Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is characterized by impulsive and hyperactive behaviors and/or inattentive behaviors.
Oppositional defiant disorder (ODD) is a behavior disorder marked by behaviors, particularly those directed towards authority figures, that are uncooperative, defiant, negativistic, irritable, and deliberately annoying.
While they are separate conditions, they often occur together. Some research suggests that as many as 40% of children with ADHD also meet the criteria for an ODD diagnosis.
This article will look at why ODD often occurs with ADHD, how the conditions are treated and managed, and coping strategies for parents and children.
Can You Have Both ADHD and ODD?
It's common for people with ADHD to also have ODD. According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), between one-third and one-half of children with ADHD also have ODD.
Some symptoms of ADHD in children include:
- Inattentive symptoms: Such as being easily distracted, making "careless" mistakes, and having difficulty with the planning, organization, and follow-through of tasks
- Hyperactive symptoms: Such as fidgeting, being constantly "on the go," and having difficulty staying seated
- Impulsive symptoms: Such as interrupting, acting without thinking, and risk-taking
ODD symptoms in children include:
- Excessive arguing
- Refusing to comply with appropriate requests
- Constantly questioning rules and refusing to follow them
- Intentionally annoying or upsetting others with their behavior
- Blaming others for their behavior or mistakes
- Being easily annoyed by others
- Frequently showing an angry attitude
All of these behaviors happen sometimes with every child, but for children with ODD, they occur much more frequently and interfere with their learning and relationships.
ADHD begins in childhood, but often persists into adulthood, though the symptoms can change over time.
Adults with ADHD may:
- Feel frequently restless
- Have poor planning and organizational skills
- Be forgetful, miss appointments and deadlines, and misplace items
- Have difficulty focusing on and finishing tasks
- Have trouble with time management
- Other behaviors related to hyperactivity, impulsivity, and inattentiveness
As with ADHD, ODD is usually diagnosed in childhood (typically in preschool, while ADHD is diagnosed primarily in school-age children). ODD usually resolves by age 18 but can persist into adulthood both on its own or along with ADHD.
Adults and adolescents with ODD are at high risk (90% chance) of being diagnosed with another mental illness in their lifetime. They are also at higher risk for social and emotional problems as adults, mood disorders (such as anxiety, depression, and bipolar disorder), conduct disorder, and substance use disorders.
Early intervention can help lower these risks.
What Causes ADHD and ODD?
The exact causes of ADHD and ODD are not known, but both are believed to have a genetic link and are likely influenced by multiple factors.
Several studies suggest that ODD may be caused by parental influences such as insecure attachment, harsh parenting, inconsistent parenting, or abuse. It is important to note that while this correlation exists, children who have a loving, supportive, and consistent home environment can also develop ODD.
Diagnosis and Treatment at a Glance
ADHD and ODD both have distinct criteria outlined in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5). While they may occur together, they are diagnosed separately according to their individual criteria.
Diagnosis typically begins with a visit to a healthcare provider who can perform a physical exam, ask about symptoms and family history, and make referrals as necessary.
ODD is usually diagnosed in early childhood. ADHD is typically diagnosed by age 12, but it's not uncommon for adults to be diagnosed with ADHD that was missed in childhood, particularly in women.
Treatment often involves addressing each condition separately when they occur together, but there can be overlap.
Medication, particularly stimulants, are a first line treatment for ADHD and can be quite effective at managing ADHD symptoms.
There is no medication specifically for ODD, but when ODD occurs with ADHD, stimulant medication can help manage the ADHD symptoms, allowing for more effective treatment for ODD using other measures.
