ADHD and ODD often occur together, but each has its own effects and often requires its own specific treatment.
It’s can be typical for a child to show signs that they’re angry, upset, or distracted. It can also be common for children to become defiant around adults from time to time. This behavior can be commonly considered a part of growing up and learning appropriate boundaries.
However, if these defiant behaviors become persistent and grow in severity, they may be signs of a behavioral disorder.
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder commonly seen in children and adults. Other neurodevelopmental disorders include oppositional defiant disorder (ODD) and conduct disorder.
You can observe the similarities or interactions between ADHD and ODD and how each affects your child’s behavior. Still, you can take helpful steps toward diagnosis, treatment, and coping mechanisms when addressing ADHD or ODD that can help you and your child thrive.
The best way to learn about these conditions can be outlining how each manifests in your child’s behaviors. Both ADHD and ODD share similar symptoms, so it can be beneficial to be patient in observing behavioral patterns.
Symptoms of ADHD center around three pillars: inattention, hyperactivity, and impulsivity.
Most people who live with ADHD exhibit symptoms that fall into each of these categories. Consider these three pillars of ADHD and their corresponding symptoms:
- inability to focus
- inability to stay on task
- inability to sit still
- constant fidgeting, tapping, or talking
- talks too much when not appropriate
- acting without thinking
- difficulty with self-control
- desiring immediate reward
- inability to delay pleasure
- interrupting others
- not considering long-term consequences
ODD is a childhood disruptive behavior disorder involving difficulty with self-control when expressing emotions and behaviors. According to the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the
- a persistent pattern of angry or irritable mood
- vindictive toward others
Diagnosing someone with ADHD can be challenging. There’s no single diagnostic test, and other mental health conditions can present similar symptoms.
Sometimes symptoms of ADHD that other people observe can only be considered the “tip of the iceberg” — as many live with other more subtle and internal symptoms that can be difficult to diagnose.
If you’re diagnosed with ADHD, you may show a steady pattern of inattention or hyperactivity and impulsivity, or both. Furthermore, these symptoms directly impact how you live and function each day.
Other conditions for an ADHD diagnosis include:
- several symptoms must exist before age 12 years
- several symptoms happen in at least two of the following settings:
- with friends and relatives
- other activities
- symptoms tend to interfere with social, work, or school life
- other mental health conditions ruled out
Receiving a diagnosis for ODD requires a similar amount of patience with a healthcare professional.
For ODD, doctors look for at least four symptoms to exist most days for at least 6 months in children. Those symptoms include:
- losing their temper
- becoming easily irritated
- arguing with authority or adults
- refusing to comply with requests from authority
- annoying others deliberately
- blaming others for their mistakes
A mild ODD diagnosis means you’re only acting out in one setting, such as school. However, if you show several of the above behaviors in more than one setting, this may indicate a more severe case of ODD.
For ADHD, doctors look for six or more symptoms of inattention and hyperactivity-impulsivity. However, people ages 17 years and older need only to present with five signs.
ODD is a childhood mental health condition seen in preschool years and can remain present until about age 10 years. After that age, symptoms tend to decline, as those diagnosed mature or their mental health disorder evolves into other conditions like conduct disorder.
Can a child have both ADHD and ODD?
ADHD and ODD comorbidity occur in about 60% of people diagnosed with ADHD. Additionally, those with both conditions have a more challenging outlook.
The ADHD defiant disorder combination may increase the chance of developing other mental health conditions such as:
With defiant ADHD, your child may exhibit symptoms from both conditions.
When treating ADHD, doctors look to reduce symptoms while improving daily functioning.
These treatment plans include:
- Prescribing a stimulant medication. These drugs work to increase the dopamine and norepinephrine in your brain, which may help improve attention.
- Prescribing a nonstimulant medication. These drugs may take longer to begin working, but many find improved focus and concentration when prescribed as part of their treatment plan.
- Therapy. Therapy focuses on altering behaviors and how to be self-aware instead of reactive.
The treatment for ODD consists of covering all environments in the child’s life to help ensure success:
- Treating at home. Techniques like parent management training are used to teach parents how to use positive reinforcement with their children to help decrease unwanted behaviors.
- Treating at school. Support is provided in school to improve performance, peer relationships, and problem-solving skills.
- Treating everywhere in-between. Medication isn’t the
first choicefor treatment, but when other treatments don’t work, they may help. Stimulants and anti-psychotic medications may also prove effective. Moreover, behavioral therapy for anger management may be helpful in reducing the severity of symptoms.
Best medication for a child with ADHD and ODD
- alpha-2 agonists
Psychostimulants may show the strongest change in behaviors, but combination therapy proves most beneficial for disruptive and aggressive behaviors.
Therapy for ADHD and ODD
Cognitive behavioral therapy (CBT) works well to supplement family and school-based therapies.
Once you receive a diagnosis for either ODD, ADHD, or both, you may want to inform your child’s teacher, counselors, and other caregivers so they’re aware of treatment.
Furthermore, if you’re considering therapy for your child to help create a more comprehensive treatment plan, a pediatrician can refer your child to a therapist near you.
ODD is common in those with ADHD, which may make diagnosis more challenging than those with ADHD alone.
ADHD occurs in children and adults, but only children receive an ODD and ADHD diagnosis. Both ODD and ADHD are complex disorders, and if someone lives with both, these disorders may require combination treatment.
If you feel your child may have symptoms of ADHD and ODD, it may be best to talk with a primary care doctor, who can refer you to specialists if necessary. After testing, they can rule out all other possible conditions and get your child started on a treatment plan that best meets their needs.
Still, more help and resources are available for those living with ODD and ADHD than ever before. It can be beneficial for those living with these disorders to take time for self-care and to practice self-compassion.
If you’re supporting a loved one who is dealing with these disorders, you may want to consider available resources. They can help you be present for yourself to be better able to be more supportive as your loved ones begin to thrive with their diagnoses.