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A Guide for Families by the

American Academy of Child andAdolescent Psychiatry

ODD

Oppositional Defant Disorder

eAACAP on aacap.orgBeuse hildhd nd dlesent

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oDD: a guide Fmilies nii

Oppositional Defant Disorder: A Guide or Families is adapted from the American Academy of Child andAdolescent PsychiatrysPractice Parameter or the Assessment and Treatment o Children and Adolescents withOppositional Defant Disorder. The AACAPPractice Parameterwas written to aid clinicians, child and adolescentpsychiatrists, physicians, and other healthcare professionals in the diagnosis and treatment of children withODD. This guide was adapted from the AACAPPractice Parameterin 2009.

This publication is protected by copyright and can be reproduced with the permission of the AmericanAcademy of Child and Adolescent Psychiatry.

2009 The American Academy of Child and Adolescent Psychiatry, all rights reseved.

Table o Contents

What Is Oppositional Defant Disorder (ODD)? 1

How Common Is ODD?2

What Causes ODD? 3

What Are the Symptoms o ODD? 4

How Is ODD Diagnosed? 5

Can ODD Occur with Other Conditions? 6

Can ODD Be Prevented? 8How Is ODD Treated? 8

How Long Does Treatment Typically Last? 12

Does ODD Improve over Time? 12

Which Therapies Have Been Shown Not to Work? 13

What Does the Future Hold? 13

Reerences 14



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What Is OppositionalDefant Disorder?

Oppositional defant disorder (ODD) is one o agroup o behavioral disorders called disruptive be-havior disorders (DBD). These disorders are calledthis because children who have these disorderstend to disrupt those around them. ODD is one othe more common mental health disorders oundin children and adolescents.

Physicians defne ODD as a pattern o disobedi-ent, hostile, and defant behavior directed towardauthority fgures. Children and adolescents withODD oten rebel, are stubborn, argue with adults,

and reuse to obey. They have angry outbursts andhave a hard time controlling their temper.

Even the best-behaved children can be uncooperative and hostile at times,particularly adolescents, but those with ODD show a constant pattern o angryand verbally aggressive behaviors, usually aimed at parents and other authorityfgures.

The most common behaviors that children and adolescents with ODDshow are:

Deance

Spitefulness Negativity

Hostilityandverbalaggression

A mental health proessional is oten called upon i these behaviors create amajor disturbance at home, at school, or with peers.

SeekingtreatmentforchildrenandadolescentssuspectedofhavingODDiscritical. This disorder is oten accompanied by other serious mental healthdisorders, and, i let untreated, can develop into conduct disorder (CD), a moreserious disruptive behavior disorder. Children with ODD who are not treated

alsoareatanincreasedriskforsubstanceabuseanddelinquency.



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Someparentshavetroubleseeingdeantbehaviorsasasymptomofamentaldisorder. They may want to wait to start treatment until the child matures tosee i he or she will grow out o it.Also, it is sometimes difcult to distinguishbetweenODDandnormal,independence-seekingbehaviorthatshowsupduring the terrible twosand early teen years.

However,thereisevidencetosuggestthatearlyinterventionandtreatmentwillhelp a child overcome ODD. Treatment also may prevent its progression into amore a serious mental health concern.

Treatment usually consists o a combination o therapies, including behavioraltherapy,parenttraining,andfamilytherapy.Somechildrenmaybenetfrommedication as well.

With treatment, children and adolescents can overcome the behavioral symp-tomsofODD.Theycanlearntechniquestomanagetheirangeranddevelop

new ways o coping with stressul situations. Treatment also can help parentslearnbetterwaystodisciplineandtechniquestorewardgoodbehavior.

With treatment, children and adolescents with ODD can overcome theirdifcult behaviors and lead happier, more ulflling lives.

HowCommonIsODD?There is a range o estimates or how many children and adolescents haveODD. Evidence suggests that between 1 and 16 percent o children andadolescents have ODD.1However,thereisnotverymuchinformationonthe prevalence o ODD in preschool children, and estimates cannot be made.2

ODD usually appears in late preschool or early school-aged children. Inyoungerchildren,ODDismorecommoninboysthangirls.However,inschool-agechildrenandadolescentstheconditionoccursaboutequallyinboys and girls.3

Although the disorder seems to occur more oten in lower socioeconomicgroups,ODDaffectsfamiliesofallbackgrounds.



