Oppositional defiant disorder (ODD) & kids

What is oppositional defiant disorder (ODD)?

Oppositional defiant disorder (ODD) is a childhood behaviour problem.

Children with ODD:

won’t do what people ask
think that what they’re being asked to do is unreasonable
get angry and aggressive about being asked to do things.

All children are disobedient and cranky sometimes, especially if they’re tired, upset or frustrated. But a child with ODD behaves like this a lot, and the behaviour is so severe that the child has trouble doing ordinary, everyday things.

Diagnosing oppositional defiant disorder (ODD)

To be diagnosed with oppositional defiant disorder (ODD), a child must have constant angry and cranky moods, along with negative, defiant behaviour that upsets other people. A child must also have at least four symptoms from the following list.

The child:

loses their temper
argues with adults
actively refuses to do what adults ask and disobeys rules
often deliberately annoys people
often blames others for mistakes or challenging behaviour
is easily annoyed by others
is often nasty or unkind.

A child with ODD shows the symptoms:

very often
in a way that interferes with daily activities
for at least six months.

If you think your child might have ODD, start by talking with your GP about a referral to a paediatrician, psychiatrist or psychologist. These health professionals can diagnose oppositional defiant disorder (ODD) and help your child develop the social, emotional, behavioural and thinking skills they need to thrive.

Your GP will probably talk with you about a mental health treatment plan for your child. If you have a plan, you can get Medicare rebates for up to 20 sessions with a psychologist. If your child is referred to a paediatrician or psychiatrist, you can get Medicare rebates for these appointments.

Behaviour management plans for oppositional defiant disorder (ODD)

Managing oppositional defiant disorder (ODD) in children is about first accepting that your child will behave in challenging ways.

The next step is working with health professionals to develop a behaviour management plan, which can make the behaviour easier to handle – for you and your child.

A good plan will help your child:

learn how to improve their behaviour and understand how it affects other people
manage strong emotions like anger and anxiety
improve the way they solve problems, communicate and get on with other children.

These things will help your child make and keep friends, say what they think without getting angry, accept no for an answer, and play well with others.

A good behaviour management plan will also help you cope with your child’s challenging behaviour by helping you:

understand the causes of your child’s behaviour
work out how you can increase your child’s positive behaviour and manage their challenging behaviour
support your child in managing strong emotions and improving social skills
work on strengthening your family relationships.

Children with ODD need professional diagnosis and treatment early on. This will help your child develop skills to make and keep friends, get and keep a job, and build a support network later in life.

Working on oppositional defiant disorder (ODD) at home

Here are some strategies for working on your child’s ODD behaviour at home:

Use specific praise to encourage positive behaviour – for example, ‘It was really helpful when you put your plate on the bench’.
Look at using a structured reward system like a reward chart. These work especially well for children aged 3-8 years.
Give short, direct and specific instructions – for example, ‘Please put the dishes in the sink’.
Give choices about when your child can do tasks, not whether your child will do them – for example, ‘Would you like to do your homework now, or after the next TV show?’
Follow up on negative behaviour straight away. For example, if your child doesn’t do what you ask, ask again and say, ‘This is the last time I am going to tell you’. If your child still doesn’t cooperate, be ready with a consequence like loss of privilege.
Use consequences in the same way and for the same behaviour every time. This means your child knows what to expect. For example, you might always use a time-out for hitting.
Acknowledge your child’s strong emotions and let them know you’re there to listen and help. For example, ‘I understanding you’re feeling angry. Do you want to talk about it?’

It’s a good idea to ask your child’s psychologist for more specific strategies that you can use at home to support your child’s therapy.

Your child needs to know that they’re important to you. One of the best ways you can send this message is by spending positive time together doing things your child enjoys. This will help to strengthen your relationship with your child.

Working with your child’s school on oppositional defiant disorder (ODD)

It can help to talk to staff at your child’s school about your child’s treatment plan and any other recommendations from your child’s psychologist, psychiatrist or paediatrician. Your child’s school might be able to help with things like:

classroom behaviour management programs – for example, seating your child at the front of the classroom away from distractions
structured classroom activities – for example, having a daily planner on the wall that lets children know what’s happening and when
alternative thinking strategies – for example, allowing children to offer their own ideas about ways to solve problems
emotional regulation programs that teach children how to manage strong emotions like anger and frustration
resilience, wellbeing and bullying intervention programs
rewards for good behaviour, so that your child doesn’t feel that they’re always being punished for unacceptable behaviour.

Your child will get the most benefit from therapy when you, your child’s mental health professionals and your child’s teachers work together.

Looking after yourself when your child has oppositional defiant disorder (ODD)

Looking after yourself gives you the energy you need to help your child with oppositional defiant disorder (ODD) grow and thrive.

Here are some tips on how you can care for yourself when you have a child with ODD:

Make some time every day to be on your own to read a book, watch a TV show, go for a walk, or do something you enjoy. Start with five minutes at the end of the day if that’s all you have.
Ask family, friends or members of your support network to look after your child for a little while so you can have some time to yourself.
Make time for some physical activity – for example, walking, yoga or swimming. A bit of exercise can give you more energy to work with your child.
Make some time to do fun activities with your partner, if you have one. Your child’s difficult behaviour can be stressful for your relationship, especially if you and your partner don’t agree about how to handle your child’s behaviour.
Seek professional help from a GP or counsellor if you feel you can’t cope.

Sharing support, advice and experiences with other parents can be a big help. You could try starting a conversation in an online forum or joining a parent support group.

Risk factors for oppositional defiant disorder (ODD)

It’s hard to say why children develop oppositional defiant disorder (ODD). But it might be a combination of genes and environmental factors. For example, there are some risk factors that are linked to ODD, like your child’s temperament and stress in your child’s life that affects their relationship with family or community.

Children with ODD often have other difficulties like learning disabilities, attention deficit hyperactivity disorder, anxiety disorders, mood disorders or language impairment.