Individual, family, and peer group therapy can be helpful for ADHD and/or ODD. This can include:
- Cognitive behavioral therapy (CBT)
- Parent training
- Social skills training
- Other broad and targeted therapies
Parenting and Disciplining Kids With ADHD and ODD
Parenting a child with ADHD and/or ODD can be daunting, but there are effective strategies:
- Routine: Develop and stick to a routine. This helps kids know what to expect and what is expected of them
- Stay calm: Frequent yelling can cause children to become used to it and tune it out, making it less effective
- Be clear: Say exactly what you want your child to do, set boundaries, and communicate what will happen if they break them
- Be consistent: Enforce the consequences you have laid out in a fair and consistent manner
- Be generous with praise: Effective praise is important, both as positive reinforcement and to mitigate the frequent negative feedback children often receive
- Help them manage emotions: Label emotions and talk through them with your child. Show them how to express emotions in acceptable ways. Modeling can help
- Pick your battles: Prioritize what is important and then follow through on it
- Avoid power struggles and arguments: Calmly and firmly state the consequence without getting into a back and forth. Step away and take a break if you feel yourself escalating
- Spend quality time together: Find activities you and your child can enjoy together. Building a relationship outside of rules and consequences is important
- Seek support: In addition to professional support for your child, it may be helpful to find a support group of other parents who understand what you are going through. Having time and interests outside of your child is beneficial too
Safety Tips to Avoid Injury
Having a safe space where children can go to calm down without hurting themselves or others can help them express their big emotions safely.
Consider providing a space with soft seating, pillows, stuffed animals, play dough and other safe sensory items. Supervision is important even in this safe space, but spending an appropriate amount of time in this environment can give space for your child (and you) to reset.
Try to ensure this space is used for self-regulation, not punishment. Recognize when you are reaching your limit. Allow another adult to step in if possible, or make sure your child is safe and walk away for a moment to calm down.
Effect of Diet on ADHD and ODD
Foods do not cause or cure ADHD or ODD. There is limited evidence to support special diets as a method of treatment, and studies have conflicting results.
More research is needed into the relationship between diet and ADHD and/or ODD.
Calming Techniques for Better Mental Health
Practices that have a calming effect for children and adults include:
- Breath focus
- Guided imagery
- Mindfulness meditation
Some of the many resources available include:
- Lives in the Balance
- Transforming the Difficult Child
- Teens with Problems
- ADDitude Magazine
- National Resource Center on AD/HD
ADHD and ODD are separate conditions but often occur together. ADHD is a psychodevelopmental disorder, while ODD is a behavior disorder.
Medication is often helpful for ADHD but rarely used for ODD alone. Several forms of therapy are useful for both disorders. Early intervention is associated with more successful treatment. Routine, consistency, and clear expectations and consequences are key to parenting children with ADHD and/or ODD.
A Word From Verywell
Parenting a child with ADHD, ODD, or both, can be daunting, but resources are available to help both you and your child.
If your child is showing signs of either or both conditions, see your healthcare provider to determine the next steps.
Frequently Asked Questions
Are ADHD and ODD considered disabilities?
In the United States, ADHD and ODD may be considered disabilities in terms of benefits under certain conditions, such as related to severity and ability to work or function in certain capacities.
Can children get expelled from school due to aggressive ODD behavior?(Video) Behavioral Strategies for ADHD and ODD
Children can be expelled for behavior associated with ODD. It's important to work with your child's school and make them aware of your child's diagnosis and challenges.
Does ODD in kids get better with age?
Most children with ODD will outgrow it by adulthood. Treatment during childhood is still important to meet their current needs and mitigate the risks if they continue to have ODD in the future.
How can a parent help their child make friends?
Parents can help their children make friends by helping them build their social skills, having supervised play dates, and practicing appropriate play and socializing with them.(Video) ADHD Kids & Oppositional Defiant Disorder (ODD) - ADHD Dude - Ryan Wexelblatt
How do you manage ADHD and ODD? ›
Individual and family therapy that may include social skills training or cognitive problem-solving skills training is another important tool. Medication is not usually effective in treating ODD alone, but when ODD co-occurs with ADHD, stimulants are still an effective ADHD treatment option.How is ADHD best managed? ›
Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling. A combination of these is often the most effective treatment. These treatments can help manage many symptoms of ADHD , but they don't cure it.Can you have ADHD and ODD at the same time? ›
These are called comorbidities. Oppositional defiant disorder (ODD) is one such condition. In fact, ODD is the most common comorbidity with ADHD. Experts believe that about four out of 10 kids with ADHD also have ODD.What are the main causes of ADHD and ODD? ›
What causes ADHD and ODD? The exact cause of these conditions is unknown. But it's believed that genetics and environmental influences may play a role. For example, a child may develop both conditions if ADHD runs in their family.How do you discipline a child with ODD problems? ›
- Treat before you punish. ...