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What Causes ODD?Thereisnoclear-cutcauseofODD.However,most experts believe that a combination o biologi-

cal,psychological,andsocialriskfactorsplayarolein the development o the disorder.4

Biological Factors

Children and adolescents are more susceptible todeveloping ODD i they have:

Aparentwithahistoryofattention-decit/hyperactivitydisorder(ADHD),ODD,orCD

Aparentwithamooddisorder(suchasdepression or bipolar disorder)

Aparentwhohasaproblemwithdrinkingorsubstance abuse

Impairmentinthepartofthebrainresponsibleor reasoning, judgment, and impulse control

Abrain-chemicalimbalance

Amotherwhosmokedduringpregnancy

Exposuretotoxins

Poornutrition

Psychological Factors

Apoorrelationshipwithoneormoreparent Aneglectfulorabsentparent

Adifcultyorinabilitytoformsocialrelationships or process social cues

Social Factors

Poverty

Chaoticenvironment

Abuse

Neglect

Lackofsupervision Uninvolvedparents

Inconsistentdiscipline

Familyinstability(suchasdivorceorfrequentmoves)



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WhatAretheSymptomsofODD?Most children argue with parents and dey authority rom time to time,especiallywhentheyaretired,hungry,orupset.Someofthebehaviors

associated with ODD also can arise in children who are undergoing atransition, who are under stress, or who are in the midst o a crisis. ThismakesthebehavioralsymptomsofODDsometimesdifcultforparentstodistinguish rom expectable stress-related behaviors.5

Children with ODD show an ongoing pattern o extreme negativity, hostility,and defance that:

Isconstant

Lastsatleast6months

Isexcessivecomparedwithwhatisusualforthechildsage

Isdisruptivetothefamilyandtheschool

Isusuallydirectedtowardanauthoritygure(parents,teachers,principal, coach)

The ollowing behavioral symptoms are associated with ODD:

Frequenttempertantrums

Excessiveargumentswithadults

Activelyrefusingtocomplywithrequestsandrules

Oftenquestioningrules

Deliberatelyannoyingandupsettingothers

Oftentouchyorannoyedbyothers

Blamingothersfortheirmistakes

Frequentoutburstsofangerandresentment

Spitefulattitudeandrevengeseeking

Typically,childrenwithODDdonotengageindelinquentbehavior.Also, children whose behavioral symptoms are specifcally related to a mood disorder,such as depression or bipolar disorder, are usually not diagnosed with ODD.

Recently, it has been discovered that girls may show the symptoms o ODDdierently than boys. Girls with ODD may show their aggressiveness through

wordsratherthanactionsandinotherindirectways.Forexample,girlswithODDaremoreapttolieandtobeuncooperativewhileboysaremorelikelytolose their temper and argue with adults.6



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HowIsODDDiagnosed?

While there is no single test that can diagnoseODD, a mental health proessional can determinewhether a child or adolescent has the disorderby assessing the childs symptoms and behaviorsandbyusingclinicalexperiencetomakeadiagnosis.

Many parents frst call upon the childs primarycare physician or an evaluation. This evaluationtypically begins by compiling a medical historyand perorming a physical examination.

Gathering Inormation

Duringtheevaluation,thechildsprimarycareclinicianwilllookforphysicalor other mental health issues that may cause problems with behavior. I thedoctor cannot fnd a physical cause or the symptoms, he or she may reer thechild to a child and adolescent psychiatrist or a mental health proessional whois trained to diagnose and treat mental illnesses in children and adolescents.

Achildandadolescentpsychiatristoraqualiedmentalhealthprofessionalusually diagnoses ODD.

A mental health proessional will gather inormation rom parents, teachers,and daycare providers as well as rom the child.

Gathering inormation rom as many people as possible will help the doctordetermine how oten the behaviors occur and where. It also will help thedoctor determine how the behaviors aect the dierent areas o the childs lie.

The mental health proessional will determine whether:

Thebehaviorissevere

Theconictsarewithpeersorauthoritygures

Thebehaviorisaresultofstressfulsituationswithinthehome

Thechildreactsnegativelytoallauthoritygures,oronlyhisorherparentsor guardians



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Answeringthesequestionswillhelpamentalhealthprofessionaldeterminewhether the child or adolescent has developed ODD or is responding to ashort-lived, stressul situation.

