Emerging in the preschool years and before adolescence, Oppositional Defiant Disorder (ODD) triggers particular behavioural responses in children, generally disproportionate to the situation. Ranging from mild to severe depending on how many contexts it appears in, it’s rarely isolated and is often associated with another condition or disorder, such as ADHD (Attention Deficit Hyperactivity Disorder).
What is Oppositional Defiant Disorder (ODD)?
Children with ODD display a pattern of defiant, angry and resentful behaviour that shows up persistently and frequently. In practice, this can take the form of active opposition (flatly refusing, without regard for requests or instructions), passive opposition (apparent agreement, even if the request is then deliberately ignored), and passive-aggressive opposition (apparent agreement, but behaviour showing the opposite).
Whatever form ODD takes, the opposition itself is spontaneous and impulsive, whereas the defiant behaviour is calculated.
Diagnostic keys: frequency and persistence
In the preschool years and before adolescence, children go through periods of opposition linked to normal development. During childhood, these help build the child’s individuality, but generally end around age 5. In adolescence, they assert the child’s position as a thinking individual with their own opinions and views.
To tell these normal (and necessary) instances of opposition apart from ODD, frequency and persistence play a key role: diagnostic criteria estimate that these behaviours need to occur, for at least 6 months, daily before age 5, and at least once a week beyond that age.
At the same time, the diagnosis needs to be supported by a broader pattern of behaviour and mood that has a noticeable impact on the individual or those around them, whether family, social, school, or professional.
Almost one in two children with ADHD also has ODD
Rarely isolated, ODD is associated with ADHD in 40% to 50% of cases. In other words, almost one in two children with ADHD also has ODD. ADHD manifests in extremely varied ways from one child to another: one symptom, inattention, hyperactivity, or impulsivity, may dominate or even be completely absent, which can make diagnosis difficult. But a child with ADHD driven by impulsivity may overreact in certain situations, bringing these symptoms closer to what might look like ODD.
That said, it’s important to understand the difference between the two disorders: children with ADHD have a dysfunction that stops them responding appropriately to a situation. Driven by their impulsive tendencies, they act without weighing up the consequences of their words or actions. But unlike children with ODD, who will deny responsibility and blame others, children with ADHD will feel sorry and accept the consequences.
Faced with ODD and/or ADHD, it’s strongly recommended to consult a specialised psychologist to better support these behaviours. As a parent, this professional can also help you understand them better and support your child day to day.
