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Oppositional Defiant Disorder in Children

  • Oppositional defiant disorder (ODD) is one of the commonly diagnosed disruptive behavior disorders of a group of behavioral problems in children and adolescents. While challenging behaviors are the hallmark of all of these disorders, ODD is specifically characterized by frequent episodes of anger, deliberately irritating or hostile behavior and a pronounced intolerance for authority.

    The term “oppositional” literally means actions that are in opposition to rules and norms for socially acceptable behavior. Children with ODD typically have a persistent pattern of irritable, angry outbursts, arguments and disobedience. While this behavior is usually directed at authority figures like parents and teachers, it can also target siblings, classmates and other children.

    ODD is a relatively common problem, and with the right care, it can be treated with a great degree of success. The key to successfully “nipping problem behaviors in the bud” is stopping the sequence of events that leads to these behaviors as early as possible. If the pattern of behavior is detected, halted and treated, the problem behaviors are likely to decrease.

    How Boston Children’s Hospital approaches oppositional defiant disorder

    Boston Children’s has a long history of pioneering important advances in behavioral and mental health for children, adolescents and families. Our Department of Psychiatry clinicians are committed to evidence-based treatments—therapies that have been tested and proven effective through careful scientific analysis, both here at our hospital and at other top health centers around the world.

    At the same time, we practice medicine that’s patient-focused and family-centered. We never lose sight of the fact that your child is, first and foremost, an individual—not merely a patient—and we include your family at every stage of the treatment process.

    Here at Boston Children’s, our clinicians use several techniques to treat oppositional defiant disorder, including:

    • first clarifying if there are other co-existing underlying disorders
    • parenting modification strategies
    • social and emotional skills training for children
    • in some cases, the addition of medication to the therapy plan

    Working with your clinician, you can make a difference for your child by learning and using new:

    • communication skills
    • parenting skills
    • conflict resolution skills
    • anger management skills


    Oppositional defiant disorder: Reviewed by David R. DeMaso, MD
    © Boston Children’s Hospital, 2012

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO