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Oppositional defiant disorder

Summary

Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by constant disobedience and hostility. ODD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).

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Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by constant disobedience and hostility. Around one in 10 children under the age of 12 years are thought to have ODD, with boys outnumbering girls by two to one. ODD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).

Early intervention and treatment is important, since children with untreated ODD may continue to be difficult and antisocial into their adult years. This can impact on their relationships, career prospects and quality of life. Some children with ODD will develop the more serious conduct disorder (CD), which is characterised by aggressive law-breaking and violent behaviours.

Characteristics of ODD


ODD behaviours usually surface when the child is at primary school, but the disorder can be found in children as young as three years of age. Some of the behaviours of a child with ODD may include:
  • Is easily angered, annoyed or irritated
  • Has frequent temper tantrums
  • Argues frequently with adults, particularly the most familiar adults in their lives such as parents
  • Refuses to obey rules
  • Seems to deliberately try to annoy or aggravate others
  • Has low self-esteem
  • Has a low frustration threshold
  • Seeks to blame others for any misfortunes and misdeeds.

The link to conduct disorder


Without intervention and treatment, some children with ODD progress to develop conduct disorder (CD), which is characterised by aggressive and delinquent behaviours including:
  • Lying
  • Being sadistic or cruel to animals and people
  • Physically or sexually abusing others
  • Law-breaking behaviours like deliberately lighting fires, vandalism or stealing.

Family life is an important risk factor


The cause of disruptive behaviour disorders is unknown, but the quality of the child’s family life seems to be an important factor in the development of ODD. Some studies have found that certain environmental factors in the family increase the risk of disruptive behaviour disorders. These include:
  • Poor parenting skills (inadequate supervision, harsh or inconsistent discipline, rejection)
  • Marital conflict
  • Domestic violence
  • Physical abuse
  • Sexual abuse
  • Neglect
  • Poverty
  • Substance misuse by parents or carers.

Diagnosis


ODD is 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 for ODD contained in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.

Treatment


Treatment options may include:
  • Parental training – to help the parents to better manage and interact with their child, including behavioural techniques that reinforce good behaviour and discourage bad behaviour. This is the primary form of treatment and the most effective. Social support is increased if the parents are trained in groups with other parents who have children with ODD.
  • Functional family therapy – to teach all family members to communicate and problem solve more effectively.
  • Consistency of care – all carers of the child (including parents, grandparents, teachers, child care workers and so on) need to be consistent in the way they behave towards and manage the child.

Where to get help

  • Your doctor (for a referral to a specialised service)
  • Child psychologist (The Australian Clinical Psychology Association referral service)
  • Child psychiatrist
  • Paediatrician
  • Specialist Children’s Services, Department of Human Services Tel. (03) 9096 0000
  • The Resource Centre for Child Health and Safety (CHAS)Tel. (03) 9345 6429
  • Association for Children with a Disability Tel. (03) 9818 2000, rural callers free call on 1800 654 013

Things to remember

  • Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by constant disobedience and hostility.
  • The quality of parenting seems to be an important factor in the development of ODD.
  • Treatment options include parent management training and family therapy.
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Fact sheet currently being reviewed.
Last reviewed: May 2011

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Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by constant disobedience and hostility. ODD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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