How Can ADHD and ODD Be Managed? (2022)

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.

How Can ADHD and ODD Be Managed? (1)

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.

In Children

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.

In Adults

ADHD begins in childhood, but often persists into adulthood, though the symptoms can change over time.

(Video) Oppositional Defiant Disorder: Raising a Child with ODD and ADHD

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

Medication, particularly stimulants, are a first line treatment for ADHD and can be quite effective at managing ADHD symptoms.

(Video) Parent Management Training for ODD, ADHD, and Conduct Disorder

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.

Therapy

Individual, family, and peer group therapy can be helpful for ADHD and/or ODD. This can include:

  • Cognitive behavioral therapy (CBT)
  • Parent training
  • Psychoeducation
  • 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
  • Yoga
  • Mindfulness meditation

Additional Resources

Some of the many resources available include:

Summary

ADHD and ODD are separate conditions but often occur together. ADHD is a psychodevelopmental disorder, while ODD is a behavior disorder.

(Video) ADHD and ODD How to Manage Video

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

FAQs

How do you treat ODD ADHD? ›

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.

Can ODD be managed? ›

Doctors, mental health professionals and child development experts can help. Behavioral treatment of ODD involves learning skills to help build positive family interactions and to manage problematic behaviors. Additional therapy, and possibly medications, may be needed to treat related mental health disorders.

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.

How do you teach a child with ADHD and 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 is the best medication for ADHD and ODD? ›

Conclusions: Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.

Is ODD caused by parenting? ›

Lack of structure or parental supervision, inconsistent discipline practices, and exposure to abuse or community violence have also been identified as factors which may contribute to the development of ODD.

What age does ODD stop? ›

Symptoms usually remain stable between the ages of 5 and 10 and typically, but not always, decline afterward. The symptoms are often apparent in multiple settings but may be more noticeable at home or school. Signs and symptoms of ODD can be grouped into three categories: Anger and irritability.

Do kids grow out of oppositional defiant disorder? ›

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.

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).

Is ODD a disability? ›

If your child has ODD and it has affected their ability to function, they may be eligible for disability benefits through the Supplemental Security Income (SSI) program.

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.

What are 4 behaviors that are associated with ODD? ›

What are the symptoms of ODD in a child?
  • Having frequent temper tantrums.
  • Arguing a lot with adults.
  • Refusing to do what an adult asks.
  • Always questioning rules and refusing to follow rules.
  • Doing things to annoy or upset others, including adults.
  • Blaming others for the child's own misbehaviors or mistakes.

How do you deal with an ODD disorder? ›

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.

What does ODD 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.

Can ODD be treated with medication? ›

The preferred ODD treatment is a combination of individual and family behavioral therapy. When therapy alone does not resolve symptoms, medication for ODD can sometimes help.

What causes ODD in a child? ›

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.

What foods should you avoid if you have ADHD? ›

Foods to Avoid With ADHD
  • Candy.
  • Corn syrup.
  • Honey.
  • Sugar.
  • Products made from white flour.
  • White rice.
  • Potatoes without the skins.
14 Jun 2021

Can ODD be treated in adults? ›

The good news is that psychotherapy and medication are both effective treatments for getting symptoms of ODD under control. If any of the following symptoms seem familiar over the last six months or longer, take the results of this screener to a mental health professional for an evaluation.

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 does ODD look like in girls? ›

The symptoms of ODD may look different in girls and boys, for whom the condition is more common. Boys with ODD tend to be more physically aggressive and have explosive anger while girls often lie, refuse to cooperate, and express symptoms in other indirect ways.

What are ODD symptoms? ›

Oppositional defiant disorder (ODD) is a childhood behavior disorder defined by a persistent pattern of hostile, vindictive, and defiant behavior toward authority figures. Children with ODD are frequently irritable, argumentative, and disobedient. ODD may be diagnosed if this behavior lasts 6 months or longer.

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.

How do I get my child tested for ODD? ›

Only a medical doctor or suitably qualified mental health professional can diagnose ODD. They will likely want to talk to both you and your child, and may also want to assess your child at school and speak to your child's teachers, in order to help them understand as fully as possible what may be going on.

Is ODD a behavior disorder? ›

Oppositional defiant disorder (ODD) is a type of disruptive behavior disorder in which children frequently defy authority with hostility, leading to serious disturbances in their daily life.

Can ODD be misdiagnosed? ›

Why ODD can be misdiagnosed. When we're making mental health diagnoses, the thing that strikes me is that the last criteria for ODD listed in the DSM-5 diagnostic manual is almost always “not better explained by something else”. In other words, there's not another condition that better explains the patient's symptoms.

