I knew my son was different when his tantrums lasted hours at a time. We knew we needed more help than our pediatrician could offer. Oppositional Defiant Disorder (ODD) is like having a child who never grows out of the terrible twos—it is a constant, all-day challenge. Here are six signs that could mean a child has ODD.

1. Tantrums
Tantrums that last hours and hours over absolutely nothing: throwing, hitting, spitting, crying, screaming and yelling with no end in sight.

2. Defiant Behavior
Doing the exact opposite of what is asked of a child, whether it is something small (like brushing teeth) or something big (not hitting).

3. Mood Swings
One minute the child is happy and laughing and the next, he’s grumpy and mad. This could be over something as “insignificant” as a toy not working.

4. Lack of Sleep
Interrupted sleep is not good for an already explosive child.

5. Praise
Children with ODD don’t always like praise.

6. Lack of Affection
Children with ODD do not always show affection. Try not to make a big deal about it. Relish the moments when hugs are offered.

Our Experience
I dreaded waking up in the morning because I didn’t want to face another day with Dylan’s defiant behavior. Each day was an all out war between the two of us and it was over anything and everything.

Sometimes he yelled at me because his underwear was too high or too low. He wouldn’t wear sneakers because they were too big or too small—even though he wore them the day before. Sometimes he’d spit at me because I put him on time out for saying he hated me. Situations like these went on every day.

Where We Found Help
We got a referral from Dylan’s pediatrician to see a behavioral therapist and kept seeking out specialist after specialist. My husband suggested we try Parent-Child Interaction Therapy (PCIT); a treatment program that reestablishes the relationship between parent and child. Therapy programs like PCIT are imperative to changing the dynamics in a household where a child has a disruptive behavioral disorder such as Oppositional Defiant Disorder (ODD).

“When parents come in to receive PCIT, there is often negative behavior going on in the household,” says Dr. Brandi Noirfalise, a clinical psychologist. “We try to normalize that experience for the parents.”

The first part of PCIT includes Child-Directed Interaction (CDI). “We try to redevelop that relationship between the parent and child,” says Dr. Noirfalise. “I have seen families come in and they’re distraught. After they go through the program, it reduces stress.”

The second part of PCIT is Parent-Directed Interaction (PDI): the parent works on leading play while the child works on listening. “PCIT is recommended as the first line of defense as treatment for Attention Deficit Hyperactive Disorder (ADHD),” says Dr. Noirfalise. “We want to treat kids at the behavioral level before prescribing medication.”

If you think that your child could have ODD, seek help. Early intervention can help navigate tough times and provide answers parents desperately need. Most importantly, hang in there. Don’t be too hard on yourself and give yourself a break when you need it. Having a child with ODD is extremely difficult and can feel very isolating.


Meagan Ruffing is a freelance writer living with a 6-year-old son who has ODD, and a 4-year-old and 2-year-old who try to keep up with the circus. She and her husband still use what they have learned in PCIT to get through the tough days.