Oppositional Defiant Children Vs. Strong Willed Children

All children are at least occasionally oppositional and defiant. It's a normal part of development. Those who act these ways may be considered strong-willed, especially during developmental phases of asserting opinions and independence; toddlers, preschoolers and teens typically display these behaviors actively. Then, somewhere between 1 to 16 percent of children have oppositional defiant disorder, or ODD, according to the American Academy of Child and Adolescent Psychiatry. Distinguishing between a strong-willed child and one with ODD can be difficult.

  1. Symptoms of ODD

    • Some symptoms of oppositional defiant disorder also manifest in all children, particularly in strong-willed individuals and those going through certain developmental phases. Other symptoms are a bit more extreme, and are mostly seen in children with ODD and other behavioral or psychological problems. Common symptoms of ODD include frequent tantrums, anger or resentment toward others, excessive arguing with others and especially adults, constant questioning of rules and decisions, active defiance, attempts to aggravate or upset people, blaming other people for mistakes, excessive irritability, frequent use of obscenities, profound negativity, spitefulness and seeking revenge, as well as a tendency to become hateful or mean-spirited when upset. Behaviors occur most often at home and school, aimed primarily at authority figures. Children with ODD don't generally consider themselves oppositional or defiant; rather, they believe they are fairly resisting unfair demands.

    Diagnosing ODD

    • Because it's often hard to tell the difference between a strong-willed child and one with oppositional defiant disorder, diagnosis must be made by a psychologist or psychiatrist. These trained professionals determine whether a child meets the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders. As with any psychological condition, there aren't any blood panels, imaging techniques or other tests to offer a conclusive and objective diagnosis. For an ODD diagnosis to be made, symptoms must be persistently present for at least six months and cause clear disruptions to home and school life. Diagnosis usually also depends in part on exclusion of other possible causes of the problem behaviors.

    Other Conditions

    • Various mental disorders and psychological conditions can present with symptoms similar to those of oppositional defiant disorder. These must be considered during the diagnostic phase, since correct diagnosis obviously influences the treatment approach. Many children with ODD suffer from one or more of these conditions in addition to the ODD, though, rather than instead of it. Other conditions that mimic ODD or commonly appear in conjunction with it include attention deficit hyperactivity disorder (ADHD), anxiety disorders, bipolar disorder, depression, learning disabilities, obsessive-compulsive disorder (OCD) and drug or alcohol addiction.

    Treatment of ODD

    • While strong-willed children can certainly face negative effects of their behavior when it causes strife in interpersonal relationships, those with oppositional defiant disorder experience frequent, chronic disruptions in most of their relationships, in and out of the home, that interfere with daily life. Because their behavior stems from a mental disorder, children with ODD don't respond to standard disciplinary actions or positive reinforcement of desirable behaviors like strong-willed or merely misbehaving children do. Treatment can be quite difficult and slow to show results. It may include individual psychotherapy, family therapy and medication. Parents must also learn coping and management techniques.

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