Acting out is typical childhood behavior and doesn’t always mean a child has a behavioral disorder.
Some children, however, have a pattern of disruptive behavior. This may eventually lead to a diagnosis of attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD).
Children with ADHD are easily distracted, disorganized, and they may have difficulty sitting still. Children with ODD are often described as angry, defiant, or vindictive.
ODD is related to a child’s conduct and how they interact with their family, friends, and teachers. ADHD is a neurodevelopmental disorder.
These conditions are different, but can occur together. Some seemingly defiant symptoms may be related to impulsivity in ADHD. In fact, it’s believed that about 40 percent of children with a diagnosis of ADHD also have ODD. Though, just like ADHD, not all children diagnosed with ODD have ADHD.
A child who only has ADHD may be full of energy or get overly excited when playing with classmates. This can sometimes lead to roughhousing and causing unintended harm to others.
Children with ADHD may also throw tantrums. But this isn’t a typical symptom of the disorder. Instead, the tantrum can be an impulse outburst due to frustration or boredom.
If the same child has ODD, not only do they have issues with impulse control, but also with an angry or irritable mood which can lead to physical aggression.
These children may have tantrums due to an inability to control their temper. They may be spiteful, upset others on purpose, and blame others for their own mistakes. In addition to getting overly excited and hurting a classmate while playing, they might lash out and blame the classmate and then refuse to apologize.
It’s important to note that traits of ODD and ADHD can also occur with learning disabilities and other conduct disorders. Care should be taken by a provider to get a clear picture of the overall symptoms before making a diagnosis.
Conduct disorder also involves things like lying, stealing, destroying property, aggression toward people or animals, and serious violations of rules, such as running away from home or truancy from school.
When ADHD and ODD occur together, a child will display symptoms of both behavioral disorders. Symptoms for both disorders must be present for at least 6 months in order for the diagnosis to be made.
SYMPTOMS OF ADHD
- inability to pay attention at school
- difficulty focusing
- trouble listening and following directions
- frequently misplacing items
- easily distracted
- forgetting daily assignments or chores
- nonstop fidgeting
- talking too much
- blurting out answers in class
- interrupting conversations
symptoms of odd
- easily loses temper or is easily annoyed
- angry and resentful
- shows hostility toward authoritative figures
- refuses to comply to requests
- purposely annoys or upsets others
- blames others for their mistakes
Keep in mind that a child doesn’t need to exhibit all symptoms of ADHD and ODD to receive a diagnosis for both conditions.
There isn’t a specific test to diagnose both ODD and ADHD. Typically, a diagnosis is made after a medical examination and a psychological evaluation to rule out other conditions, such as depression or a learning disability.
To assist with a diagnosis, doctors may request a child’s personal and family medical history, as well as interview a child’s teacher, babysitter, or other people the child has frequent contact with.
When these conditions occur together, treatments involve medication to reduce hyperactivity and inattention, as well as therapy to treat defiant behavior.
Stimulants are used to treat ADHD and work by balancing chemicals in the brain. These medicines are fast-acting, but it can take time to find the right dosage for your child.
Some stimulants have been associated with heart-related deaths in children who have heart defects. Your doctor may request an electrocardiogram before prescribing these drugs. This test measures the electrical activity in your child’s heart and looks for heart problems.
Some cognitive-enhancing drugs, antihypertensive drugs, and antidepressants are also used to treat ADHD. Some children may also benefit from behavioral therapy, family therapy, and social skills training.
Medication isn’t used to treat ODD unless there are other symptoms to treat. There are no FDA-approved medications to treat ODD. Treatment typically involves individual and family therapy. Family therapy can improve communication and parent-child interactions.
Your child may also receive cognitive problem-solving training. This training helps them correct the negative thought patterns that can lead to behavior problems. Some children also receive social skills training to learn the proper way to interact with their peers.
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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.
Symptoms vary, but can include patterns of behavior that result in self-harm. These children may also approach social interactions with aggression.
As far as environmental factors, lead exposure may raise the risk for ADHD. A child may also be at risk for ODD if there’s a history of harsh discipline, abuse, or neglect at home.
A diagnosis of both ADHD and ODD can cause a child to have difficulties at home and at school. It can lead to strained relationships with their parents, siblings, and classmates.
Also, having an inability to focus or sit still and arguing with teachers can result in poor school performance.
If left untreated, both conditions can trigger low self-esteem and depression. This puts a child at risk for misuse of alcohol or drugs, antisocial behavior, and even suicide.
Speak with your child’s doctor if they have signs of ADHD, ODD, or both. Your doctor can refer a mental health professional. Or, you can find a doctor using the American Psychological Association’s Psychologist Locator.
A child psychologist or psychiatrist can provide a diagnosis and create a treatment plan based on the severity of your child’s condition.
Early intervention is crucial when a child displays symptoms of ADHD or ODD. Treatment might involve a combination of medication and psychotherapy to relieve symptoms and correct negative patterns.
Even when therapy works, some children need ongoing treatment to keep these conditions under control. Don’t hesitate to seek help and talk with your child’s healthcare provider about any concerns.