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Children who show defiant, hostile and negative behaviour towards adults and other children over an extended period of time could have defiant disorder. Here we explain what it is and how to get help.

What is defiant disorder?

Defiant disorder, also known as Oppositional Defiant Disorder (ODD), is a behavioural disorder usually diagnosed in childhood. Children with ODD exhibit a pattern of defiant, hostile and negative behaviour towards adults and other children over an extended period of time. This behaviour is different from a child’s normal testing of limits, and is more intense and frequent.

What are the symptoms of defiance syndrome?

The symptoms of defiant disorder can vary from child-to-child but often include a pattern of negative, defiant and hostile behaviour. Here are some common symptoms:

  • Frequent tantrums: Intense outbursts of anger and frustration.
  • Arguing with adults: Questioning of rules or instructions, and prone to arguing.
  • Deliberately annoying behaviour: Deliberate attempts to try to annoy others.
  • Defying rules and instructions: Refusal to follow rules, ignoring of adult requests and instructions.
  • Blaming others: Blaming others for their mistakes or bad behaviour.
  • Easily irritated: Easily irritated by others.
  • Frequently angry or resentful: Frequent anger or resentfulness.
  • Revengeful: Vindictiveness or preoccupation with thoughts of revenge.

These symptoms must be present for at least six months for a diagnosis to be made. It is important to note that all children may exhibit some of these behaviours at different times, but for children with ODD they are intense and frequent, significantly affecting their daily functioning and social relationships.

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Defiance syndrome at different ages

ODD affects children and adolescents differently depending on their age. In young children, ODD can manifest itself as intense anger and resistance to routines. As children reach preschool age, the symptoms become more pronounced, with direct challenges to rules and difficulties in social settings. At school, this behaviour can lead to academic and social problems. Adolescents often engage in risky behaviour and conflict with authority figures. Early intervention, with strategies such as parent education and behavioural therapy, is essential for management, to support the child’s development and promote positive social interactions. Collaboration between family, school and professionals is central to effectively supporting children with defiant disorder.

Defiant disorder and neuropsychiatric problems

ODD can often coexist with other neuropsychiatric conditions such as ADHD and Autism Spectrum Disorder (ASD). These diagnoses can amplify each other’s symptoms and make treatment more complex. As an example, the impulsivity of ADHD may be intensified by the defiant behaviours, while communication difficulties in ASD may express themselves as defiance syndrome.

Integrated treatment plans that combine behavioural therapy, medical treatment and personalised support are essential to manage these complex cases. To provide effective treatment and support for children with ASD and co-occurring neuropsychiatric conditions, parent education and family therapy play a central role.


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Treatment of defiant disorder

Treatment for ODD focuses on improving the child’s social skills, emotional regulation, and reducing challenging behaviours. This is achieved through a combination of treatment methods. Behavioural therapy and parenting support play a central role, with parents learning effective strategies to manage behavioural problems at home. Cognitive behavioural therapy (CBT) is used to help the child identify and change negative thought patterns, while social skills training focuses on developing adequate ways to interact with others.

Family therapy is important for improving communication within the family and resolving conflicts, to strengthen the parent-child relationship. School-based interventions, including adjustments to the school environment, support the child’s learning and social interaction. Although there is no specific medication for defiant disorder, medication can be considered to manage concurrent symptoms related to conditions such as ADHD.

A multimodal treatment approach, combining these methods, is often recommended to address defiant disorder. It involves close collaboration between the family, school staff and health professionals to create an individualised treatment plan. Early intervention is important to reduce ODD and support the child’s development over time.


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12 frequently asked questions about defiant disorder

What is defiant disorder?

Defiant disorder, also known as Oppositional Defiant Disorder (ODD), is a behavioural disorder usually diagnosed in childhood. Children with ODD exhibit a pattern of defiant, hostile, and negative behaviour towards adults and other children over an extended time.

What are the symptoms of defiant disorder?

Defiant disorder is characteried by persistent defiance, hostility, and negative behaviour towards authority figures, which differs from normal behaviour in its intensity and duration. Symptoms include anger outbursts, argumentation, defiance of rules, and a tendency to annoy others. Symptoms should be present for at least six months for a diagnosis.

How does defiant disorder differ at different ages?

In young children, defiant disorder can manifest as intense anger and resistance to routines. As children reach preschool age, the symptoms become more pronounced, with direct challenges to rules and difficulties in social settings. At school age, these behaviours can lead to academic and social problems, while adolescence can mean increased risky behaviour and conflict with authority figures.

How does defiant disorder manifest itself in ADHD?

The diagnosis can amplify symptoms, for example, the impulsivity of ADHD can be intensified by defiant behaviour,

How does defiant disorder manifest itself in autism?

In autism you may have communication difficulties that can be expressed as defiant behaviour.

How can defiant disorder be treated?

Treatment of defiant disorder focuses on improving the child’s social skills, emotional regulation, and reducing challenging behaviours. This is achieved through a combination of treatment methods.

What is CBT?

Cognitive behavioural therapy (CBT) is an evidence-based therapy that helps individuals identify and challenge negative thought patterns and behaviours that contribute to ill health.

How long is a treatment?

Treatment is tailored to the nature of the child’s or parent’s problem. It can be anything from a few sessions to a longer treatment over a couple of years.

What is a child psychologist?

A child psychologist is a licensed professional with knowledge and experience in working for the well-being and mental health of children and parents.

What does a child psychologist do?

Child psychologists offer therapy and counselling, but also provide parental support and treatment for the whole family when needed. They also work with schools to create good conditions for the child.

Can I see a child psychologist online?

Lavendla has a team of psychologists and therapists available for online sessions. Book an initial session through our website with the therapist of your choice.

Where can I get help from a child psychologist?

You can contact your GP for a referral to a psychologist. Alternatively, book a session with one of Lavendla’s experienced child psychologists who are available to help.

How does treatment with a child psychologist work?

Seeking help from a psychologist or therapist is an important step when a child is experiencing mental health difficulties, or if you are having difficulties as a parent. Here is a brief overview of the treatment steps:

First step: An initial consultation for the psychologist to assess needs through discussions with the child and parents.

Treatment plan: An individualised plan is developed, based on your specific situation and needs.

Types of therapy: The treatment method is adapted to the situation and may include play therapy for younger children, as well as talk therapy and CBT for older children, which focuses on changing negative thought patterns and behaviours. Other methods such as family therapy can also be helpful.

Parental counselling: Parents receive guidance and support to help their child at home.

Monitoring and adjustment: The treatment plan is continuously evaluated and adjusted as needed to ensure the best possible outcome.

Working with a psychologist can give you and your child the tools needed to manage emotions and behaviours in a healthy way. Lavendla has psychologists and therapists who can help make the difficult easier.

Lavendla – Making the difficult easier

Written by dominic

Dominic is a Cape Town-based copywriter and editor with a background in psychology.