As a therapist i have conducted ADHD evaluations using the materials of Dr. Daniel Amen for over 10 years. You can explore his information and start an evaluation on his website here https://addtypetest.com/. I found that many of my clients who exhibited behaviors like ODD or were diagnosed with ODD often suffered from Overfocused ADHD
“In order to focus, it is necessary to continually be able to shift your attention. People suffering with Overfocused ADD have most of the ADD features, but rather than not being able to pay attention (they also have difficulties with , they have difficulty shifting their attention; they become hyper-focused on certain things while tuning everything else out. These folks tend to get stuck or locked into negative thought patterns and behaviors. This type of ADD is often found in substance abusers as well as the children and grandchildren of alcoholics.
Common symptoms in Overfocused ADD
Core symptoms of ADD
Excessive or senseless worrying
Getting stuck in loops of negative thoughts
Oppositional and argumentative
Tendency toward compulsive behaviors
Difficulty seeing options
Tendency to hold grudges
Difficulty shifting attention from subject to subject
Tendency to hold onto own opinion and not listen to others
Needing to have things done a certain way or they get upset
May or may not be hyperactive
Overfocused ADD SPECT scan findings show increased activity at rest and during concentration in the anterior cingulate gyrus, as well as decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.”
They often were hard to redirect even if they logically knew the consequences were bad.
These individuals exhibited a lot of anger when attempting to redirect them.
My own son also suffers from this type of ADHD and we had to fix a lot of holes in the wall together as he grew up.
According to his materials and my experience in working with these individuals giving them a stimulant to help attention (if needed) combined with a small dose of an SSRI like Zoloft (most often used since the FDA approves its use with children), prozac , paxil, etc. gives the most benefit. These antidepressants increase Serotonin in an area of the brain that tends to “get stuck” when Serotonin levels are low. I have seen these children becomes much more flexible and Oppositional often within a few days.
The other condition on his web site labeled “ring of fire” ADHD (sometimes diagnosed ADHD with bipolar tendencies) is often associated with intense short lived anger and is usually helped with Intuniv but your child’s behavior appears to be more in line with the overfocused ADHD which often does not respond well to Intuniv.
This is not intended to medical advice or providing a diagnosis. I encourage you to explore the website mentioned above.
I hope this helps,