Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. To be diagnosed with ODD, a child's behavior must be worse than their peers and meet criteria in the DSM. ODD is usually diagnosed by age 8 and affects 1-6% of children, more commonly boys. It can be caused by inconsistent parenting, learning difficulties, family factors and may co-exist with other disorders like ADHD. Treatment involves therapy, parenting programs, and in some cases medication, with the goal of developing coping skills to reduce frustration and defiance.