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Does oppositional defiant behavior improve as the child gets older?

Some lucky kids will outgrow Oppositional Defiant Disorder. About 50% of kids who have this disorder as preschoolers will have no psychiatric problems at all by age 8. Follow-up studies have found that approximately 67% of kids diagnosed with Oppositional Defiant Disorder who received treatment will be symptom-free after three years. However, studies also show that approximately 30% of kids who were diagnosed with Oppositional Defiant Disorder will go on to develop Conduct Disorder.

Other studies show that when the behavioral symptoms of Oppositional Defiant Disorder begin in early life (i.e., preschool or earlier), the youngster or teen will have less chance of being symptom-free later in life. Also, the risk of developing Conduct Disorder is three times greater for kids who were initially diagnosed in preschool. In addition, preschool kids with Oppositional Defiant Disorder are more likely to have coexisting conditions (e.g., ADHD, anxiety disorders, mood disorders, depression, bipolar disorder) later in life.

In all age groups, approximately 10% of kids and teens diagnosed with Oppositional Defiant Disorder will eventually develop a more lasting personality disorder (e.g., antisocial personality disorder). However, most kids and teens will improve over time, especially if they receive treatment. Mothers and fathers who suspect that their youngster has a behavioral problem should have their youngster evaluated. For kids who receive treatment early, the outlook is very good.

By the time children diagnosed with Oppositional Defiant Disorder reach the 5th or 6th grade, about 25% will have mood or anxiety problems. Thus, it is very important to watch for signs of mood disorder and anxiety as kids with Oppositional Defiant Disorder grow older. By the time preschoolers with Oppositional Defiant Disorder are 8 years old, only 5% have Oppositional Defiant Disorder and nothing else (i.e., no other coexisting conditions).

About 5-10 % of preschoolers with Oppositional Defiant Disorder will eventually end up with ADHD and no signs of Oppositional Defiant Disorder at all. Other times Oppositional Defiant Disorder turns into Conduct Disorder. This usually happens fairly early though (i.e., after a 3-4 years of Oppositional Defiant Disorder, if it hasn't turned into Conduct Disorder, it probably never will). The best predictor of a youngster with Oppositional Defiant Disorder graduating to Conduct Disorder is if there is a history of a biologic parent who engaged in criminal activity and also had (or has) Oppositional Defiant Disorder.

Grown-ups who had Oppositional Defiant Disorder as a child often do best if they can work for themselves and stay away from drugs and alcohol. However their tendency to irritate others often persists even into adulthood, which often leads to a lonely life.

Help for Parents with Oppositional Defiant Children and Teens

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