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Oppositional Defiant Disorder (ODD) is a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures. ODD is characterized by symptoms such as arguing with authorities, refusal to comply with requests, losing temper, irritability, externalizing blame for misbehavior, vengeful behavior, annoying and provocative behavior, and appearing angry and resentful. To qualify diagnostically, such behaviors must cause significant impairment and/or clearly interfere in a substantial way with the child's functioning at home or at school, given that many children will demonstrate "normal" patterns of resistance to comply with parental requests. For this reason, it is imperative that professionals evaluate children and parents, teachers, or other adults in their life, identify children as demonstrating clinically significant oppositionality, and a thorough assessment must be used to determine whether such behavior exceeds the duration, intensity, and frequency of behaviors typical for other children of similar age.

The primary complaint most parents express for children with ODD is that they typically do not follow through with a request, either quietly, defiantly, or argumentatively. These children are typically described as "pushing" for what they want, and not listening to or heeding parental or teacher's directions. For pre-school ages, ODD manifests in frequent, severe, temper tantrums and intolerance of frustration. Pre-schoolers often have extreme difficulty delaying gratification and often become extremely hostile and vocal when resisting. At older ages, tantrum behavior may persist, but oppositionality and defiance usually become more sophisticated in terms of "talking back", passive-aggressive refusal to follow parental requests, and destructive and aggressive behavior. Parents may feel held hostage by their child's threats or their behavior. Inconsistent discipline is the primary cause of children developing ODD related behavior patterns and parents who "give children what they want" are often a primary contributor, although parental psychological difficulties, including depression, substance abuse, and excessive anger or aggression toward children may also contribute.

For children with ADHD who also have a diagnosis of ODD, the cause of ODD is most often the result of the child's overactive discontrolled behaviors which does not receive sufficient limit setting and structure from parents, nor sufficient positive reinforcement for pro-social or desired behaviors when they are present. It is true that most "normal" parents are not equipped to deal with the level of behavioral challenge an ADHD child presents. Without exceptional parenting, firm limit setting, and much excessive praise and positive reinforcement for appropriate behavior, ADHD children often develop ODD.
OPPOSITIONAL DEFIANT DISORDER