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Oppositional Defiant Disorder

How Common Is Oppositional Defiant Disorder?

Estimates suggest that 2%-16% of children and teens have ODD. In younger children, ODD is more common in boys. In older children, it occurs about equally in boys and in girls. It typically begins by age 8.

How Is Oppositional Defiant Disorder Diagnosed?

As with adults, mental illnesses in children are diagnosed based on signs and symptoms that suggest a particular illness like ODD. If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose ODD, the doctor may sometimes use tests such as neuroimaging studies or blood tests if they suspect that there may be a medical explanation for the behavior problems that occur. The doctor also will look for signs of other conditions that often occur along with ODD, such as ADHD and depression.

If the doctor cannot find a physical cause for the symptoms, he or she will likely refer the child to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses in children and teens. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental illness. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitude and behavior. The doctor often must rely on reports from the child's parents, teachers, and other adults because children often have trouble explaining their problems or understanding their symptoms.

How Is Oppositional Defiant Disorder Treated?

Treatment for ODD is determined based on many factors, including the child's age, the severity of symptoms, and the child's ability to participate in and tolerate specific therapies. Treatment usually consists of a combination of the following:

  • Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the child develop more effective coping and problem-solving skills, and ways to express and control anger. A type of therapy called cognitive-behavioral therapy aims to reshape the child's thinking (cognition) to improve behavior. Family therapy may be used to help improve family interactions and communication among family members. A specialized therapy technique called parent management training (PMT) teaches parents ways to positively alter their child's behavior.  Behavior management plans also often involve developing contracts between parent and child that identify rewards for positive behaviors and consequences (punishments) for negative behaviors.  
  • Medication: While there is no medication that is scientifically established or formally approved to treat ODD, drugs may sometimes be used to treat other mental illnesses that may be present, such as ADHD or depression.

 

What Is the Outlook for Children With Oppositional Defiant Disorder?

If your child is showing signs of ODD, it is very important that you seek care from a qualified mental health professional immediately. Without treatment, children with ODD may experience rejection by classmates and other peers because of their poor social skills and aggressive and annoying behavior. In addition, a child with ODD has a greater chance of developing a more serious behavioral disorder called conduct disorder. When started early, treatment is usually very effective.

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