Because ODD can look different at different ages of childhood, and because determining the severity and constancy of symptoms is so subjective, it's important to take a closer look at warning signs and how they play out in day-to-day life at home and at school. Pay attention to reports from teachers, after-school caregivers, and other adults in your child's life, as they can tell you more about how much your child's behavior is interfering with his ability to function, and can help a psychologist get a better picture of the child's symptoms.

Warning Signs in Young Children

It's difficult to ascribe defiant behavior to children under age three because, well, they call it “terrible twos” for a reason. Between ages three and six, your life might feel like the situations described below:

Zöe is a bright five-year-old who, at age two, took the initiative to learn numbers and letters, amazing her mom with her desire to learn. She's extremely gifted intellectually. Somewhere along the line, though, she has become increasingly “difficult,” which makes her mom worried because kindergarten is just a few months away and she wants her to start school off on the right foot. There is one situation in particular that her mother dreads because she knows it triggers an explosive outburst and all-out power struggle: getting ready for day camp in the morning.

The trigger in this situation is transition from one activity to another. It's also a useful time for Zöe to get her mom's undivided attention and see just how far she can push the limits. Can she make mom late for work? What will happen if she doesn't get ready to go on time — will she get to stay home?

It's a warm summer morning, and Zöe's mom Melanie has an important meeting at work after she drops Zöe off at day camp. “Zöe, remember that today's swim day at day camp! Don't forget to pack your bathing suit and towel,” she reminds her cheerfully. Zöe loves swimming, but Melanie's cheerfulness is a thin veneer over a feeling of dread because this is how the daily power struggle begins. Zöe scowls, but other than that, she doesn't seem to have heard. She's eating breakfast in her pajamas at a snail's pace as Melanie packs them both lunch while eating her own breakfast with one hand. A few minutes later, Melanie says, “Zöe, finish your breakfast and get your bathing suit right now, or you're going to be in big trouble.” Zöe then says she doesn't want to go to camp, and Melanie responds by saying she doesn't have a choice, and if she's not ready to go in seven minutes, she'll have no TV for a week. Zöe responds to this by yelling, “I hate you!” She then dumps her cereal on the floor and stalks off to her room, pausing to knock over a vase of dried flowers in the living room on the way.

Warning Signs in School-Aged Children

Connor is a fourth-grade student who has ADHD and has always had trouble in school. His parents have helped him through it and given him strategies to do better, and Connor has stopped taking Ritalin. However, Connor's teacher has called his parents into the school a half-dozen times this year to discuss his disruptive behaviors, which are more than just the typical ADHD behaviors like trouble sitting still or careless inattention to tasks.

Today, his teacher tells Connor's parents that Connor has become aggressive, kicking a playground monitor who told him his turn on the monkey bars was over. He has also picked up some new swear words that he's used toward the teacher or other kids who protest his disruptive behaviors, and deliberately let the classroom mouse out of its cage during quiet reading time.

Other kids are disdainful or fearful of him, and the teacher sounds and looks fed up. Connor's parents don't know what to say — he's started being aggressive at home, too. None of this was in the ADHD materials the child psychologist gave them two years ago when she first diagnosed him.

Warning Signs in Teens

Max has lived with his dad and his dad's girlfriend for the past seven years. Like his dad, he has always been considered terse and grumpy, and his dad's girlfriend is usually sort of afraid of him, though both adults try to include him in their meals and entertainment. Now that he's sixteen, he has a driver's license and resists being at their home at all. It's getting harder and harder to account for his whereabouts, and the adults worry he has warning signs of every teenage problem in the book: delinquency, bad grades, alcohol and drug use, sexual activity, and a general “attitude problem.” Detention and even suspension are becoming a habit, with Max regularly mouthing off to teachers at school.

Whatever attempts at normalcy and structure they've tried to give him, it all falls apart the day Max is booked at the police station for throwing a rock at a police car. There's no denying that he's crossed a line from normal teenage defiance into crime, and what's worse is that Max shows no remorse, nonchalantly excusing his behavior by reasoning that the cop shouldn't have been staring at him.