Assessmenttools,suchasratingscalesandquestionnaires,mayhelpthechilds doctor measure the severity o the behaviors. These tools also may assistinestablishingadiagnosisandtrackingprogressoncetreatmentbegins.7

Inadditiontoestablishingaprimarydiagnosis,thedoctorwilllookforsignsofotherconditionsthatoftenoccuralongwithODD,suchasADHD,anxiety,andmooddisorders.Thedoctoralsoshouldlookforsignsthatthechildhasbeen involved in bullyingas either the victim or perpetrator. Involvement inbullyingoftenisasignthatthechildisatriskforaggressionandviolence.8

Establishing a Relationship

Likemanymentalhealthdisorders,ODDisnotalwayseasytoaccuratelydiagnose. Open communication among the mental health proessionaland the parents and child can help overcome the difculties diagnosing thisdisorder.Forexample,somechildrenseetheirbehaviorsasjustiedandare unmotivated to change. Also, some parents can become deensive whenquestionedabouttheirparentingstyle.Havingtheparentandthechildviewthe mental health proessional as an ally can help.9

Establishing a good relationship with a mental health proessionalis important to determining whether the childs behavior is a response toa short-lived situation or transition, ODD, or another serious behavioral

condition, such as CD or a mood disorder.

Can ODD Occur withOther Conditions?Many children who are diagnosed with ODD also have other treatablementalhealthandlearningconditions.Havingmorethanoneconditioniscalledhavingcoexistingconditions.SomeconditionsthatcoexistwithODD are:

ADHD

Anxietydisorders

Mooddisorders(suchasdepressionandbipolardisorder)

Learningdisorders

Languagedisorders



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Research indicates that some children developthe behavioral symptoms o ODD as a way tomanage anxiety or uncertainty.10 Anxiety dis-orders and mood disorders are similar to ODD

in that they are oten a response to uncertaintyand an unstable home and school environment.ThesesimilaritiesmakeitmorelikelythatODDand anxiety disorder and a mood disorder (suchas depression) will occur together.11

Among all conditions that coexist with ODD,ADHDisthemostcommon.Bothdisordersshare common symptoms o disruptive behav-iors.However,childrenandadolescentswhohavebothODDandADHDtendtobemore

aggressive, have more o the negative behavioral symptoms o ODD, andperorm less well in school than those who have ODD alone. These childrenalso tend to have more disruption in their amilies and with their relationshipswith authority fgures than children who do not have ODD.12

Doctors have ound that ODD can be a precursor to CD. CD is a more seriousbehavioral disorder that can result in destructive antisocial behavior.

While ODD behaviors may start in early preschool years, CD usually appearswhenchildrenareolder.AchildoradolescentwhohasADHDasacoexist-ingconditionalsoseemstobeatincreasedriskofdevelopingCD.Inaddition,studiesshowthathavingCDputschildrenandadolescentsatriskofdevelop-

ing a mood disorder or antisocial personality disorder later in lie.13

WhilehavingODDandacoexistingconditionputsachildatriskfordevelop-ing other more serious mental health issues, treatments exist that can improvethesymptomsofADHD,anxietydisorders,mooddisorders,andlearningandlanguage disorders. Also, treating other mental health and learning conditionsthat occur along with ODD has been shown to decrease the behavioral symp-toms o ODD.



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Can ODD BePrevented?

There is research that shows that early-interventionand school-based programs along with individualtherapy can help prevent ODD.14

Amongpreschoolers,theHeadStartprogramhasbeen shown to help children do well in school andpreventdelinquencylaterinlife.HeadStartisapro-gramoftheUnitedStatesDepartmentofHealthandHumanServices(US-HHS)thatprovideseducation,health, and other services to low-income children andtheir amilies. Young children in this program learnsocialskillsandhowtoresolveconictandmanage

anger.15Ahomevisittohigh-riskchildrenalsohas been shown to help prevent ODD among pre-schoolers.16

Amongadolescents,psychotherapy(talktherapy),social-skillstraining,vocational training, and help with academics can help reduce disruptivebehavior. In addition, school-based programs can be eective in stoppingbullying, reducing antisocial behavior, and improving peer relationships.17

Parent-management training programs have proven eective in preventingODD among all age groups. These programs teach parents how to develop a

nurturing and secure relationship with their child and how to set boundaries orunacceptable behavior.18 More inormation about parent-management trainingcan be ound on page nine o this guide.

