Table of ContentsView AllTable of ContentsADHD and ODD LinksCausesDiagnosisTreatmentTips for Parents
Table of ContentsView All
View All
Table of Contents
ADHD and ODD Links
Causes
Diagnosis
Treatment
Tips for Parents
This article explains why ODD often occurs with ADHD, how the conditions are treated and managed, and coping strategies for parents and children.
Verywell / Laura Porter
Link Between ADHD and ODD
Research suggests that as many as one-third to one-half of children with either ADHD or ODD also meet the criteria for the other.
While it isn’t entirely clear why ADHD and ODD co-occur so frequently, researchers have identified a few overlapping risk factors, including:
Adverse life events are the strongest risk factor for both conditions.
ADHD is a neurodevelopmental disorder, meaning that it affects the growth and development of the brain. As a result, ADHD can lead to challenges with language, emotions, behavior, self-control, learning, and memory.
The two disorders cause different symptom profiles, some of which can overlap.
Common Symptoms
Children with ADHD often feel frustrated quickly, which can lead toangry temper tantrums—especially in response to boredom. Children with ODD are also prone to throwing tantrums, but those tantrums are more likely to become physicallyaggressive.
When paired with impulsivity, which is characteristic of both disorders, a child with ADHD and ODD may have angry outbursts in response to boredom that may lead to aggression. The child may refuse to comply with requests to apologize or blame others for their own mistakes.
Other examples of how ADHD and ODD manifest together include:
While occasional argumentativeness and irritability is normal for most teens, a child with ODD and ADHD will start to test boundaries from a much earlier age—as early as preschool in some cases.
Unique Symptoms of ADHD
Some symptoms of ADHD in children include:
ADHD begins in childhood, but often persists into adulthood, though the symptoms can change over time.
Adults with ADHDmay:
Unique Symptoms of ODD
ODD symptoms in children include:
Adults with ODD may:
ADHD and ODD both have distinct criteria outlined in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5). While they may occur together, they are diagnosed separately according to their individual criteria.
Diagnosis typically begins with a visit to a healthcare provider who can perform a physical exam, ask about symptoms and family history, and make referrals as necessary.
Treatment often involves addressing each condition separately when they occur together, but there can be overlap.
Treating ADHD and ODD
Children with comorbid ADHD and ODD are at an increased risk of developing anxiety, depression, conduct disorder, and personality disorders later in life. They are also more likely to engage in aggressive or criminal behaviors than people with ADHD or ODD alone. Starting treatment from an early age reduces these risks.
Medication
Medication is not effective for treating the core symptoms of ODD. For someone with ODD and ADHD, medication is typically prescribed to reduce the inattentive, hyperactive, and impulsive symptoms of ADHD.
The first-line treatment for ADHD is stimulant medication, such as:
When ODD occurs with ADHD, stimulant medication can help manage ADHD symptoms, allowing for more effective treatment for ODD using other measures.
Behavior Modification
Behavior modification is an effective treatment for people with ADHD and ODD, especially when used in conjunction with medication to treat ADHD symptoms.
The goal of behavior modification is to learn or strengthen positive behaviors and eliminate ones that are unwanted. It also involves forming developmentally appropriate consequences for misbehavior.
Behavioral parent training is widely considered the first-line treatment for children with ODD. However, the main criticism of BPT is that it does not directly identify, address, or engage with the underlying emotions that lead to misbehavior.
Therapy
Individual, family, and peer group therapy can be helpful for ADHD and/or ODD. This can include the following:
Calming Techniques
A 2023 study published inFrontiers of Psychologyshowed that combined yoga and music interventions on a daily basis can be an effective treatment for children with comorbid ADHD and ODD.
Other practices that have a calming effect on children and adults include:
Parenting Children With ADHD and ODD
Parenting a child with ADHD and/or ODD can be daunting, but there are effective strategies:
Safety TipsHaving a safe space where children can go to calm down without hurting themselves or others can help themexpress their big emotions safely. Try to ensure this space is used for self-regulation, not punishment. Recognize when you are reaching your limit. Allow another adult to step in if possible, or make sure your child is safe and walk away for a moment to calm down.
Safety Tips
Having a safe space where children can go to calm down without hurting themselves or others can help themexpress their big emotions safely. Try to ensure this space is used for self-regulation, not punishment. Recognize when you are reaching your limit. Allow another adult to step in if possible, or make sure your child is safe and walk away for a moment to calm down.
Summary
ADHD and ODD are separate conditions but often occur together. ADHD is a psychodevelopmental disorder that causes hyperactivity and impulsivity and/or inattention, while ODD is a behavior disorder that causes defiant, irritable, and hostile behavior.
