If a child's behavior has worsened and become delinquent (for example, dangerous anger or violence, destroying property, and stealing) for a year or more, the problem may be a more serious condition called conduct disorder

ODD usually starts in the late preschool years and the early teenage years. It may start at any age. Young children who are very irritable (for example, very colicky babies) often develop ODD. Children with attention deficit/hyperactivity disorder (ADHD), speech and language problems, or school problems are also at greater risk of having ODD.

The exact causes of ODD are not fully understood. It tends to run in families, but home environment and parenting also have an effect. ODD may occur in children from any background, but it is more common in children with a parent who:

• Has a history of ODD, conduct disorder, substance abuse problems, or mood problems like depression.
• Has marriage troubles.
• Uses harsh discipline.
• Pays little attention to his or her children.

In young children, ODD is more common in boys. In adolescence, it is equally common in boys and girls. From 2% to 15% of children ages 3 to 18 develop ODD at some time in their childhood. Most have a mild form of the disorder.

A child behaves this way for at least 6 months:

• Defies rules and authority at home and at school far more than what is usual for their age and sex.
• Has an angry attitude.
• Often seeks to annoy adults and peers.
• Blames others for their misbehaviors and negative attitudes.
• Throws severe temper tantrums and talks back to adults

There are no medical tests for ODD. A therapist or health care provider will ask about your child's symptoms and how long your child has been behaving this way. If behaviors like the ones listed are a reaction to a recent event such as child abuse or divorce, the diagnosis may be adjustment disorder with disturbance of conduct instead of ODD. If stealing, vandalism, or assault goes on for a year or more, the child may have conduct disorder.

The best treatment is good child management by parents, teachers, and daycare providers. ODD children need very firm limits with clear rules, consistent results, and immediate rewards for good behavior. Be calm during discipline. Since these children seek to annoy, if you become angry and yell, it may increase how often they misbehave. Severe punishments do not help the problem, but instead seem to make it worse. Talking with a child therapist is helpful.

Medicines and herbal supplements are not useful with simple ODD. Medicines do help when ODD exists with attention deficit/hyperactivity disorder (ADHD) or mood problems, such as childhood depression. Your health care provider or therapist will determine the best treatment.

With good child management by adults, many children grow out of ODD. The most common times for major improvements are before the teenage years or in young adulthood. In some children the condition worsens into full-blown delinquency (conduct disorder) by late childhood or teenage years.

The main things to do are:

• Remember not to use anger or yell when you discipline your child.
• Tell your child what you expect.
• Take notice of your child's efforts to behave.
• Praise helping behaviors.
• Reward good behaviors.
• Help your child to handle conflicts.
• Teach your child to cooperate with others.
• Be consistent and set clear rules.
• Seek professional help.