DEAR READER: All children and teens have moments when they can be difficult, moody and/or argumentative. This is perfectly normal. However, when tantrums, arguing and angry or disruptive behaviors (especially toward the parent/guardian and other authority figures) become regular occurrences, ODD may be the reason.

Symptoms are hard to distinguish from normal behaviors of strong-willed or emotional people. In fact, the symptoms of ODD are the same as behaviors expected during certain stages of a child’s development. When these behaviors become persistent, are clearly disruptive to the family, home or school, and have lasted at least six months, ODD must be considered.

Negativity, defiance, hostility toward authority figures and disobedience are common with ODD and lead to temper tantrums, academic problems, anger, resentment, argumentative, spiteful or vindictive behavior with adults and aggressiveness toward peers. There may be deliberate annoyance of others, blaming others for mistakes, difficulty maintaining friendships, easy annoyance, acting irritably and refusal to comply with adult rules or requests. ODD often accompanies other problems, such as depression, anxiety and attention deficit/hyperactivity disorder (ADHD).

There is no clear cause, but it is thought that is it likely the result of a combination of inherited and environmental factors.

Possible risk factors include having a parent with a mood or substance-abuse disorder; exposure to violence; lack of supervision; being abused or neglected; having parents with a severely troubled marriage; family financial problems; inconsistent or harsh discipline; lack of positive parental involvement; parents with a history of ADHD, ODD or conduct issues; and family instability, such as multiple moves, school changes or the use of childcare providers.

Diagnosis is not made through blood or other physical testing. A child must meet certain criteria set by the American Psychiatric Association. In order to have a positive diagnosis, the child must show a pattern of abnormal behavior for six or more months (as compared to what is typical for the child’s peers) and meet at least four of the eight criteria. The behavior must also cause significant problems at work, home or school; must occur on its own rather than as part of another mental disorder; and must not meet the diagnostic criteria for conduct disorder or antisocial personality disorder (in those over age 18).

Treatment of ODD typically involves several types of psychotherapy and training for the child and parents. Medication to treat any associated conditions, such as ADHD, may also be used. Individual and family therapy can help the child manage anger and express feelings, as well as helping the family understand how the child is feeling and provide a safe, neutral environment to discuss concerns, and learn how to cope and work together. Parent-child interaction therapy (PCIT) teaches parents how to interact with their children in order to bring out their best behavior without stressing the parent and straining the (likely) already tenuous relationship. Training may include social-skills training, which teach the child how to interact with others in a positive manner; parent training similar to PCIT; and cognitive problem-solving training, which aids the child in identifying patterns that lead to behavioral problems and thus change them.

I believe the best approach to the situation is for your entire family to seek out some or all of the treatment options I’ve detailed. In this way, everyone can come to understand what is happening and how best to handle problems when they arise.