Understanding ODD, emotional regulation + what might be happening beneath challenging behaviour
You ask your child to put on their shoes. Thirty seconds later, you're in a full-blown standoff over something that should have taken two minutes.
You've tried staying calm, setting boundaries, offering choices and being consistent. Yet the smallest requests can still turn into the biggest moments of the day. And when someone suggests you just need to be firmer, it's hard not to feel misunderstood.
Because you know your child. You see their kindness, humour and curiosity, alongside the moments when everything seems to unravel. What if challenging behaviour isn't always about a child choosing to be difficult?
Sometimes behaviour reflects emotions that feel overwhelming, skills still developing or needs that aren't immediately obvious. Understanding what's happening beneath the behaviour can change how we respond.
What the ODD Label Gives You + What It Doesn't
Oppositional Defiant Disorder (ODD) is a recognised behavioural condition involving an ongoing pattern of anger, irritability, arguing or defiance that affects everyday life. For some families, a diagnosis brings relief. It gives a name to experiences they've been trying to understand for years. Clinicians look for patterns lasting at least six months and consider how behaviour affects the child's relationships, learning and daily activities.
Severity is generally described by how many settings are affected:
Mild: one setting
Moderate: two settings
Severe: three or more settings
This matters because a child who struggles mainly at home may have different needs from one experiencing difficulties across several environments. A diagnosis can help guide support, but it doesn't tell us everything about the child behind the behaviour.
The Numbers Worth Knowing
ODD is estimated to affect approximately 3% of children, although estimates vary. It can also occur alongside ADHD, anxiety and other developmental or mental health conditions. Research suggests many children no longer meet the full diagnostic criteria over time, although some continue to experience emotional or behavioural difficulties.
This is why early, individualised support matters. Rather than focusing only on stopping a behaviour, it's worth understanding what might be contributing to it.
Your Child's Gas Pedal + Brake Pedal
One way we explain the autonomic nervous system at Restore is through the idea of a gas pedal and a brake pedal.
The sympathetic nervous system is the gas pedal. It helps prepare the body for action, alertness and responding to challenges.
The parasympathetic nervous system is the brake pedal. It supports rest, digestion and recovery.
Both are necessary, constantly adapting to what's happening around us. When a child becomes overwhelmed, their stress response may become more active. You might notice faster breathing, tense muscles, shouting or difficulty listening.
In these moments, accessing emotional regulation and problem-solving skills can become harder. That doesn't mean every child with ODD has a nervous system permanently stuck in fight or flight. It simply reminds us that behaviour isn't always a deliberate choice, and regulation is a skill children develop over time.
Same Diagnosis, Different Nervous Systems
Two children with the same diagnosis can have very different experiences. One might struggle when plans change. Another may find frustration, impulsivity or sensory environments particularly difficult.
The nervous system plays an important role in how we respond to stress, and researchers are exploring how autonomic activity relates to emotional regulation. The vagus nerve is part of this system, while heart rate variability (HRV) can provide information about aspects of autonomic activity.
However, HRV isn't a diagnostic test for ODD and can't explain an individual child's behaviour. The important takeaway is that children with the same diagnosis don't necessarily need the same support.
The Perfect Storm Behind the Behaviour
At Restore, we sometimes use The Perfect Storm as an educational framework for exploring the different experiences that form part of a child's story.
This might include:
Pregnancy + birth: maternal wellbeing, birth experiences and developmental history
Early childhood health: illness, sleep, feeding and medication history
Ongoing stress: family changes, school experiences, relationships and sensory demands
These experiences provide context, not a diagnosis. A difficult birth, maternal stress or antibiotic exposure doesn't mean a child will develop ODD. Behavioural conditions involve a complex interaction of developmental, psychological, biological and environmental factors. Understanding the history can help us see the bigger picture without looking for one event to blame.
Why Strategies Sometimes Stop Working
Perhaps you've tried reward charts, routines, parenting programs or different approaches recommended by your child's healthcare team. Some things help. Others seem to work for a while before the challenges return. That doesn't necessarily mean the strategy has failed.
Children's needs change, and different challenges require different kinds of support. Evidence-based approaches for ODD can include parent management training, behavioural interventions, family support and care for coexisting conditions such as ADHD.
Sometimes the next step is revisiting the plan or exploring whether additional needs have been overlooked. The goal isn't simply to make a child more compliant. It's to help them develop the skills and support they need.
Where Might Chiropractic Fit?
At Restore, we take the time to understand each child's individual health history, development and physical needs.
Our chiropractors focus on the neuro-musculoskeletal system, looking at areas such as joint movement, muscle function and physical tension where clinically relevant.
For children experiencing behavioural or emotional difficulties, their GP, paediatrician, psychologist and other relevant practitioners remain important members of their healthcare team.
Where a musculoskeletal concern is also present, chiropractic assessment may form one part of their broader care.
It's about understanding the whole child while recognising the different roles each practitioner plays.
What About INSiGHT Scans?
INSiGHT technology may be used as one part of an individual chiropractic assessment at Restore.
Depending on the scan, we can collect information relating to:
sEMG: electrical activity associated with muscles
Thermal scanning: patterns in skin temperature
HRV: variation in timing between heartbeats, which may provide information related to autonomic activity
These findings are considered alongside the child's health history and physical examination.
They don't diagnose ODD or identify the cause of behavioural challenges, but may provide additional information relevant to chiropractic assessment.
You Are Your Child's Best Advocate
If you've spent years navigating difficult behaviour, school conversations and parenting advice, you know there's so much more to your child than their hardest moments. You see the funny, thoughtful, curious person who sometimes struggles with things other children seem to manage easily.
And while a diagnosis can be useful, it doesn't define everything about who they are. Sometimes the most helpful question isn't “How do we stop this behaviour?” It's “What is making this moment difficult, and what support might help?”
If you're concerned about your child's behaviour or emotional regulation, your GP can help guide appropriate assessment and support.
At Restore, we're always happy to learn more about your family's story and discuss whether there are musculoskeletal concerns relevant to chiropractic care. Because your child is so much more than a diagnosis or a difficult day, and understanding their individual needs is where meaningful support begins.
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Important information: This article provides general educational information only and isn't intended to diagnose or treat ODD, ADHD or other developmental or mental health conditions. Chiropractic care focuses on clinically appropriate neuro-musculoskeletal concerns and doesn't replace medical, psychological or allied health care. If you're concerned about your child's behaviour or development, speak with your GP or another appropriately qualified healthcare professional.
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American Academy of Child and Adolescent Psychiatry (AACAP). Oppositional Defiant Disorder Resource Center.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
StatPearls / NCBI Bookshelf. Oppositional Defiant Disorder.
Raising Children Network. Resources on challenging behaviour and emotional regulation.
Original Article
Adapted from Why Defiance Isn't a Choice for Some Kids, originally published by PX Docs.