Oppositional Defiant Disorder in Children: Symptoms, Causes, Treatment, Complications

Sometimes well-behaved children might become moody and argumentative, but if you notice in your child behavior the persistent pattern of rage, argumentative behavior, disobeying direct orders from you, and then it might be possible that your child is suffering from oppositional defiant disorder (ODD). Parents might think that only they have to deal with their child alone suffering from oppositional defiant disorder (ODD). But now a day’s child experts, doctors are available to help the parents. Oppositional defiant disorder (ODD) can be treated. The oppositional defiant disorder (ODD) child has to undergo therapies which involve interaction with family members. This would help the child to build better behavior skills and if needed certain medications can also be used to treat the disorder.

Oppositional Defiant Disorder in Children

What are the Symptoms of Oppositional Defiant Disorder (ODD) in Children?

Sometimes it is quite difficult to find any differences between a regular strong willed child and to that of an oppositional defiant disorder (ODD) child. Oppositional behavior is normal at certain stage of a child’s growth. Children, in their teenage years usually try to take control of the situation. All teens go through this phase at a certain age of time. However, a child suffering from oppositional defiant disorder (ODD) begins to show this behavior in their early teen years. This usually creates differences with family members, school friends. A Manual on mental conditions had been published by American Psychiatric Association entitled ‘The Diagnostic and Statistical Manual of Mental Disorder (DSM-5).’ This book is used by doctors to diagnose health condition of mentally ill patients. It is also used by insurance companies for verification purposes as well.

Following Symptom Criteria Listed for Diagnosing Oppositional Defiant Disorder (ODD) are Shown in DSM-5 which is as Follows:

  • Child suffering from oppositional defiant disorder (ODD) will show at least four of these symptoms mentioned. Angry and irritable mood; argumentative and defiant behavior towards others, vindictiveness.
  • Happens to at-least one person who is not a sibling
  • Will face significant problems in dealing with school work, home.
  • The problem usually lasts for a minimum of six months.

DSM-5 Symptom Criteria for Diagnosis of Oppositional Defiant Disorder (ODD) in Children Include both Emotional and Behavioral Symptoms

Both emotional and behavioral symptoms had been mentioned in DSM-5 which can catch if diagnoses are:

Angry and Irritable Mood:

  • Often gets agitated at very short note.
  • Opposes every authority
  • Is not at all cooperative

Argumentative and Defiant Behavior:

  • Generally argues with grownups, adults with authority.
  • Do not like to be controlled over any matter; do not follow guidelines and rules.
  • Refuses to comply with any sets of rules and regulations.
  • Usually blames others for their bad deeds.


  • The child is vindictive in nature
  • Child has shown vindictive nature or behavior at least twice in the last six months.

In order to understand parents that their child is suffering from oppositional defiant disorder (ODD), one of the possible ways to ensure that is; the child below age of five suffering from oppositional defiant disorder (ODD) will show these symptoms every now and then. However children above the age of five will show improper behavior at least twice in six months.

Children suffering from oppositional defiant disorder (ODD) will show rare severity in their behavior:

  • Mild: The Child suffering from ODD will show symptoms of oppositional defiant disorder only in some respective places such as homes or at schools.
  • Moderate: Child will show oppositional defiant disorder (ODD) symptoms at the places which they don’t like.
  • Severe: Some kids are likely to show symptoms at all places they go. This goes under severe category of oppositional defiant disorder (ODD).

It may be possible that symptoms of oppositional defiant disorder arise at some palaces but eventually he or she shows such symptoms at all place. This might be due to frustration or due to anxiety.

When to Visit a Specialist?

The children with oppositional defiant disorder (ODD) do not find their behavior offensive. Instead for them, they are being reasonable to others while other is trying to outgrow them. It is advisable to the parents to check the behavior and symptoms of oppositional defiant disorder (ODD) in children, and if they find any similarity in it with their kid’s behavior then it would be better to consult doctors. If you really care for your child’s offensive behavior then it would be better to consult doctors who might further refer you to some specialist in this case.

What Causes Oppositional Defiant Disorder in Children?

