“Should We Drop the ODD Label?”

Should we stop using the oppositional defiant disorder (ODD) label to describe children with ADHD who are extremely argumentative and inflexible? Are these behaviors just a part of the ADHD puzzle for some? Can they be addressed without pathologizing kids?

By Ryan Wexelblatt, LCSW Updated on April 7, 2022

Teen boy with oppositional defiant disorder and ADHD

How We Pathologize ADHD Behaviors

The mental health field does a lot of pathologizing of kids with ADHD with various labels, including oppositional defiant disorder (ODD). I want to move ADHD away from being so pathologized in the mental health field, and part of that is changing the language around it. We need to keep using ADHD, of course, because it is a neurodevelopmental challenge, but I think we need to drop the ODD label and here is why.

Why We Should Stop Using ODD to Describe Children

ODD is a description of behaviors; it is not a standalone diagnosis and it is not a neurodevelopmental challenge like ADHD. Those behaviors associated with ODD are rooted in inflexibility, which is an aspect of executive function; or they are rooted in anxiety; or they are rooted in a need for control, which is common among kids with adverse childhood experiences.

When you say your child has ADHD and ODD, it’s just pathologizing them because it’s adding another label to describe an aspect of his ADHD profile that has no biological basis that we know of.

What to Say Instead

Instead of saying, “My child has ADHD and ODD,” say “My child has ADHD and he has a propensity to be inflexible.” Or “My child has ADHD and he’s argumentative a lot.” What that is doing is looking at ADHD more holistically and using terms that describe the behaviors as part of ADHD, which is what I think they are.

Do you agree? Share your viewpoint in the Comments section below.