HowIsODDTreated?There is no one-size-fts-all treatment or children and adolescents with ODD.The most eective treatment plans are tailored to the needs and behavioralsymptoms o each child. Treatment decisions are typically based on a numbero dierent things, including the childs age, the severity o the behaviors, andwhether the child has a coexisting mental health condition.19



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The goals and circumstances o the parentsalso are important when orming a treatmentplan. In many cases, treatment may last severalmonthsormoreandrequirescommitmentandollow-through by parents as well as by others

involved in the childs care.

Types o Treatment

Treatment usually consists o a combination o:

Parent-Management Training Programs andFamily Therapy to teachparents and other amily members how tomanage the childs behavior.Parents, amily members, and other caregiv-ersaretaughttechniquesin

positive reinorcement and ways to disciplinemore eectively.

Cognitive Problem-Solving Skills Training to reduce inappropriate behav-iors by teaching the child positive ways o responding to stressul situations.ChildrenwithODDoftenonlyknowofnegativewaysofinterpretingandrespondingtoreal-lifesituations.Cognitiveproblemsolvingskillstraining teaches them how to see situations and respond appropriately.

Social-Skills Programs and School-Based Programs to teach children andadolescents how to relate more positively to peers and ways to improve theirschoolwork.Thesetherapiesaremostsuccessfulwhentheyareconductedin a natural environment, such as at the school or in a social group.

Medication may be necessary to help control some o the more distressingsymptoms o ODD as well as the symptoms o coexisting conditions, suchasADHD,anxiety,andmooddisorders.However,medicationaloneisnot a treatment or ODD.

Treatments or Each Age Group

Forpreschool-agechildren,treatmentoftenconcentratesonparent-manage-menttrainingandeducation.School-agechildrenperformbestwithacombi-nation o school-based intervention, parent-management training, and individ-ualtherapy.Foradolescents,individualtherapyalongwithparent-managementtraining has been shown to be the most eective orm o treatment.



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Inallagegroups,individualtherapyfocusingonproblem-solvingskillsalsohasbeen shown to greatly improve the behavior o children and adolescents withODD.Problem-solvingskillstrainingshouldbespecictothechildsbehavior-alproblems,gearedtothechildsage,andfocusedonhelpingthechildacquirenewproblem-solvingskills.

More About Parent-Management Training

Studieshaveshownthatinterveningwithparentsisoneofthemosteffectiveways to reduce the behavioral symptoms o ODD in all age groups.20 Parent-management training teaches parents positive ways to manage their childsbehavior,disciplinetechniques,andage-appropriatesupervision.Itisthetreatment o choice to prevent disruptive childhood behavior or manymental health proessionals.

This approach embraces the ollowing principles:

Increasedpositiveparentingpractices,suchasprovidingsupportiveandconsistent supervision and discipline

Decreasednegativeparentingpractices,suchastheuseofharshpunishmentand ocus on inappropriate behaviors

Consistentpunishmentfordisruptivebehavior

Predictable,immediateparentalresponse

Many o the ollowing programs and publications have been noted as positivemodelsbytheSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)oftheUnitedStatesHealthandHumanServices(US-HHS):

Programs

Program Name Age Range Contact Information

Inedible Yes U t 8 yes .InedibleYes.m

Tile p-psitive pentin pm U t 13 yes htt://5.tile.net

pent-child Intetin They (pcIT) U t 8 yes .it.

cente cllbtive pblem Slvin U t 18 yes .exlsivehild.m

The adlesent Tnsitins

pm (aTp)

11 t 13 yes htt://.uen.edu/t.htm



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Publications

Book Name Age Range Publication Information

The Defant Childby Duls riley, ph.D. U t 13 yes The guild pess

The Explosive Childby r.w. geene U t 13 yes He pebks

The Kazdin Method or Parenting the

Defant Childby alln E. Kzdin, ph.D.

U t 18 yes Huhtn Mifin

Parent Management Trainingby alln Kzdin U t 18 yes oxd Univesity pess

Multisystematic Treatment o Antisocial

Behavior in Children and Adolescents

by Stt Henele, Snj Shenld,

chles Bduin, nd Melis rlnd

U t 18 yes The guild pess

Helping the Noncompliant Childby

rbet MMhn nd rex Fehnd

U t 18 yes The guild pess

Medication

MedicationalonehasnotbeenproveneffectiveintreatingODD.However,medication may be a useul part o a comprehensive treatment plan to helpcontrolspecicbehaviorsandtotreatcoexistingconditions,suchasADHD,anxiety, and mood disorders.