- Exercise away hostility. ...
- Know your child's patterns. ...
- Be clear about rules and consequences. ...
- Stay cool-headed and under control. ...
- Use a code word like 'bubble gum. ...
- Stay positive.
Conclusion: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself.What are 4 behaviors that are associated with ODD? ›
- Often argues with adults or people in authority.
- Often actively defies or refuses to comply with adults' requests or rules.
- Often deliberately annoys or upsets people.
- Often blames others for his or her mistakes or misbehavior.
Some children with ODD will eventually outgrow the disorder. Symptoms may disappear as they age. However, as much as 30 percent of children with ODD eventually develop a conduct disorder. About 10 percent of children with ODD may eventually develop a personality disorder, like antisocial personality disorder.How do you calm down a child with ADHD? ›
- Follow instructions. ...
- Be consistent with your parenting. ...
- Break up homework with activities. ...
- Form the behavior. ...
- Allow them to fidget. ...
- Let your child play before taking on big tasks. ...
- Help them practice relaxation.
Often, the best way to discipline a child with ADHD is via a simple program of behavior modification: Define age-appropriate, attainable goals and then systematically reward each small achievement until the behavior becomes routine.
How can you control ADHD without medication? ›
A well-balanced diet, exercise, and meditation are all good options for individuals looking to reduce their ADHD symptoms. However, while these natural ADHD remedies may reduce the severity of certain ADHD symptoms, they do not address the individual's underlying brain dysregulation.What are 3 ways to treat ADHD? ›
How Effective Are Different Types of Treatment? Based on the best available evidence, effective strategies include treating ADHD with medication, parent-delivered behavior therapy, and teacher-delivered behavior therapy.How do you calm a child with ADHD without medication? ›
- Encourage good sleeping habits. ...
- Make dietary changes. ...
- Practice mindfulness with them. ...
- Introduce them to music. ...
- Engage them in more outdoor activities. ...
- Enroll them in behavioral therapy. ...
- Try brain training.
40 percent of children with attention deficit disorder (ADHD) also develop oppositional defiant disorder (ODD). Some experts suggest that ODD may be tied to ADHD-related impulsivity.
“These are symptoms of the problem that cause problems at home.” Here, Howard explained, is where oppositional behavior comes in. Children with ADHD tend to make a lot of mistakes, and often the same mistakes, which annoys the parent to no end. So when the parent asks “Did you do that?” the immediate response is “no.”How does ODD affect the brain? ›
Research shows that children with ODD have trouble controlling impulses and emotional behavior. Scientists believe that these children may have underdeveloped prefrontal cortexes—or, the part of the brain that is in charge of executive functioning and managing impulsive behavior.What does oppositional defiant disorder turn into? ›
ODD and CD are diagnosed more often in boys than in girls. If not managed promptly, ODD can progress to CD, which can then transition to antisocial personality disorder.What are the three main types of symptoms for ODD? ›
Signs and symptoms of ODD can be grouped into three categories: Anger and irritability. Argumentative and defiant behavior. Vindictiveness.Can a child with ADHD lead a normal life? ›
Effective treatment is available. If your child has ADHD, your pediatrician can offer a long-term treatment plan to help your child lead a happy and healthy life.What medication helps with ODD? ›
No medications are FDA-approved for the treatment of ODD in the U.S. Nonetheless, clinical experience has shown that the majority of children and adolescents with ODD do show signs of improvement with a low dose of atypical neuroleptics – arippirazole (Abilify) and risperidone (Risperidal), for example.
