Defiant Behavior in Children and Oppositional Defiant Disorder Diagnosis

By Jan Cheek, MSW, LCSW

Observing and experiencing defiant behavior in children is absolutely normal in certain circumstances as children tend to test limits and learn to express their frustration, resistance, and reluctance in doing things they do not want to do.  However, in the normal course of child development and in the typical establishment of hierarchical power and authority, children learn quickly to defer to regard and respect the wisdom and authority of their parents or adult leaders. This dynamic usually occurs through repetitive modeling of behaviors starting very early in life such that parents often feel more and more satisfied that as children get older they can simply be told about a rule and expected to follow it secondary to learned discipline and rewards and consequences from an early age.

All children tend to be oppositional or to defy rules as a normal course of growth and development. This is a typical part of learning how to test limits and express frustration.  Increased defiance is especially common through the toddler years and adolescent years particularly when fatigue and sleep disturbances are a factor, when there is increased stress and tension, and hunger or thirst. This typical defiance responds to parental intervention and discipline when consistent, and with predictable responses from authority figures to extinguish the negative behavior.

If oppositional and defiant behaviors of a child or teen become intense in nature, purposeful, hostile and cruel, violent and aggressive, actually directed toward parents and authority figures, and even pre-meditated, then there may be grave cause to be concerned about a diagnosis of Oppositional Defiant Disorder.  Other symptoms of ODD include the following:  rageful behavior, argumentative with people of all ages- but particularly adults, deliberately annoying to other people, easily annoyed and irritated by others, sometimes cruel to animals –particularly if the animal is well-loved by an adult or other family member, readily blames other people for his or her misdeeds, increasingly satisfied with creating chaos, frustration, and upset in situations.

It is estimated that about 5% of all children and adolescents meet criteria for Oppositional Defiant Disorder and about 40% of all children and adolescents who have Attention Deficit Hyperactivity Disorder (ADHD) also have ODD.  Having ODD causes a significant impairment in social, occupational, and academic functioning. Family functioning suffers tremendously.  Often parents are intent on teaching the defiant child the “right way” and the better way to manage a situation and do this by talking through and attempting to resolve disputes and focusing on the outcomes. However, the ultimate frustration is that the child or teen who has ODD has no interest in outcomes or resolutions. They are not reasonable or rational participants in an argument. They are participating in order simply to gain power in the process. Knowing that they can create anger and escalation with the other participants creates that “winning” scenario for the child or teen. They have no goal to participate in searching for outcomes or resolutions and thus the key for parenting through this is for parents and authority figures to understand the disorder so that patterns of oppositional behavior can be changed. 

It is critical to assess what the payoffs are in the relational system. It often takes a neutral and objective person to evaluate what the emotional trigger responses are that consistently give a child or teen with ODD the power they consider the “winning” edge.  While it is critical as well to determine what the effective love and nurturing messages are in the system and develop balance.  Intervention may also require psychiatric medication intervention to settle intense hostility and aggressive behaviors.

Behavioral Healthcare Associates, LLC is a comprehensive mental health practice with a double boarded child-adolescent/general psychiatrist along with several well-trained therapists able to assess exactly whether ODD is a diagnostic concern for your loved one, and if so, to make treatment recommendations. Please call 919-292-1464 to make an appointment or for more information…. Or review the website for additional information…..