Did you know that 40 percent of children with ADHD also develop opposition defiant disorder (ODD) — a condition marked by chronic aggression, frequent outbursts, and a tendency to argue, ignore requests, and engage in intentionally annoying behavior.
“These children are most comfortable when they’re in the middle of a conflict,” says Douglas Riley, Ph.D., author of The Defiant Child and a child psychologist in Newport News, Virginia. “As soon as you begin arguing with them, you’re on their turf. They keep throwing out the bait, and their parents keep taking it—until the parents end up with the kid in family therapy, wondering where they’ve gone wrong.”
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No one knows why so many children with ADD/ADHD exhibit oppositional behavior, but some experts suggest that ODD may be tied to ADHD-related impulsivity.
“Many ADD/ADHD kids who are diagnosed with ODD are showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.”
Other experts suggest that ODD is a way for kids to cope with the frustration and emotional pain associated with having ADD/ADHD.
About half of all preschoolers diagnosed with ODD outgrow the problem by age 8, while older kids with ODD are less likely to do so. If left untreated, oppositional behavior can evolve into conduct disorder and more serious behavioral problems.
The first step in managing ODD is making sure that the child’s ADD/ADHD is under control. Typically, a doctor will put a child on a regimen of ADHD medication, which, in some cases, can also reduce ODD symptoms. Most children with ODD also use behavior modification techniques to help manage the condition. In severe cases, a child may need to see a family therapist trained in childhood behavior problems.
It’s a good idea for the therapist to also screen your child for anxiety, depression, and bipolar disorder, all of which can cause ODD.