Published on ADDitudeMag.com

ODD and ADHD: Parenting Your Defiant Child

ADHD behavior issues often partner with oppositional defiant disorder (ODD), making discipline a challenge. Try these strategies for managing and treating an angry, defiant child.


More Than Defiant

Every parent of a child with attention deficit knows what it’s like to deal with behavior problems—saying no to requests or blurting words out. Children with ADHD and ODD take defiant behavior to the extreme. They have a pattern of angry, violent, and disruptive behaviors toward parents, caretakers, and other authority figures.

ODD and ADHD: Stats and Facts

Forty percent of children with ADHD also develop ODD. Before puberty, ODD is more common in boys; after puberty, it is equally common in both genders. About half of all preschoolers diagnosed with ODD outgrow the problem by age eight. Older kids with ODD are less likely to outgrow it.

ODD and ADHD: The Links

A child’s oppositional behaviors aren’t intentional. Experts think that ODD is linked to intense impulsivity. Not being able to control impulses, combined with the stress and frustration of trying to get on top of ADHD symptoms every day, lead some children to lash out, physically and verbally. 

An ODD Diagnosis Is Tricky

Every child will act out and test his boundaries. It may be hard to know whether a child is normally defiant or has ODD. Consult a therapist trained in childhood behavioral problems. He should also screen for anxiety, depression, and bipolar disorder—each of which may cause oppositional behavior. Left untreated, ODD can evolve into conduct disorder, a more serious behavioral problem.

Steps to Treating ODD

Treatment starts with controlling ADHD symptoms. When a child’s hyperactivity, impulsiveness, and inattention are reduced, there is usually an improvement in ODD symptoms. Stimulant medications have been shown to decrease ADHD symptoms, as well as those of ODD, by up to 50 percent.

Go Beyond Stimulants

If a child doesn’t respond well to stimulants, some doctors prescribe the non-stimulant atomoxetine (brand name: Strattera). In one study, researchers found that the medication significantly reduced ODD and ADHD symptoms. However, higher doses of the medication were needed to control symptoms.

Change a Child’s Behavior—by Changing Yours

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. Therapists will also work with a parent and child together to solve specific challenges.

Discipline in Three Steps

ODD experts find the following strategy effective for parents: Ask your child calmly to do something. If he doesn’t respond to you in two minutes, gently tell him, “I’m asking you a second time. Do you know what I’m asking you to do—and the consequences if you don’t? Please make a smart decision.” If you have to ask a third time, he suffers the pre-arranged consequence’—no TV or video games for an hour.

Get Everyone on the Same Page

For behavior therapy to work, the child’s caregivers should use the same discipline strategies that you do. Grandparents, teachers, nannies, and other adults who spend time alone with your child must understand which carrots and sticks you use and, above all, to use them consistently. If one of them gives into your child’s bad behavior, it can undermine your discipline program.

Do Not Take ODD Personally

It is hard for a parent to remain calm when a child is verbally abusing her, but don’t overreact. Yelling or spanking may worsen a child’s oppositional behaviors. Stay calm and emotionally neutral amid your child’s defiance. Oppositional kids have radar for adult hostility. If they pick up your anger, they’re going to match it.

Make Room for Praise

Helping parents learn to praise good behavior is one of the toughest challenges therapists face. Many parents are so focused on bad behavior that they stop reinforcing positive ones. A few tips: Specify the praiseworthy behavior, be enthusiastic while not overdoing it, and finish up with a non-verbal gesture—a kiss on the cheek or a hug.

Be Creative and Be Consistent

The more creatively you tailor your program of rewards and punishments to your child’s specific abilities and needs, the better. Her needs change as she grows. Creativity is important, but consistency is vital to success. Consistency in the way you treat your child—setting rules, conveying expectations—is the key to cleaning up your child’s ODD act.

More ADHD Behavior Help

For more must-have resources on managing behavior issues in ADHD children, visit the Defusing Defiant and Oppositional Behavior Resource Center.

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