Question
What are the key differences between a strong-willed child and a child with oppositional defiant disorder (ODD)?
Answer
A strong-willed child may challenge authority or express frustration in specific contexts, but their behavior is typically situational and can be managed with appropriate structure and guidance. In contrast, a child with oppositional defiant disorder (ODD) demonstrates more pervasive and disruptive behavior, marked by chronic anger, irritability, and defiance that occur across multiple environments. ODD is characterized by at least six months of persistent symptoms that are not explained by external stressors, trauma, or comorbid conditions. Additionally, physiological factors, such as hyperactivity in the hypothalamus or adrenal glands, can lead to an overproduction of cortisol and adrenaline in stressful situations, impairing the child’s ability to regulate emotions and control behavior. These symptoms distinguish ODD from the situational defiance seen in strong-willed children, as the former is more consistent, enduring, and physiologically driven.
This Ask the Expert is an edited excerpt from the course, Strong-Willed Vs. Oppositional Defiant Disorder, presented by Tere Bowen-Irish, OTR/L.