Rules of Oppositional Defiant Disorder: A New Therapeutic Concept

Objective: Oppositional Defiant Disorder (ODD) commonly co-exists with ADHD and merits specific interventions. Our aim was to reframe ODD as a set of external rules that the child can reject. We surveyed parents for their views on ‘Rules of ODD’ as a therapeutic concept. Method: Parents of 85 children with ADHD and ODD were invited to rank 7 Rules of ODD in order of relevance and give additional comments. Results: Sixty-six (77%) considered the concept useful; 24 (31%) made additional comments or suggestions. The highest ranked rules were: ‘Always argue or disagree’ and ‘Never admit to being wrong’. No parent suggested the concept was harmful. Conclusions: Rules of ODD was considered useful by most parents. We hope that by redefining ODD as a series of external rules, the stigma of this diagnosis may be lessened, and the child empowered to make their own more rational decisions.