Identification and Treatment of Children With Oppositional Defiant Disorder: A Case Study of One State's Public Service System

This case study of a statewide publicly funded service system followed children ages 3 to 17 years enrolled in Tennessee's Medicaid System over a 5-year period. Oppositional defiant disorder (ODD) was found to be the third most commonly diagnosed psychiatric disorder in this group, diagnosed in 3% of the enrolled population at an average age of 11.7 years. Several factors were found to be associated with the age of onset, including race and gender. Over half of those diagnosed with ODD also were diagnosed with another psychiatric disorder. Over the time period, use of inpatient/residential treatment, family therapy, and medication management increased, while other service types decreased. Implications regarding clinical, administrative, policy, and research issues are discussed for public sector psychologists and others.