What does ODD look like in the classroom? ›
These students can appear defiant, disobedient, angry and irritable. They might argue with parents, teachers and other students. They may find it hard to follow teachers' instructions. They may lose their temper if they feel like something isn't going their way.What to do with students who have ODD? ›
Be sensitive to self-esteem issues. Provide feedback to your student with ODD in private, and avoid asking the student to perform difficult tasks in front of classmates. It can be helpful to praise positive behaviors, such as staying seated, not calling out, taking turns, and being respectful.At what age is ODD diagnosed? ›
When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age.Does caffeine help ADHD? ›
Some studies have found that caffeine can boost concentration for people with ADHD. Since it's a stimulant drug, it mimics some of the effects of stronger stimulants used to treat ADHD, such as amphetamine medications. However, caffeine alone is less effective than prescription medications.Is ODD the parents fault? ›
One of the most important things to know about ODD is that it's not the parent's fault. There are many reasons a child may have ODD. Trauma, such as divorce and death, is a common cause, and it was the reason for my daughter's ODD.What is the main cause of ODD *? ›
Oppositional Defiant Disorder (ODD) is thought to be caused by a combination of biological, psychological, and social factors. ODD tends to occur in families with a history of Attention Deficit Hyperactivity Disorder (ADHD), substance use disorders, or mood disorders such as depression or bipolar disorder.Is ODD genetic? ›
Genetic: It has been shown that ODD is likely a hereditary condition and that if an individual has a close relative with this mental illness, they have a predisposition to the development of oppositional defiant disorder.Is ODD caused by trauma? ›
Factors such as a chaotic home life, inconsistent discipline by parents, and being exposed to abuse, neglect, or trauma at an early age can all lead to the onset of ODD symptoms.What happens to ODD kids as adults? ›
Some children with ODD outgrow the condition by age eight or nine. But about half of them continue to experience symptoms of ODD through adulthood. People with ODD report feeling angry all of the time, and about 40 percent of them become progressively worse and develop antisocial personality disorder.Does ODD run in families? ›
ODD is genetic.
Oppositional defiant behavior tends to run in families. Studies show that the development of the condition is more heavily influenced by genes than it is by environmental factors. A child diagnosed with ODD quite frequently has a first-degree relative with ODD.
Can a child with ADHD control their Behaviour? ›
While children with ADHD can still learn what is acceptable and what isn't, their disorder does make them more prone to impulsive behavior. Fostering the development of a child with ADHD means that you will have to modify your behavior and learn to manage the behavior of your child.What is an ADHD meltdown? ›
ADHD meltdowns are sudden outbursts of frustration and anger that seem to come out of nowhere. If your child is struggling to control their emotions, there are ways to help them. For children with attention deficit hyperactivity disorder (ADHD), impulsivity can present in many ways.What toys help with ADHD? ›
- Fidget Spinners. Fidget spinners are small toys that come in a variety of hues and silhouettes. ...
- Rubik's Cube. With its bright colors and perfectly hand-sized design, the classic Rubik's Cube is an excellent toy for ADHD. ...
- Tangle Toys. ...
- Shape-Shifting Boxes. ...
- Stress Ball. ...
- Magnet Balls. ...
- Putty or Play Dough. ...
- Liquid Motion Sandscape.