The specific cause of oppositional defiant disorder (ODD) is not known yet, but it is believed that several factors such as biological, environmental or genetic issues might be causing the oppositional defiant disorder (ODD).

  • Biological Causes: Some of the specialists suggest that there may be biological causes behind oppositional defiant disorder (ODD) behavior. Such as damage to brain in which usually brain cells are affected or other brain chemical or neurotransmitters are affected. Neurotransmitter helps in communication between various nerve cells. Damage to neurotransmitter may be a major reason for the cause of oppositional defiant disorder.
  • Environmental Causes: Various social issues such as abusive neighborhood, dysfunctional family may develop or contribute to oppositional defiant disorder.
  • Genetic Causes: Normally child suffering from oppositional defiant disorder (ODD) has someone in the family with mental disorder from which they are inherited with.

What are the Risk Factors of Oppositional Defiant Disorder in Children?

Possible risk factors which are related to oppositional defiant disorder (ODD) are:

  • Temperament: Child who has temperament issues find it difficult to cope up with surrounding. Frustration and anxiety are major problems faced by an oppositional defiant disorder (ODD) child.
  • Parenting issues: Lack of parental supervision, love and affection from family usually makes them harsh.
  • Other family issues: A child who lives with parent or family discord or has a parent with a mental health or substance use disorder. Families with history of mental illness are also a main risk factor as it would be inherited to next generation.

What are the Complications of Oppositional Defiant Disorder in Children?

Children with oppositional defiant disorder (ODD) can face problems with anyone whether it is parents, teachers, friends or siblings. This makes them difficult to maintain a relationship or friendship.

Complications of Oppositional Defiant Disorder (ODD) Include:

  • Low performance at schools or at work
  • Lead to anti-social activities.
  • Control problems over themselves.
  • Suicidal tendency

Many of the kids with oppositional defiant disorder (ODD) face other problems like metal disability such as:

Treating these other mental health conditions may help improve ODD symptoms. And it may be difficult to treat ODD if these other conditions are not evaluated and treated appropriately.

Tests to Diagnose Oppositional Defiant Disorder in Children

In order to determine the oppositional defiant disorder (ODD) various psychological evaluation tests will be conducted keeping the following aspects in mind:

  • The overall health conditions of your child.
  • Intensity of child’s attitude toward others.
  • Existence of other mental as well as learning disorder.

Associated Mental Health Conditions

It is very difficult to distinguish between the symptoms of oppositional defiant disorder (ODD) and other mental health problems. It is so because oppositional defiant disorder (ODD) usually occurs along with other mental disabilities. It is important for the parents to distinguish the other major problems because those disabilities will only worsen the effect of oppositional defiant disorder (ODD) on a child.

What are the Treatment Options for Oppositional Defiant Disorder in Children?

Treating oppositional defiant disorder (ODD) involves few steps in which both the child and parents have to take an active part. The treatment for oppositional defiant disorder in children can usually last for months. Basically, medications are not used in case of oppositional defiant disorder (ODD) but if the child is suffering from other mental diseases such as Attention Deficit Hyperactivity Disorder (ADHD) then the treatment would be done accordingly and use of medications would be allowed.

The treatment for oppositional defiant disorder child usually involves:

  • Parent Training: The specialist will help the parents to cope up with the frustration the parents face while managing their child. Parent training would allow having smooth conversion with their oppositional defiant disorder (ODD) children so that all the members of the family shared equal goals.
  • Parent Child Interaction Therapy (PCIT): The specialist would guide the parents in managing their children. In this way the parents will also understands the flaws in their parenting.
  • Individual & Family Therapy: Your child also might benefit from therapy that will help him or her learn how to interact more positively and effectively collaborate with peers.
  • Social Skill Training: Social training will help the child suffering from oppositional defiant disorder (ODD) to become more positive towards his society.

Parents need to be more precise about their instruction to their children. They should have full control over the consequences. Parents should be more polite towards their children’s behavior. They need to praise their children for good behavior.

However, it is not easy to consistently face the ignorance. But the parents need to work on their patience. Learning skill will require months of practice and dedication.

Most important part to parenting training is showing love and affection towards their child even if the child is not behaving properly.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:November 2, 2021

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