Oppositional Defiant Disorder

What Does Oppositional Defiant Disorder Look Like in Children?

Symptoms of oppositional defiant disorder include regular temper tantrums, excessive arguments with adults, and uncooperative, deliberately annoying, or mean and spiteful behavior.

A little boy screams at the airport. He may need anger management for kids.
A little boy screams at the airport. He may need anger management for kids.

Oppositional defiant disorder (ODD) impacts anywhere between 1 and 16 percent of children and adolescents in the general population, however it is far more prevalent in patients with ADHD. The symptoms of ODD may look different in girls and boys, for whom the condition is more common. Boys with ODD tend to be more physically aggressive and have explosive anger while girls often lie, refuse to cooperate, and express symptoms in other indirect ways. ODD is usually diagnosed in childhood; some children outgrow the condition by age eight or nine.

Children with ODD thwart, obstruct, frustrate, demean, and resist anyone in a position of authority (parents, teachers, coaches, police, etc.). They purposefully bother and irritate others. Between ages two and three, and in the teen years, most children exhibit aggressive and irritating behavior from time to time. At least four of the following symptoms must be present consistently for six months or longer to merit an ODD diagnosis:

  • Loses temper
  • Argues with adults
  • Actively defies or refuses to comply with adults’ requests or rules
  • Deliberately annoys people
  • Blames others for his or her mistakes or misbehavior
  • Easily annoyed by others
  • Angry and resentful
  • Spiteful or vindictive

ODD manifests in two ways. The pediatric version is present from an early age, and can make a child very difficult to raise. The second type is adolescent-onset ODD, which makes once-loving children almost impossible to live with. Home and school become places of almost constant conflict.

Symptoms at Home

As the list of symptoms above demonstrates, symptoms of ODD in children can look a lot like certain symptoms of ADHD, anxiety, or hormonal moodiness. To determine whether your perpetually angry child may be showing signs of ODD, look for the following warning signs at home:

  • Your child throws huge tantrums when he gets home from school, and the consequences for acting out only make him more agitated.
  • Simple reminders, like to put socks in the hamper and not on the floor, trigger aggression or meltdowns.
  • Consequences don’t work, nor do they seem to have any impact on behavior. Your child just doesn’t take rules seriously.
  • You’re like a broken record. Your child hears, but ignores you over and over.
  • Your child tells little lies, even after you’ve stressed the importance of telling the truth.
  • Public tantrums in restaurants and check-out lines are keeping you and your family homebound.
  • It’s like your child is seeking conflict, purposely trying to ignite your anger.
  • Your child refuses to accept blame when he has done something wrong.

Symptoms at School

A child with ODD does more than just act out in class. He may have repeated meltdowns at school, and display aggressive behavior toward classmates or staff. Some signs of ODD at school include:

  • Your child was sent to the principal’s office (again) for shoving a classmate.
  • The teacher complains that he is throwing things in class again.
  • The teacher notes that your child is baiting classmates, picking fights with them by purposely doing things he knows annoy them.
  • When given detention for acting out, your child has an explosion so extreme she is sent home for the day.
  • Forget, “The dog ate it.” Your child has a new made-up story about his missing homework every day.
  • A reminder to pick up paintbrushes after art class triggered aggression with the art teacher.

Any child that shows symptoms of oppositional behavior needs appropriate treatment by a psychiatrist, psychologist, or therapist who is familiar with the disorder. Counseling should involve both the child and the parents, and focus on ways to cope with such behavior. If the child becomes dangerous to himself or others, hospitalization may be necessary.

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