Is ODD a stand alone diagnosis? ›

ODD does not stand alone and generally has a high comorbidity rate with other mental health conditions. Common co-occurring mental health conditions in children and adolescents with ODD are: Depression. Anxiety disorders.

What causes 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 does ODD affect the brain? ›

Deficits in Impulse Control

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.

Is ADHD a form of autism? ›

Autism spectrum disorder and ADHD are related in several ways. ADHD is not on the autism spectrum, but they have some of the same symptoms. And having one of these conditions increases the chances of having the other. Experts have changed the way they think about how autism and ADHD are related.

Can I claim benefits for a child with ADHD? ›

Funding and benefits - ADHD Embrace. ADHD is recognised as a condition which qualifies for disability benefits and funding.

Is ADHD considered special needs? ›

However, ADHD falls under the category “Other Health Impaired” and not under “Specific Learning Disabilities.” Individuals with ADHD can also qualify for accommodations under the ADA and Section 504 if their ADHD impacts a major life function such as learning.

What category does ODD fall under? ›

ODD is one of a group of behavioural disorders known collectively as disruptive behaviour disorders, which include conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).

What does ODD look like in a child? ›

Children with ODD are uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures. They are more troubling to others than they are to themselves.

Is ADHD genetic? ›

ADHD tends to run in families and, in most cases, it's thought the genes you inherit from your parents are a significant factor in developing the condition. Research shows that parents and siblings of someone with ADHD are more likely to have ADHD themselves.

Can girls have ODD? ›

In girls, ODD is associated with depressive and anxiety disorders and internalizing symptoms (anxiety, depression and somatic complaints). These results suggest that therapeutic approaches with boys and girls with ODD should include different elements.

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.

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).

Is ODD a disability? ›

If your child has ODD and it has affected their ability to function, they may be eligible for disability benefits through the Supplemental Security Income (SSI) program.

What's the difference between ADHD and ODD? ›

The key difference between ADHD and ODD is that children with ADHD are easily distracted and disorganized, while children with ODD are angry and defiant. For example, a child with ADHD may impulsively push another child and later regret it.

Is ODD caused by parenting? ›

Lack of structure or parental supervision, inconsistent discipline practices, and exposure to abuse or community violence have also been identified as factors which may contribute to the development of ODD.

What are 4 behaviors that are associated with ODD? ›

What are the symptoms of ODD in a child?
  • Having frequent temper tantrums.
  • Arguing a lot with adults.
  • Refusing to do what an adult asks.
  • Always questioning rules and refusing to follow rules.
  • Doing things to annoy or upset others, including adults.
  • Blaming others for the child's own misbehaviors or mistakes.

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.

What foods should an ADHD child avoid? ›

Some of the common foods that can cause ADHD reactions include milk, chocolate, soy, wheat, eggs, beans, corn, tomatoes, grapes, and oranges. If you suspect a food sensitivity may be contributing to your child's ADHD symptoms, talk to your ADHD dietitian or doctor about trying an elimination diet.

What causes 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 does ODD affect the brain? ›

Deficits in Impulse Control

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.

Can a child outgrow ODD? ›

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.

Can ODD be 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.

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.

At what age can ODD be 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.

How is ODD diagnosed? ›

For a child to be diagnosed with ODD, they must have a pattern of disruptive behavior including at least four symptoms from this list:
  1. Often loses temper.
  2. Easily annoyed.
  3. Often angry and resentful.
  4. Argues with adults.
  5. Breaks rules.
  6. Annoys or hurts people on purpose.
  7. Blames others for behavior.
8 Apr 2022

How do I get my child tested for ODD? ›

Only a medical doctor or suitably qualified mental health professional can diagnose ODD. They will likely want to talk to both you and your child, and may also want to assess your child at school and speak to your child's teachers, in order to help them understand as fully as possible what may be going on.

Videos

1. ADHD? ODD? It Could Be Trauma
(StarrCommonwealth)
2. ADHD and ODD Behavior Management
(Intensivecareforyou.com)
3. How Oppositional Defiant Disorder Ruptures Families — and How to Manage It (w/ Dr. William Dodson)
(ADDitude Magazine)
4. "ADHD and Oppositional Defiance" Q&A Session for Parents on Discipline Strategies
(ADDitude Magazine)
5. Behavior Management Strategies for Oppositional Defiant Disorder
(BonnieandThomasLiotta)
6. Everything You Should Know About Oppositional Defiant Disorder in ADHD Children
(ADDitude Magazine)

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