Defiant Children—Disorder or Not?

November 28, 2024

A teenage girl sits with her parents. — By Monstera Production from Pexels

By Anatta Zarchi

Rebellious, defiant behaviors are normal in children and adolescents to a certain extent. I know I used to be very defiant towards authority figures when I was younger! However, defiant behavior may reach a point where it becomes difficult for parents to manage and may also affect the child’s relationships and ability to function in certain environments or circumstances.

Oppositional defiant disorder (ODD) is exactly what it sounds like. It is characterized by angry, hostile moods and defiant behaviors in children. Here a gray area emerges—many children tend to be defiant or have stages when they are very defiant, so what is classified as a disorder and what is not? And more importantly, at what stage should you seek professional support for yourself or your child?

Recognising ODD

Let’s look at some of the facts to make a little more sense of this. ODD is characterized by a pattern of rebellious and hostile behavior towards adults, authority figures, or other people in the child’s life. It typically develops around six to eight years old and is more common in boys than girls. ODD can range from mild to severe—some children might only exhibit these behaviors in specific environments or with specific people, while others may exhibit them constantly.

As with all mental health conditions and struggles, symptoms need to be present for a certain amount of time in order for it to be classified as a disorder. The DSM-5, which is the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders”, states that there must be at least six months of angry, hostile, argumentative, and defiant moods and behaviors in order to fit the criteria for ODD. The persistence, intensity, and frequency of diagnostics vary for each age group. For example, the criteria for children younger than five would be exhibiting these behaviors on most days for at least six months. For children older than five, the criteria is at least once a week for at least six months. Other criteria, such as environmental and cultural factors, should also be taken into consideration. The DSM-5 is linked at the end of this article, for anyone interested in taking a closer look.

Causes of ODD

So what causes ODD? No definite causes have yet been determined, though there are two main theories:

Developmental theory: the child develops ODD due to struggles with becoming independent from their parents or main caretaker.
Learning/environmental theory: behaviors that correspond with ODD are either learned from parents and caretakers, or from the child’s environment. They could also be a reaction to negative reinforcement, negligence, abuse, authoritarian parenting, and so on.

Another possible cause may be genetics—a child’s natural temperament could make them more susceptible to angry moods and defiant behaviors. ODD tends to present alongside ADHD and other mood, anxiety, and conduct disorders, meaning that behaviors associated with ODD are often related to other mental health struggles.

Supporting children with defiant behaviors

The counselors at New Counseling Service (NCS) want to emphasize that labeling should not be the main priority, and that just because a child exhibits these behaviors does not necessarily mean they have ODD. What matters is that the child is given the support they need and that parents have the tools to assist them, as well as getting support for themselves.

NCS counselors Dave and Savinee tell us that they have worked with many children who exhibit ODD behaviors, but that very few people are diagnosed with it in Thailand. A child does not need to have an ODD diagnosis to get professional support; as long as you feel that something is out of the scope of your ability to handle, or that your child might benefit from additional support, seeking help is always an option and always OK. Defiant behavior could be a result of many things, and it could be beneficial for the child to unpack that regardless of any labels or diagnoses.

Below are some therapeutic modalities that are often used to treat ODD or related behaviors:

Cognitive behavioral therapy (CBT) helps the child learn how to control impulsive, angry, or hostile behaviors and regulate their emotions and how they respond to others.
Family therapy: if parents or caretaker(s) are the main target of the child’s hostile and defiant behaviors, family therapy could help the child learn how to communicate effectively with their family.
Group therapy: if the child’s hostile and defiant behaviors are mostly directed at their peers, group therapy could help the child learn how to interact with others.
Medication is not used to treat ODD, but it could be used if the child also has ADHD, anxiety, or other mood disorders in which medication is helpful.

Effective methods also depend on a variety of factors such as age and specific behaviors and circumstances.

You might be wondering—do these defiant behaviors usually go away? The answer is yes. Most behaviors associated with ODD are resolved within a few years, as these behaviors are common and expected in children and adolescents. However, they could persist in some cases, mostly where ODD behaviors are correlated with other mood or conduct disorders. It isn’t always possible to tell whether something will go away on its own or how long it will take, so as long as you feel that your child would benefit from external support, therapy is always an option.

As the current hypothesis is that defiant behaviors are a result of developmental or environmental factors, there are things you can practice at home to help your children cope with and regulate their emotions. Setting a healthy example of anger management, speaking to them calmly, and immersing them in a positive and loving environment is always a good idea. Remember that each child is unique and has unique circumstances, so the same thing might not work for every child.

Finally, I want to emphasize once more that defiant behaviors do not necessarily mean that a child has ODD; the focus is best placed on methods of support rather than labeling.

About the Author

Anna works for New Counseling Service (NCS), the first and only licensed mental health center in the heart of Bangkok. NCS has provided counseling services in Thailand and surrounding regions for over 20 years, with therapists specializing in a wide variety of issues such as anxiety, depression, work stress, relationships, and more.

Contact: info@ncsbkk.com; Phone: +66-2-114-7556; ncsbkk.com; FB/IG: @ncsbkk.

Recognising ODD

Causes of ODD

Supporting children with defiant behaviors

Further Reading

About the Author