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There are three main paths that a child will take and this seems to depend on the level/intensity of the oppositional behavior.
First, there are some lucky children who outgrow this. The exact number is not clear, but this is probably not the
majority. The aggressiveness is very stable.( i.e. aggressive 2 year olds are likely to be aggressive 20 year olds.) Only
IQ is more stable over years than aggression.
Second, ODD may turn into conduct disorder (CD). This usually happens
fairly early. That is, after 3-4 years of ODD, if it hasn't turned into CD, it won't ever. Predictors of a child with ODD
getting CD would include a history of a biological parent who was a career criminal, and very severe ODD.)
Third,
the child may continue to have ODD. Indications are that this is likely the most common path. If you look at a group of preschool
boys who have ODD and check them out two years later, about 75% still have something wrong. Sometimes ODD at that age changes
into something else, but that is rare. More often ODD just continues on. The more common thing that happens is that children
with ODD develop signs of mood disorders or anxiety as they get older. By the time these children are in the end of elementary
school, about 25% will have mood or anxiety problems which are disabling. That means that it is very important to watch for
signs of mood disorder and anxiety as children with ODD grow older.
Will children with ODD end up as criminals?
Probably not unless they develop conduct disorder. Even
then, many will grow out of it. Life may not be easy.
People with ODD who are grown up often do best if they can work for themselves and stay away from alcohol. However their tendency
to irritate others often leads to a lonely life.
While this can be initially disturbing and bleak, it is important
to remember that some children respond well to treatment. Generally, with treatment, reasonable adjustment in social settings
and in the workplace can be made in adulthood. This is why, as parents, it is most important that we work with these children
at an early age, to help them learn to channel their energies and control their behaviors using methods outlined in "treatment"
section previously mentioned.
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