I believe my child is showing signs of oppositional defiant disorder (ODD) – How can I get them the help they need?

Note: NAMI volunteers are not medical or mental health professionals, and we cannot offer medical or mental health advice.  The material outlined below is informational and we hope that it helps provide guidance toward getting support.

Oppositional Defiant Disorder (ODD) is a behavior disorder found in children. Children who live with ODD display defiant and hostile behavior towards authority figures such as parents, teachers, and older siblings.  

Signs of ODD usually present themselves before a child is eight years old and typically begin when a child is two to three years of age. While symptoms of ODD in children start earlier in childhood, the symptoms can continue well into the child’s teenage years. Generally, boys are more likely to receive an ODD diagnosis than girls.   

While children tend to fight, argue, and disobey their parents, children with ODD will display this behavior repeatedly.  Symptoms of ODD include:   

• Arguing with authority figures. 
• Purposefully disobeying authority figures. 
• Frequent anger and irritability.  
• Losing their temper easily.  
• Acting retaliatory and hurtful. 
• Blaming others for their behavior. 

If a child is displaying signs of ODD, a mental health care professional or child psychiatrist can make a diagnosis. They will observe the child’s behavior and speak with the child’s parents and teachers to learn more about the situation. A mental health professional will look to see if the behavior negatively impacts the child’s education and social life, and if the behavior is related to drug use or an unrelated mental health condition.   

To be diagnosed with ODD, a child must show:   

• Repeated anger and irritability. 
• Repeated argumentative and defiant behavior. 
• Symptoms that last a minimum of six months.   

Therapy is the most common form of treatment for ODD, with certain medications occasionally being prescribed to help with treatment. Different forms of therapy such as cognitive-behavioral therapy, parent-child interaction therapy, Parent Management Training – Oregon Model (PMTO), and family therapy can help children with ODD. Most therapy is aimed at improving communication and understanding between the parent and child.  

Some studies have linked oppositional, defiant behaviors in children to a previous history of trauma. Trauma can significantly impact a person’s ability to regulate emotions and control their impulses. If your child has been exposed to traumatic situations in the past, you may wish to speak with their mental health provider about whether trauma-focused interventions could help treat the symptoms of ODD they experience. 

Although there is not a medication strictly for ODD, medications can be used for children who display both symptoms of ODD and ADHD, depression, anxiety, and other related conditions.  Children who live with mood or anxiety disorders are more likely to have ODD. Children with ADHD and conduct disorders are also more likely to receive a diagnosis. 

The following, additional resources may be of help:

• NAMI Basics OnDemand is an education program for parents, caregivers and other family members who provide care for youth (ages 22 and younger) who are experiencing mental health symptoms. This program is free to participants, self-paced and available 24/7. Register online today.   
• NAMI's Book You are Not Alone for Parents and Caregivers has a chapter on "Living with the Child Who Is Angry, Defiant or Disruptive" that describes how emotional dysregulation shows up in children with different mental health conditions. The authors offer suggestions and a helpful model (regulate, relate, reason, and reframe) for empowering children to learn skills that promote critical thinking and emotion regulation. 
• American Academy of Child and Adolescent Psychiatry (ODD Resource Center) provides information and resources for families and youth on ODD. The website includes a child and adolescent psychiatrist finder.  
• Child Mind Institute (section on ODD) offers info about children’s mental health issues for parents and educators, including a symptom checker for a wide range of disorders. You can contact Child Mind Institute at (212) 308-3118.  
• VeryWell Mind has a website that contains an informative section on ODD, providing information and links to resources on the condition, treatment options, what to do after diagnosis, preparing your child for school, encouraging responsible behavior, and enforcing consequences when a child with ODD engages in disruptive or harmful behavior. 
• Oppositional Defiant Disorder Online Support Group is a website operated by DailyStrength, a division of Sharecare that serves as a social network where users provide one another with emotional support. The site contains 500+ online communities that deal with different medical conditions or life challenges and includes a group specific to ODD that can be accessed here.  

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