It may be difficult at times to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's normal to exhibit oppositional behavior at certain stages of a child's development. But there is a range between the usual independence-seeking behavior of children and that of oppositional defiant disorder.

Signs of ODD generally begin before a child is 8 years old. Sometimes ODD may develop later, but almost always before the early teen years. When ODD behavior develops, the signs tend to begin gradually and then worsen over months or years.

Your child may be displaying signs of ODD instead of normal moodiness if the behaviors:

  • Are persistent
  • Have lasted at least six months
  • Are clearly disruptive to the family and home or school environment

The following are behaviors associated with ODD:

  • Negativity
  • Defiance
  • Disobedience
  • Hostility directed toward authority figures

These behaviors might cause your child to regularly and consistently:

  • Have temper tantrums
  • Be argumentative with adults
  • Refuse to comply with adult requests or rules
  • Annoy other people deliberately
  • Blames others for mistakes or misbehavior
  • Acts touchy and is easily annoyed
  • Feel anger and resentment
  • Be spiteful or vindictive
  • Act aggressively toward peers
  • Have difficulty maintaining friendships
  • Have academic problems
  • Feel a lack of self-esteem

In addition, your child isn't likely to see his or her behavior as defiant. Instead, your child will probably believe that unreasonable demands are being placed on him or her.

Related mental health issues

Oppositional defiant disorder often occurs along with other behavioral or mental health problems such as:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Anxiety
  • Depression

The symptoms of ODD may be difficult to distinguish from those of other behavioral or mental health problems.

It's important to diagnose and treat any co-occurring illnesses because they can create or worsen irritability and defiance if left untreated. Additionally, it's important to identify and treat any related substance abuse and dependence. Substance abuse and dependence in children may be associated with irritability and changes in the child's usual personality.

When to see a doctor

If you're concerned about your child's behavior or your own ability to parent a challenging child, seek help from your doctor, a child psychologist or child behavioral expert. Your primary care doctor or your child's pediatrician can refer you to someone who is appropriate.

The earlier this disorder can be managed, the better. Treatment can help restore your child's self-esteem and rebuild a positive relationship between you and your child. Your child's relationships with other important adults in his or her life — such as teachers, clergy and care providers — also will benefit from early treatment.

Jan. 06, 2012