SuccessfultreatmentofcoexistingconditionsoftenmakesODDtreatmentmoreeffective.Forexample,medicationusedtotreatchildrenwithADHDhasbeenshowntolessenbehavioralsymptomswhenODDandADHDcoexist. When children and adolescents with ODD also have a mood disorderor anxiety, treatment with antidepressants and anti-anxiety medications hasbeen show to help lessen the behavioral symptoms o ODD.21

Early Identifcation and Treatment

Behaviors that go along with ODD are difcult to change. Thereore, earlyidentifcation and treatment o ODD give children and adolescents the bestchance or success.



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HowLongDoesTreatmentTypicallyLast?

Most treatment plans or children and adolescents with ODD last severalmonthsorlonger.ForthosewithamoresevereODD,orODDthatdoesnotrespond to therapy, treatment can last many years and may include placementin a treatment center.

A residential treatment center only should be considered or amilies whoare not able to provide therapy at home or at school. In-home services arepreerable to residential placement and are oten sponsored by state andlocal child welare agencies.22

Does ODD Improve over Time?Formanychildren,ODDdoesimproveovertime.Follow-upstudieshaveound that approximately 67 percent o children diagnosed with ODD whoreceivedtreatmentwillbesymptom-freeafterthreeyears.However,studiesalso show that approximately 30 percent o children who were diagnosed withODD will go on to develop CD.23

Other studies show that when the behavioral symptoms o ODD begin inearly lie (preschool or earlier), the child or adolescent will have less chanceofbeingsymptom-freelaterinlife.Also,theriskofdevelopingCDisthreetimes greater or children who were initially diagnosed in preschool.

Inaddition,preschoolchildrenwithODDaremorelikelytohavecoexistingconditions,suchasADHD,anxietydisorders,ormooddisorders(depressionor bipolar disorder) later in lie.

In all age groups, approximately 10 percent o children and adolescentsdiagnosed with ODD will eventually develop a more lasting personalitydisorder, such as antisocial personality disorder.24

However,mostchildrenandadolescentswillimproveovertime,especiallyifthey receive treatment. Parents who suspect that their child has a behavioralproblemshouldhavetheirchildevaluated.Forchildrenwhoreceivetreatment,theoutlookisverygood.



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WhichTherapiesHaveBeenShownNottoWork?

Experts agree that therapies given in a one-time or short-lived ashion, suchas boot camps, tough-love camps, or scare tactics, are not eective or childrenand adolescents with ODD. In act, these approaches may do more harm thangood. Trying to scare or orcibly coerce children and adolescents into behavingmay only reinorce aggressive behavior.25

Children respond best to treatment that rewards positive behavior and teachesthemskillstomanagenegativebehavior.

WhatDoestheFutureHold?It was once thought that most children would outgrow ODD by adulthood.Wenowknowthisisnotalwaystrue.WhilesomeofthesymptomsofODDcan go away over time, and many children outgrow the disorder, some childrenwithODDwillcontinuetoexperiencetheconsequencesofODDduringtheirlater years.

Forthosewhodonotreceivetreatment,ODDcandevelopintoCD,amoreserious behavioral disorder. O those with CD, almost 40 percent will developantisocial personality disorder in adulthood.26

Early diagnosis and treatment can help these individuals learn how to cope

with stressul situations and manage their behavioral symptoms.

Psychotherapy,parent-managementtraining,skillstraining,andfamilytherapywork.ResearchshowsthatchildrenandadolescentsrespondwelltotherapyforODD. In act, or those who receive treatment, many are symptom-ree oncetherapy has concluded and will go on to lead rewarding and happy lives.



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Reerences1LoeberR,BurkeJD,LaheyBB,WintersA,ZeraM(2000),Oppositional

defant and conduct disorder: a review o the past 10 years, part I.J AmAcad Child Adolesc Psychiatry 39:1468-1484.

2 American Psychiatric Association (1980), Diagnostic and Statistical Manualof Mental Disorders,Third Edition (DSM-III).Washington,DC:American Psychiatric Press.

