Frequently acting disrespectful

2. Argumentative and Defiant Behaviour

Children with Oppositional Defiant Disorder may show signs like:

• Deliberately trying to annoy others
• Arguing excessively
• Blame others for their mistakes 
• Refusing to accept any requests or comply with rules

3. Vindictiveness

Signs of vindictiveness in this disorder are like:

• Looking for opportunities to seek revenge
• Saying hurtful things when they are upset

The main causes of Oppositional Defiant Disorder are not yet known. However, some sources suggest this disorder could develop from a combination of certain factors.  

 This includes the following:

• Genetic Factors

Genetics is one of the major causes of ODD and is responsible for the development of at least 50% of this mental health disorder. In addition, children who have a relative with any of the psychological disorders are potentially at risk of developing this disorder.

Furthermore, there is a tendency among these kids or teens to develop other mental health issues like ADHD, learning differences, or depression. Thus, suggesting a link between the conditions.

• Biological Factors

Some scholars suggest behavioural disorders like ODD can develop from some changes in the brain structure. Moreover, issues with neurotransmitters are also linked to the causes of this behavioural disorder.

• Environmental Factors

Growing up in a chaotic family and not being treated well and inconsistent parenting can contribute to the development of this condition. 

In addition, peer pressure, deviant peer groups, poverty, violence, and unstable social or economic factors are also the factors that provoke symptoms of ODD.

Children with the following risk factors are more likely to develop this behavioural disorder. 

• Lack of discipline and no adult supervision
• Instability in their lifestyle like divorce of parents, transfer to different places, frequently changing schools, etc.
• A financial crisis in their family

Behavioural health specialists can diagnose conditions like ODD in children if they display four and more symptoms for six months. So, if your children display signs of Oppositional Defiant Disorder, you must take them to a specialist. 

Mental health professionals will use interviews targeted at young patients and some assessment tools to evaluate their conditions. They may also ask the parents and other family members for a report on their kid’s behaviour.

Moreover, a psychiatrist or psychologist aims to distinguish ODD symptoms from other conditions with similar signs in the diagnosis of Oppositional Defiant Disorder. For example, ADHD, mood disorders, anxiety disorders, OCD, etc., are some disorders that may show similar signs and symptoms.

The treatment of Oppositional Defiant Disorder varies on different aspects:

• Age 
• Severity of the symptoms
• Child’s ability to tolerate the therapies
• Whether the child has other behavioural issues

Depending on these factors a specialist devises the treatment method Oppositional Defiant Disorder in children. The treatment process for this condition includes a combination of the following:

1. Parent Management Training

PMT is the main treatment process for oppositional behaviour. There are different types of programs, which include multiple sessions. In these sessions, parents are trained to identify problematic behaviours of their kids. In addition, they also learn ways to include positive interactions and appropriate punishments or reinforcements. Correct implementation of PMT has shown a significant downfall of Oppositional Defiant Disorder in children. 

2. Psychotherapy

This is a type of talk therapy that is used for a variety of treatments to identify a change in troubling emotions. The common varieties of psychotherapy that help treat ODD are:

• Cognitive Behavioural Therapy (CBT)

This is a goal-oriented therapy directed towards an individual. A therapist helps kids with mental health disorders to look deeper into their thoughts and emotions through this therapy. They aim to let the children know how their thoughts affect their actions. Moreover, they learn to adopt healthier thinking patterns and manage their anger through CBT.   

• Family-Focused Therapy

As the name implies, this therapy is for children along with their parents. In this therapy, your kids would be a part of a joint therapy session where a professional would guide you through psychoeducation regarding ODD. Furthermore, it also allows you to find ways to improve ways of communication and problem-solving skills.

3. Medications

Although there is no particular medicine to cure Oppositional Defiant Disorder in children, doctors may prescribe medications to treat specific symptoms or other related conditions like depression, anxiety, ADHD, etc.

4. Homoeopathic Remedies

Some may also rely on homoeopathic medicines for treating this mental health condition. Since homoeopathy is a patient-oriented technique with fewer side effects than conventional medicines, many parents rely on it. 

Some common homoeopathic remedies for ODD are:

• Cina
• Natrum Muriaticum
• Antimonium Crudum

5. School-Based Interventions

For young kids experiencing such chronic behavioural issues, it is important to have supportive peers and teachers to recover. Schools can include positive interventions which can be useful in treating ODD. For example, they can use the following:

• Methods to make kids with this disorder follow classroom rules by using acceptable social reactions.
• Educating tools to improve the behaviour of all the kids in the classroom.
• Techniques to prevent oppositional behaviour from growing

If you notice persistent symptoms of the behavioural disorder in your child or they harm other kids in school. You must consult a professional therapist for this. They will assess your child’s behaviour and suggest further treatment methods.

It can be difficult to prevent the onset of Oppositional Defiant Disorder in children because it is a brain disorder. Moreover, it can be caused due to several reasons. 

Nevertheless, recognising the symptoms and providing the right treatment can minimise the severity of its consequences. Along with this, offering a supportive, nurturing and consistent environment may help curb the frequency of the episodes. 

Common Co-Occurring Conditions 

Disruptive behaviour disorders like ODD can co-occur with other mental disorders in children. Particularly in ADHD, anxiety disorders and mood disorders. It is observed that most children with Oppositional Defiant Disorder also experience one of the following conditions.

• Attention-Deficit Hyperactivity/Disorder (ADHD)
• Anxiety Disorders
• Learning Disorders
• Depression or other mood disorders
• Impulsive Control Disorders

Incidents of co-occurrence of such behavioural disorders with other psychological issues cause functional impairment in children.

As the researchers have estimated, Oppositional Defiant Disorder can affect 2% to 11% of children. However, many cases remain undiagnosed or misdiagnosed with other kinds of mental disorders.

The prevalence of this disorder declines with an increase in age. Hence, the cases of teenagers mostly remain undetected.

Children with ODD undergo several issues in school, home, and social settings. Mild or moderate defiant disorders tend to improve with age. In comparison, the severe ones can evolve into conduct disorders. 

If no treatment or parental support is provided to such children, it can cause a poor prognosis. At the same time, appropriate treatment like individual or positive parenting and family therapy can lead to a successful outlook.

Many parents inquire about the ways to take care of their children with ODD. Besides talking to a therapist and following their medications, you can help your kid in the following ways:

• Build on Positive Reinforcement

Praise your child and give positive affirmations when they cooperate or be flexible.

• Take Breaks When You Need

If you realise you are about to say something that may start a conflict with your child, step away or take a break. This will have a significant impact on your kids as well. They will learn to take a break when they are about to say something hurtful.

• Make Consistent Rules

You can make age-appropriate limits for the consequences when they behave unwillingly. However, these rules must be enforced consistently to make them aware of their boundaries.

• Take Care of Yourself

Adults who are supporting their kids to overcome this disorder often find it overwhelming. Hence, you must maintain your interests and hobbies, practice self-care and do other activities you like. 

A combination of all these will help you create a positive environment in your home. In such supportive surroundings, your kid will develop better behavioural traits and eventually reduce the signs of this mental disorder.

So, to conclude, Oppositional Defiant Disorder is a psychological condition which is prevalent in young children. It is hard to recognise this because everyone has a notion that kids of this age are unruly and often show uncooperative hostility. Although these are some basic signs of ODD, a psychiatrist only considers this condition if the child has four or more symptoms.