What is oppositional defiant disorder (ODD) in children?

Oppositional defiant disorder (ODD) is a type of behavior disorder. It's mostly diagnosed in childhood. Children with ODD show a pattern of uncooperative, defiant, and hostile behaviour toward peers, parents, teachers, and other authority figures. They are more troubling to others than they are to themselves.

Oppositional Defiant Disorder (ODD) is a condition that is commonly seen in up to 50% of children and young people with ADHD.

What causes ODD in a child?

Experts don’t know what causes ODD. But there are 2 main theories for why it occurs:

• Developmental theory. This theory suggests that the problems start when children are toddlers. Children and teens with ODD may have had trouble learning to become independent from a parent or other main person to whom they were emotionally attached. Their behavior may be normal developmental issues that are lasting beyond the toddler years.

• Learning theory. This theory suggests that the negative symptoms of ODD are learned attitudes. They mirror the effects of negative reinforcement methods used by parents and others in power. The use of negative reinforcement increases the child’s ODD behaviors. That’s because these behaviors allow the child to get what they want: attention and reaction from parents or others.

What are the symptoms of ODD in a child?

Most symptoms seen in children and teens with ODD also happen at times in other children without it. This is very true for children around ages 2 or 3, or during the teen years. Many children tend to disobey, argue with parents, or defy authority. They may often behave this way when they are tired, hungry, or upset. But in children and teens with ODD, these symptoms happen more often and are more severe. They also interfere with learning and school adjustment. And in some cases, they disrupt the child’s relationships with others.

Symptoms of ODD may include:

• Having frequent temper tantrums

• Arguing a lot with adults

• Refusing to do what an adult asks

• Always questioning rules and refusing to follow rules

• Doing things to annoy or upset others, including adults

• Blaming others for the child’s own misbehaviors or mistakes

• Being easily annoyed by others

• Often having an angry attitude

• Speaking harshly or unkindly

• Seeking revenge or being vindictive

ODD can be mild, moderate, or severe:

• Mild ODD. The symptoms occur only in 1 setting (home or school).

• Moderate ODD. The symptoms are seen in at least 2 settings (home and school).

• Severe ODD. The symptoms occur in 3 or more settings (for instance at home or school, with peers, or in public).

Many of these symptoms can be caused by other mental health problems. Make sure your child sees a healthcare provider for a diagnosis.

Praise and Reward

Children who are oppositional respond well to positive behaviour reinforcement we can do this by offering them the chance to earn rewards by acting appropriately rather than taking the rewards away as a consequence.

Using a pom-pom or Lego brick token system are good ways to introduce a reward system. This is where each piece rewarded will gain a minute of reward time at a chosen time of day.

For younger children and children whom need frequent rewards having reward time before lunch then again before home time. The activity should be chosen by the child and should be something that is not always accessible. The tokens should be given discreetly by all staff involved in the child’s care and given whenever the child is on task and doing the right thing.

The tokens should not be taken away as a consequence, the child would simply not earn that extra token should they be displaying undesirable behaviour.

Although this might not come naturally, we should practice and avoid direct praise – this is because a child who is defiant, their instincts are often to do the opposite of what you say or ask. If the child is congratulated for working quietly, it could encourage them to start shouting out.

Instead, we should acknowledge their success and progress by providing them with quiet feedback using impartial measures of improvement for example, ‘your noise level today is level 1’ you can link this to a reward system.