3ConnorDF(2002),Aggression and Antisocial Behavior in Children andAdolescents: Research and Treatment.NewYork:TheGuilfordPress.

4BurkeJD,LoeberR,BirmaherB(2002),Oppositionaldeantandconductdisorder: a review o the past 10 years, part II. J Am Acad Child Adolesc

Psychiatry 41:1275-1293.

5SkovgaardAM,HoumannT,LandorphSL,ChristiansenE(2004),Assessment and classifcation o psychopathology in epidemiological

research o children 0Y3 years o age: a review o the literature. Eur ChildAdolesc Psychiatry 13:337-346.


7CollettBR,OhanJL,MyersKM(2003),Ten-yearreviewofratingscales.VI:Scalesassessingexternalizingbehaviors. J Am Acad Child AdolescPsychiatry 42:1143-1170.

8 Olweus D (1994), Bullying at schools: basic acts and eects o a schoolbased intervention program.J Child Psychol Psychiatry 35:1171-1190.

9SantistebanDA,SzapocznikJ,Perez-VidalA,KurtinesWM,MurrayEJ, LaPerriereA(1996),Efcacyofinterventionforengagingyouthandfamiliesinto treatment and some variables that may contribute to dierentialeectiveness.J Family Psychol 10:35-44.

10WilsonJ,SteinerH(2002),Conductproblems,substanceabuseandsocialanxiety. Clin Child Psychol Psychiatry 7:235-247.


12AngoldA,CostelloEJ,ErkanliA(1999),Co-morbidity. J Child PsycholPsychiatry 40:57-87.

13American Psychiatric Association (1980), Diagnostic and Statistical Manualof Mental Disorders, Third Edition(DSM-III).Washington,DC:American

Psychiatric Press.



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14BurkeJD,LoeberR,BirmaherB(2002),Oppositionaldeantandconduct disorder: a review o the past 10 years, part II. J Am Acad Child Adolesc



16EckenrodeJ,GanzelB,HendersonCR,SmithE,OldsDL,PowersJ,ColeR,KitzmanH,SidoraK(2000),Preventingchildabuseandneglectwithaprogram o nurse home visitation: the limiting eects o domestic violence.

JAMA 284:1385-1391.

17BurkeJD,LoeberR,BirmaherB(2002),Oppositionaldeantandconduct disorder: a review o the past 10 years, part II.J Am Acad Child Adolesc


18BurkeJD,LoeberR,BirmaherB(2002),Oppositionaldeantandconduct disorder: a review o the past 10 years, part II.J Am Acad Child Adolesc


19KazdinAE(2005),Parent Management Training: Treatment for Oppositional,Aggressive, and Antisocial Behavior in Children and Adolescents.NewYork:OxfordUniversityPress.

20BrestanEV,EybergSM(1998),Effectivepsychosocialtreatmentsofconduct-disorderedchildrenandadolescents:29years,82studies,and5,272kids.

J Clin Child Psychol 27:180-189.

21ConnorDF,GlattSJ,LopezID,JacksonD,MelloniRH(2002),Psychopharma -cologyandaggression:I.Ameta-analysisofstimulanteffectsonovert/covertaggression-relatedbehaviorsinADHD.J Am Acad Child Adolesc Psychiatry41:253-261.

22Chamberlain P (2003), An overview o the history and development o themultidimensional treatment oster care model and the supporting research.In: Treating Chronic Juvenile Offenders: Advances Made Through the Oregon

Multidimensional Treatment Foster Care Model.LawandPublicPolicy,Cham-berlain P, ed. Washington, DC: American Psychological Association, pp 47-67.


24RutterM,GillerH,HagellA(1999),Antisocialbehaviorbyyoungpeople. J Am Acad Child Adolesc Psychiatry 38:1320-1321.


26ZoccolilloM,PicklesA,QuintonD,RutterM(1992),Theoutcomeof conduct disorder.Psychol Med 22:971-986.



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This publication is protected by copyright and can be reproduced with the permission of the AmericanAcademy of Child and Adolescent Psychiatry

This guide is part o the eAACAP Resource Center on oppositional defantdisorder ODD. The resource center includes inormation on how and when toseekhelp.TheeAACAPODDResourceCenterisavailableontheAmericanAcademy o Child and Adolescent Psychiatry Website at www.aacap.org.



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