What Is ODD?
An increasingly common behavioral disorder in children, ODD affects between 1 and 6 percent of children today. Before puberty, it's more common in boys, but after puberty it affects boys and girls at about the same rate, though you'll see that there is some discussion about how it affects the genders and ages differently.
Clinical Definition of ODD
According to the official diagnostic manual of the American Psychiatric Association (APA), a diagnosis of ODD can be made when a child frequently exhibits a pattern of four or more of the following behaviors for six months or more:
Loss of temper
Arguments with adults
Active defiance of rules and requests
Blaming of others for misbehavior
Being deliberately annoying toward others, as well as being easily annoyed by others
Oppositional defiance disorder develops gradually, over a period of a few months or even years. Frequency, duration, and severity of the behaviors are all key in making a diagnosis of ODD; however, a diagnosis of ODD cannot be made if the child's symptoms point to conduct disorder. A diagnosis of ODD can be made if your child has attention deficit disorder or attention-deficit/hyperactivity disorder.
ODD versus Defiance: What's the Difference?
There's more of a continuum between run-of-the-mill defiance and behavior that warrants a diagnosis and treatment, than there is a clear dividing line. Because describing behaviors is largely subjunctive, and because they can vary in severity from one day to the next, it's hard for even the researchers at the APA to measure them. Largely, deciding whether a behavior occurs “often” or is “extremely” annoying instead of “moderately annoying” is up to you.
And that's important, because you and the rest of your family are the ones suffering every day, along with your defiant child. A therapist treating a child with ODD (and supporting the parents) will rely primarily on your reports of your child's behavior. If your child's behavior has you at your wit's end, and you or others in the house live in fear of the child or avoid him, it's likely that the behaviors are severe and frequent, as the criteria stipulate. Also, if your child is frequently in trouble with law enforcement or school authorities, or if his behaviors result in diminished school performance, loss of friends, or deterioration of family relationships, it's likely those behaviors are severe and frequent.
Kids with ODD can get worse without professional intervention. This does not mean that your child is crazy or needs to be removed from your care, but it does mean that undertaking new parenting strategies is even more crucial, and those new strategies won't work on their own — you will need to seek treatment and support from a professional, like a licensed professional psychologist, psychiatrist, or Marriage and Family Therapist (MFT). It also means that your family is probably experiencing severe disruptions and that the parents and other siblings could likely benefit from the support, structure, and perspective that therapy can offer.
Kids who are violent or could become violent need immediate professional help. If you find yourself wondering if your child would intentionally harm someone, or you hear your child threaten to do so or see your child hurting animals, find a therapist immediately and tell her about this observation in your first conversation.
Some parents may dread the label that ODD or another disorder puts on their child, and could delay seeking a diagnosis because of their fear of what it might mean for their child's future. It's important to be aware of your fears and treat them as valid — you love your child and don't want him labeled with a behavioral disorder on top of everything else your family is dealing with right now. However, it's important to realize that your child's behaviors already are what they are, and a diagnosis doesn't cause a disorder. In fact, a diagnosis may even provide some relief for you by validating your feelings of stress — if your child has ODD, it makes sense that you would be at the end of your rope with him, and you shouldn't feel guilty or that you're a bad parent if you're on edge all the time.