The symptoms of oppositional defiant disorder (ODD) are all considered normal behaviors for children, especially toddlers and teenagers. This makes ODD difficult to define and diagnose. The key is the intensity and duration of the symptoms. For example, whereas a normal toddler may kick and scream about some perceived injustice for several minutes, an ODD child may continue such behavior for several grueling hours. And whereas a normal teenager may periodically enjoy annoying his or her younger siblings, the ODD teen will disrupt an entire classroom to the point that his actions result in expulsion.
According to the American Academy of Family Physicians, ODD refers to a recurrent pattern of developmentally inappropriate, negativistic, defiant and disobedient behavior toward authority figures beginning in childhood or adolescence [source: American Academy of Family Physicians]. Specific symptoms of ODD may include:
- Being "touchy" or quick to lose one's temper
- Being argumentative with authority figures
- Refusal to comply with requests or rules
- Deliberately annoying people
- Blaming others for one's own mistakes or misbehavior
- Vindictiveness, spitefulness and having a tendency to seek revenge
For a diagnosis of ODD, a child must display these symptoms for at least six months. The symptoms must also be present in multiple settings -- say at home and at school -- and the child must show some degree of impairment. For example, the symptoms may be affecting the child's health or ability to learn. Moreover, a diagnosis of ODD requires that other potential causes of the symptoms, such as a psychotic or mood disorder, be ruled out [source: American Academy of Family Physicians].
Parents, teachers or other authority figures initially identify most children who are suffering from ODD. However, an actual ODD diagnosis requires an evaluation by a psychiatrist or mental health professional. An ODD diagnosis is usually made based on a series of behavioral and psychological tests as well as input from parents, teachers and members of the child's extended family. In many cases, children suspected of having ODD can be reliably screened during the preschool years [source: Keenan].
ODD can be difficult to distinguish from several other behavioral disorders, including depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). In the next section, we'll compare ODD with these and other pediatric mental health conditions.