What is it?
Oppositional Defiant Disorder (ODD) is a behavioural disorder that mainly affects young children and is characterized by a pattern of repetitive and consistent disobedience, opposition and defiance towards authority figures. While most parents can probably identify those traits in their children from time to time, children with ODD persist in these behaviours for at least six months. ODD can cause significant emotional issues within the family unit, as well as affect the child’s learning and social development.
Is it common?
Around one in ten children under the age of 12 years are thought to have Oppositional Defiant Disorder (ODD), with boys outnumbering girls by two to one. Many cases of ODD are observed early in the child’s life, either before or soon after they start school. Some children develop ODD later into their adolescence, in which case it is often as a result of a specific trigger (such as parental divorce or unemployment) that significantly changes their family dynamic.
What are the causes?
While most parents can probably identify those traits in their children from time to time, children with ODD persist in these behaviours for at least six months.
The primary causes of ODD appear to be family-related, with ODD being more common in dysfunctional households, or where there is serous conflict between parents. The Victorian government’s Better Health channel identifies the following family issues as risk factors:
- Poor parenting skills (inadequate supervision, harsh or inconsistent discipline, rejection)
- Marital conflict
- Domestic violence
- Physical abuse
- Sexual abuse
- Substance misuse by parents or carers.
Research also indicates that more than half of all children who are diagnosed with Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD or ADHD) have a co-occurring diagnosis of ODD.
What are the symptoms?
Oppositional Defiant Disorder usually presents in the preschool/early school years. The typical symptoms, as described in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) include:
- persistent stubbornness and refusal to comply with instructions or
- unwillingness to compromise with adults or peers
- deliberate and persistent testing of the limits
- failing to accept responsibility for one’s own actions and blaming others for one’s own mistakes
- deliberately annoying others
- frequently losing one’s temper
ODD needs to be professionally diagnosed by a child psychologist, child psychiatrist or paediatrician specialising in behavioural disorders. Diagnosis involves detailed interviews with the child (if they are old enough), parents and teachers, and comparing the child’s behaviour with the checklist above.
What are the treatments?
Because ODD is classified as a behavioural issue, treatments will revolve around individual counseling, therapy and training as well as group support, for both the child, the parents and the child’s teachers. There is strong evidence that early intervention to assist with family function can help to prevent the child developing more serious disorders and mental health issues down the track.
If the child is also diagnosed with ADD/ADHD then this will be incorporated into their overall management plan.
Royal Australian College of General Practitioners ODD discussion paper