Kids who can’t stop saying no: does oppositional defiance disorder (ODD) need medical intervention?

Parents of children with a controversial mental health condition say a diagnosis liberated them, but a psychologist warns going down the medical route isn’t ideal.

Kids behaving badly is part of parenthood, but when these behaviours are prolonged and nasty, many parents turn to medical experts for diagnoses.

New research from the University of Sydney found the diagnosis of a particularly troubling condition can liberate parents and help them better understand their child’s challenging behaviour.

But a leading psychologist has warned against an overreliance on the ‘medical model’ to address a condition she says can be managed through consistent parenting.

Oppositional defiance disorder (ODD) is one of the many mental health conditions causing concern for Australian parents, families, schools and communities.

The condition is characterised by a frequent and persistent pattern of angry and irritable mood, argumentative and defiant behaviour and vindictiveness.

For many, this may simply seem like naughtiness, but ODD is a recognised behaviour disorder, which some think may affect as many as one in ten Australians aged under 12.

ODD could affect one in ten Australian kids.

World-first research by University of Sydney explored parents of children with ODD’s perception of diagnosis, with three in four parents finding the diagnosis helpful.

Of these parents, over 90 per cent said it helped them better understand their child’s behaviour and develop strategies to address it.

Two in three parents said the diagnosis helped them feel they were not to blame for their child’s “behavioural challenges”.

The team of researchers said the findings challenged concerns about the harmful effects of “diagnostic labelling”, which remains a “controversial issue”.

“There are several concerns about potential negative effects of labelling, including pathologising normal behaviour, stigma, the label functioning as a self-fulfilling prophecy, and a negative impact on child development, self-esteem and identity,” the report said.

Psychologist Clare Rowe said although diagnoses can be helpful for parents to better understand their child’s challenging behaviour, it can also have unintended consequences.

Ms Rowe warned against turning “every behavioural struggle into a psychiatric disorder”.

“It can unintentionally keep families stuck in a medical model – waiting for a specialist, a program, or a diagnosis to solve the problem,” Ms Rowe said.

“When in fact the most effective interventions come from consistent parenting, clear expectations, and family support.

“We risk disempowering parents if we imply that their child’s behaviour is a medical defect rather than a developmental challenge that can be changed.

“We know from decades of research that ODD is best understood as a combination of temperament, learned behaviour, and the family or school environment.

“Children are not ‘born oppositional’ – they learn these patterns through reinforcement, stress, or inconsistent boundaries.

“For that reason, treatment focuses on relationships and parenting strategies rather than medication or ‘fixing’ the child’s brain.

“We shouldn’t dismiss the genuine distress these families feel, but nor should we turn every behavioural struggle into a psychiatric disorder.”

Have an education story to share? Email us at [e-mail]

Originally published as Kids who can’t stop saying no: does oppositional defiance disorder (ODD) need medical intervention?