The behaviors characteristic of ODD (Table 16–1) can lead to difficulties in all realms of social, academic, or occupational functioning. The central feature is conflict with authority, and problem behaviors are most frequently seen in interactions with those in charge. Requests or limits on behavior typically elicit a sharp reaction, and confrontations quickly degenerate into control struggles. The disputes and conflicts may be over seemingly trivial matters, but perceived threats to control and autonomy are critical issues for children with this disorder. Although negative and disobedient behavior can be normative at certain stages of development or in special circumstances, this disorder is characterized by behaviors that are more severe and frequent than normally expected and result in significant functional impairment.