ODD is a common childhood and teen problem. Children with ODD are repeatedly disobedient and hostile for 6 months or more. The problem behaviors are more frequent and worse than typical for the child's age and sex.
If a child's behavior has worsened (for example, dangerous anger or violence, destroying property, and stealing) for a year or more, the problem may be a more serious condition called conduct disorder.
The exact causes of ODD are not fully understood. It tends to run in families, but home environment and parenting also have an effect. ODD may occur in children from any background, but it is more common in children with a parent who:
ODD usually starts in the late preschool years or the early teenage years. It may start at any age. Young children who are very irritable (for example, very colicky babies) often develop ODD. Children with attention deficit/hyperactivity disorder (ADHD), speech and language problems, or school problems are also at greater risk of having ODD.
In young children, ODD is more common in boys. It is equally common in teenage boys and girls. From 2% to 15% of children ages 3 to 18 develop ODD at some time in their childhood. Most have a mild form of the disorder.
A child behaves this way for at least 6 months:
There are no medical tests for ODD. A therapist or healthcare provider will ask about your child's symptoms and how long your child has been behaving this way.
If behaviors like the ones listed are a reaction to a recent event such as child abuse or divorce, the diagnosis may be adjustment disorder with disturbance of conduct instead of ODD. If stealing, vandalism, or assault goes on for a year or more, the child may have conduct disorder.
The best treatment is good child management by parents, teachers, and daycare providers. ODD children need very firm limits with clear rules, consistent results, and immediate rewards for good behavior.
Be calm during discipline. Since these children seek to annoy, if you become angry and yell, it may increase how often they misbehave. Severe punishments do not help the problem, but instead seem to make it worse.
Talking with a child therapist is helpful.
Medicines are not useful with simple ODD. Medicines do help when ODD exists with attention deficit/hyperactivity disorder (ADHD) or mood problems, such as childhood depression or bipolar disorder. Your healthcare provider or therapist will select the best treatment.
With good child management by adults, many children grow out of ODD. The most common times for major improvements are before the teenage years or in young adulthood.
In some children the condition worsens into conduct disorder by late childhood or teenage years.
The main things to do are:
If severe behavior problems have lasted more than a few months, talk with your child's healthcare provider or a mental health therapist. They can help you learn if your child has ADHD, a mood problem, or some other childhood problem.