Yelling doesn't help kids with ADHD learn better behavior. In fact, harsh punishment can lead them to act out more in the future. Try these calm, collected ways to deal with discipline instead.How do I get my ADHD child to listen? ›
Gain your child's attention by saying her name or making eye contact. If getting his attention is a challenge in itself, it often helps to stand or sit directly in front of him, make eye contact, and maintain frequent eye contact during listening practice.How do you discipline someone with ADHD? ›
Use visual prompts that remind them of their goals, what is important to them and what motivates them. Additionally, they can break big tasks into pieces, develop a plan of action and make time visible. Practice being kind to themselves and show themselves compassion.What triggers oppositional defiant disorder? ›
Factors such as a chaotic home life, inconsistent discipline by parents, and being exposed to abuse, neglect, or trauma at an early age can all lead to the onset of ODD symptoms. Risk Factors: Family history of mental illness. Witnessing violent or aggressive behaviors. Exposure to trauma / abuse/ neglect.Is ADHD and ODD a disability? ›
If your child has been diagnosed with ADHD, or ADD, he or she can qualify for Supplemental Security Income (SSI) disability benefits if the severity of the child's ADHD meets the Social Security Administration's childhood impairment listing for neurodevelopmental disorders (listing 112.11).What is the best medication for a child with ADHD and anxiety? ›
Stimulants, atomoxetine, and selective serotonin reuptake inhibitors (SSRIs) have been advocated for children with anxiety and ADHD. Given the high risk of behavioral disinhibition with SSRIs in children,2 stimulants or atomoxetine are suggested as first-line medications.What are 4 behaviors that are associated with ODD? ›
- Often argues with adults or people in authority.
- Often actively defies or refuses to comply with adults' requests or rules.
- Often deliberately annoys or upsets people.
- Often blames others for his or her mistakes or misbehavior.
Can you grow out of ODD? ›
Kids may grow out of ODD, but without treatment many will continue to have behavior problems. Getting treatment early can put kids on a better track for the future and make life easier for the whole family.What medication helps with ODD? ›
No medications are FDA-approved for the treatment of ODD in the U.S. Nonetheless, clinical experience has shown that the majority of children and adolescents with ODD do show signs of improvement with a low dose of atypical neuroleptics – arippirazole (Abilify) and risperidone (Risperidal), for example.What is the best medication for ADHD and ODD? ›
Conclusion: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself.How do you break a child's ODD? ›
The treatment of choice for ODD is parent management training. Parents are taught to change their reactions to a child's behavior — good and bad. Training involves using carrots and sticks — giving well-defined rewards and praise when your child cooperates, and consequences for misbehavior.Can a child with ADHD lead a normal life? ›
Effective treatment is available. If your child has ADHD, your pediatrician can offer a long-term treatment plan to help your child lead a happy and healthy life.Why punishment doesn't help ADHD? ›
Punishing a child with ADHD for difficult behaviors is ineffective and counterproductive because they don't have the luxuries of regulating their emotions and behaviors like a neurotypical child would. Punishment only results in them feeling guilty and ashamed for what they couldn't control.What to do with students who have ODD? ›
Be sensitive to self-esteem issues. Provide feedback to your student with ODD in private, and avoid asking the student to perform difficult tasks in front of classmates. It can be helpful to praise positive behaviors, such as staying seated, not calling out, taking turns, and being respectful.What does ODD look like in the classroom? ›
These students can appear defiant, disobedient, angry and irritable. They might argue with parents, teachers and other students. They may find it hard to follow teachers' instructions. They may lose their temper if they feel like something isn't going their way.What is the safest ADHD medication for a child? ›
What are the best ADHD meds for kids? Most children with ADHD experience symptom improvement while taking a stimulant medication such as methylphenidate (Ritalin, Metadate, Concerta, Quillivant XR, Jornay PM, Adhansia XR, etc.) or amphetamine (Adderall, Dexedrine, Dynavel XR, Adzenys XR, etc.).How do you treat ADHD without medication? ›
What Helps ADHD Naturally? A well-balanced diet, exercise, and meditation are all good options for individuals looking to reduce their ADHD symptoms. However, while these natural ADHD remedies may reduce the severity of certain ADHD symptoms, they do not address the individual's underlying brain dysregulation.
Do all kids with ADHD need medication? ›
Not every child with ADHD needs medicine. But medicine can help most kids with ADHD stay focused longer, listen better, and fidget less. Kids also benefit from behavioral therapy to learn and practice skills like staying organized or waiting their turn without interrupting.