Healthy Minds

Emotional Growth

Oppositional Defiant Disorder (ODD)

When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age.

Children with ODD are more likely to act oppositional or defiant around people they know well, such as caregivers, family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.

Signs and symptoms

  • Often being angry or losing one’s temper.
  • Often arguing with adults or refusing to comply with adults’ rules or requests.
  • Often resentful or spiteful.
  • Deliberately annoying others or becoming annoyed with others.
  • Often blaming other people for one’s own mistakes or misbehavior.


Some of the signs of behavior problems, such as not following rules in school, could be related to learning problems which may need additional intervention.

The first step is to talk with a healthcare provider. A comprehensive evaluation by a mental health professional is needed to get the right diagnosis.


For younger children, the treatment with the strongest evidence is behavior therapy training for parents, where a therapist helps the parent learn effective ways to strengthen the parent-child relationship and respond to the child’s behavior.

For school-age children and teens, an often-used effective treatment is a combination of training and therapy that includes the child, the family, and the school.

The Agency for Health Care Research and Quality (AHRQ) conducted a review in 2010 of all existing studies on treatment options for children younger than 6 years of age.

The review found enough evidence to recommend parent training in behavior therapy as a good treatment option for children under 6 with ADHD symptoms and for disruptive behavior, in general.

The review also identified four programs for parents of young children with ADHD that reduced symptoms and problem behaviors related to ADHD:

  • Triple P (Positive Parenting Program).
  • Incredible Years Parenting Program.
  • Parent-Child Interaction Therapy.
  • New Forest Parenting Program.