Helping all children become happy learners
Oppositional Defiant Disorder
Introduction
Oppositional Defiant Disorder (ODD) is defined as a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness in children and adolescents. (DSM-V) ODD is not associated with physical violence though children can be highly verbally aggressive. For physically violent children see Conduct Disorder.
ODD is relatively common condition with some studies suggesting a prevalence rate of 5% in pre-school children rising to about 11-13% in pre-adolescents. ODD affects both genders with slightly more boys than girls being diagnosed with the condition.
behaviours are associated with ODD
Typical behaviours of ODD include:
losing one's temper
arguing with adults
actively defying adults' requests or rules
deliberately annoying others
blaming others for their mistakes
is touchy and easily annoyed
being angry and resentful
being spiteful or vindictive
Diagnosis
Most children will exhibit ODD type behaviours at some point in their childhood. In particular, during toddlerhood when many children experience the 'Terrible Two's' and during the teenage years when it is 'normal' for adolescents to exhibit a range of challenging and discordant behaviours similar to those of ODD children.
ODD is therefore diagnosed because of the frequency, perseverence and severity of these behaviours. Diagnosis requires at least four of the eight behaviours identified above to be present for at least six months. Some behaviours may wax and wane depending on other factors affecting the child and their family but will tend to be consistent over time.
Risk Factors For ODD
ODD can be diagnosed on it's own but it also quite common for it to be co-morbid with other behavioual diagnoses. It is often diagnosed in children with ADHD and less frequently in children with Autistic Spectrum Disorder or other anxiety conditions. Evidence suggests that these conditions have a large degree of inheritability and likewise ODD has a high level genetic inheritability. However, a range of environmental factors also influence the likelihood of developing ODD. These include:
irritability and intense reactions to negative situations in toddlerhood
poor relationships with peers
social and economic disadvantage
poor reading of other's emotions particularly fear
housing in areas prone to crime and violence
inconsistent parenting and particularly poor attachment with one or more parents
ODD at home
Oppositional and defiant behaviour is most often directed at parents. It is not uncommon for children with ODD to be managing their behaviour in school settings whilst being incredibly challenging and difficult at home. This can be particularly so for girls in primary schools but also includes many boys with anxiety. As a result many parents find themselves struggling to manage their child without recognition by school professionals of their child's behavioural and emotional needs. For parents having a discussion with the family doctor is usually the most appropriate pathway to a clinician who can make a diagnosis.
Research suggests that parenting courses can be very supportive in helping parents develop a range of skills and attributes to better manage children with ODD. There is also advice and strategies available on the Managing ODD page.

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