ADHD and Oppositional Defiant Disorder

All children are defiant from time to time. Many children go through tough periods as toddlers and preteens. Uncooperative behavior that is frequent or severe may be called Oppositional Defiant Disorder (ODD).

What is oppositional defiant disorder (ODD)?

• The child is frequently uncooperative, defiant, or hostile
• This is causing problems at home, at school, or in another setting.
• The difficult behavior is more frequent than in others the same age.
• Symptoms of ODD may occur in multiple settings (for example, home and school) or just one (usually at home).
• Symptoms have been present for more than 6 months.

What are the symptoms of ODD?

• Frequent temper tantrums
• Excessive arguing with adults
• Often questioning rules
• Active defiance and refusal to follow adult requests and rules
• Deliberate attempts to annoy or upset people
• Blaming others for his or her mistakes or misbehavior
• Often being touchy or easily annoyed by others
• Frequent anger and resentment
• Mean and hateful talking when upset
• Spiteful attitude and revenge seeking

Do ADHD and ODD frequently co-occur?

• Yes. About 40% of children with ADHD are also diagnosed with ODD.
• Children often have symptoms of ADHD before symptoms of ODD.
• ADHD makes a child act without thinking or not notice adult requests. ADHD also includes trouble with a sense of time. Children with ADHD may have trouble getting started or switching activities. Adults often see these behaviors as defiant or disrespectful.
• If ADHD is not treated effectively, children are more likely to develop ODD.
• Behaviors due to ADHD can make parents constantly irritated with the child. Having adults mad at you a lot can make you defiant.

How is oppositional defiant disorder treated?

• Behavior therapy is the main treatment for ODD.
• This therapy includes teaching parents ways to manage behavior.
• Therapy may also teach the child ways to control his or her anger.
• Therapy can help build positive communication between family members.
• Getting the right medication for ADHD, if present, can help a lot but there is no specific medicine for ODD.

What should I do if I think my child has ODD?

• Your child should receive a full evaluation for ODD.
• Be prepared to give specific examples of difficult behavior and how you handle it.
• The evaluation will also assess for other problems or disorders, such as depression.
• Talk to your child's doctor about getting an evaluation for ODD.

How do children with ODD turn out?

• Children with ODD can be successful adults with good treatment.
• Helping the child feel optimistic and accepted are things that help assure a good future.