Every child tests limits and misbehaves, often by going against a parent, teacher, or caregiver’s wishes. However, consistent, intense defiance is sometimes classified as Oppositional Defiant Disorder (ODD), a behavior disorder most often diagnosed in children. If you have a particularly uncooperative child and are wondering if this is a phase or a sign you should seek outside help, there are some signs and symptoms. We spoke with psychiatrist and parent coach Jess Beachkofsky on how to tell the difference and what to do if you suspect ODD.
Signs and symptoms
The markers of ODD are:
- Arguing with adults more than usual
- Temper tantrums
- Resentment or holding grudges
- When upset, using mean or hateful language
- Deliberately being annoying or provocative, yet easily annoyed by others
- Questioning and refusing to comply with rules or authority
- Blaming others instead of taking responsibility for actions or mistakes
- Seeking revenge
The way to tell ODD from developmentally appropriate anger, tantrums, and misbehavior, even a very bad patch, is duration and intensity. “The most notable thing with ODD is going to be the severity and pervasiveness,” Beachkofsky says. You need to notice the behaviors for more than six months to rule out a developmental leap. For children under five, behaviors must occur most days and, over five, when impulse control might be more developed, you must notice signs at least once a week in order to justify an ODD diagnosis.
The other difference between regular defiance and disordered behavior is context. While it’s somewhat normal for kids to behave worse for parents (sorry), kids with ODD are equal opportunity defiers. “ODD is going to be pretty consistent and not a ‘sometimes they’re fine, and sometimes they’re not’ kind of thing,” Beachkofsky says. She says it’s not just with a sibling, or at one location; it’s everywhere and with everyone.
What to do if you suspect ODD
The problem with ODD is that, without intervention, it can, understandably, create problems for your child as they grow and people are less lenient toward tantrums and kids who refuse to follow rules. While you can wait to see if your child’s behavior is a phase, “if it bothers the kid or others and has a negative impact on other important areas like school or socially,” Beachkofsky says it would be worth looking into.
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When you’re exasperated or confused by your child’s behavior, it can be hard to keep track of how long something concerning has been going on. Beachkofsky suggests parents “keep good notes about concerning behavior to see if it’s really as often, bad, and has been going on for as long as they really think it has.” If there is cause for concern, she says “Confusion about what you’re really seeing should be addressed by a mental health professional like a child and adolescent psychiatrist or may require psychological testing.” A mental health practitioner will likely also look for other conditions, such as ADHD, anxiety, learning disabilities, and other causes or contributors to your child’s behavior before making an ODD determination. Sometimes ODD comes in conjunction with another diagnosis.
Treatment and management
Untreated, ODD can become a conduct disorder such as antisocial personality disorder, so getting your child help early is important. Your particular child will need an individualized plan to best treat their and your family’s needs, but usually a combination of individual and family therapy is what is recommended for ODD.
You will also want to loop in your child’s school to your treatment plan, both so they can help your child and so they can treat your child’s behavior as a disorder, not a problem. Knowing you are aware of your child’s defiance and are working to get them help will likely help with the process and show your child they are supported from all sides.
In your interactions with your child and in giving advice to others who interact with them:
- Focus on positive reinforcement.
- Do have consistent consequences for harmful or disruptive behavior, but have them focus on repair and have them be connected to the behavior.
- Plan many breaks or cool-downs. Model this in yourself.
- Avoid power struggles whenever possible.
The same research on ODD that says some kids develop conduct disorders shows that most children don’t. Most kids, especially when given early intervention and consistent, attentive parenting, see a decrease in ODD symptoms within three years. Asking for help when you have a child with difficult behavior can seem daunting, but getting your child the interventions they need can serve them well in the long run.