Medication is often helpful for ADHD but rarely used for ODD alone. Several forms of therapy are useful for both disorders. Early intervention is associated with more successful treatment. Routine, consistency, clear expectations, and consequences are key to parenting children with ADHD and/or ODD.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cincinnati Children’s.Oppositional defiant disorder.Harvey E, Breaux R, Lugo-Candelas C.Early development of comorbidity between symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder.J Abnorm Psychol. 2016 Feb;125(2):154-167. doi:10.1037/abn0000090Noordermeer SDS, Luman M, Weeda WD, et al.Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder.Eur Child Adolesc Psychiatry. 2017;26(10):1155-1164. doi:10.1007/s00787-017-0972-4Noordermeer S, Luman M, Greven C, et al.Structural brain abnormalities of attention-deficit/hyperactivity disorder with oppositional defiant disorder.Biologic Psychiatr. 2017 Nov;82(9):642-650. doi:10.1016/j.biopsych.2017.07.008Cleveland Clinic.Attention-deficit/hyperactivity disorder (ADHD).Johns Hopkins Medicine.Behavior disorders.Riley M, Ahmed S, Locke AB.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.National Health Service.Symptoms of attention deficit hyperactivity disorder (ADHD).Johnston O, Derella O, Burke J.Identification of oppositional defiant disorder in young adult college students.J Psychopathol Behavior. 2018 Dec;40(4):563-572. doi:10.1007/s10862-018-9696-0Hood B, Elrod M, DeWine D.Treatment of childhood oppositional defiant disorder.Curr Treat Options Peds. 2015 Apr;2015(1):155-167. doi:10.1007/s40746-015-0015-7Nazarova V, Sokolov A, Chubarev V, Tarasov V, Schiöth H.Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.Front Pharmacol. 2022 Nov;13(1):1066988. doi:10.3389/fphar.2022.1066988Di Giuseppe M, Prout T, Rice T.Regulation-focused psychotherapy for children (RFP-C): Advances in the treatment of ADHD and ODD in childhood and adolescence.Front Pscyhol. 2020 Nov;11(1):1-4. doi:10.3389/fpsyg.2020.572917Center for Disease Control and Prevention.Parent training in behavior management for ADHD.NYU Langone.Cognitive therapy for attention deficit hyperactivity disorder.Powell L, Parker J, Weighall A, Harpin V.Psychoeducation intervention effectiveness to improve social skills in young people with ADHD: a meta-analysis.J Atten Disord. 2022 Feb;26(3):340-357. doi:10.1177/1087054721997553Storebø O, Andersen M, Skoog M, et al.Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years.Cochrane Database Syst Rev. 2019 Jun;2019(6):CD008223. doi:10.1002/14651858.CD008223.pub3Luo X, Huang X, Lin S.Yoga and music intervention reduces inattention, hyperactivity/impulsivity, and oppositional defiant disorder in children’s consumer with comorbid ADHD and ODD.Front Psychol. 2023 Sep;14(1):1150018. doi:10.3389/fpsyg.2023.1150018Harvard Health.Six relaxation techniques to reduce stress.Johns Hopkins Medicine.Imagery.Santonastaso O, Zaccari V, Crescentini C, et al.Clinical application of mindfulness-oriented meditation: A preliminary study in children with ADHD.Int J Environ Res Pub Health. 2020 Aug;17(18):6916. doi:10.3390/ijerph17186916American Academy of Child and Adolescent Psychiatry.Oppositional defiant disorder.
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cincinnati Children’s.Oppositional defiant disorder.Harvey E, Breaux R, Lugo-Candelas C.Early development of comorbidity between symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder.J Abnorm Psychol. 2016 Feb;125(2):154-167. doi:10.1037/abn0000090Noordermeer SDS, Luman M, Weeda WD, et al.Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder.Eur Child Adolesc Psychiatry. 2017;26(10):1155-1164. doi:10.1007/s00787-017-0972-4Noordermeer S, Luman M, Greven C, et al.Structural brain abnormalities of attention-deficit/hyperactivity disorder with oppositional defiant disorder.Biologic Psychiatr. 2017 Nov;82(9):642-650. doi:10.1016/j.biopsych.2017.07.008Cleveland Clinic.Attention-deficit/hyperactivity disorder (ADHD).Johns Hopkins Medicine.Behavior disorders.Riley M, Ahmed S, Locke AB.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.National Health Service.Symptoms of attention deficit hyperactivity disorder (ADHD).Johnston O, Derella O, Burke J.Identification of oppositional defiant disorder in young adult college students.J Psychopathol Behavior. 2018 Dec;40(4):563-572. doi:10.1007/s10862-018-9696-0Hood B, Elrod M, DeWine D.Treatment of childhood oppositional defiant disorder.Curr Treat Options Peds. 2015 Apr;2015(1):155-167. doi:10.1007/s40746-015-0015-7Nazarova V, Sokolov A, Chubarev V, Tarasov V, Schiöth H.Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.Front Pharmacol. 2022 Nov;13(1):1066988. doi:10.3389/fphar.2022.1066988Di Giuseppe M, Prout T, Rice T.Regulation-focused psychotherapy for children (RFP-C): Advances in the treatment of ADHD and ODD in childhood and adolescence.Front Pscyhol. 2020 Nov;11(1):1-4. doi:10.3389/fpsyg.2020.572917Center for Disease Control and Prevention.Parent training in behavior management for ADHD.NYU Langone.Cognitive therapy for attention deficit hyperactivity disorder.Powell L, Parker J, Weighall A, Harpin V.Psychoeducation intervention effectiveness to improve social skills in young people with ADHD: a meta-analysis.J Atten Disord. 2022 Feb;26(3):340-357. doi:10.1177/1087054721997553Storebø O, Andersen M, Skoog M, et al.Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years.Cochrane Database Syst Rev. 2019 Jun;2019(6):CD008223. doi:10.1002/14651858.CD008223.pub3Luo X, Huang X, Lin S.Yoga and music intervention reduces inattention, hyperactivity/impulsivity, and oppositional defiant disorder in children’s consumer with comorbid ADHD and ODD.Front Psychol. 2023 Sep;14(1):1150018. doi:10.3389/fpsyg.2023.1150018Harvard Health.Six relaxation techniques to reduce stress.Johns Hopkins Medicine.Imagery.Santonastaso O, Zaccari V, Crescentini C, et al.Clinical application of mindfulness-oriented meditation: A preliminary study in children with ADHD.Int J Environ Res Pub Health. 2020 Aug;17(18):6916. doi:10.3390/ijerph17186916American Academy of Child and Adolescent Psychiatry.Oppositional defiant disorder.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cincinnati Children’s.Oppositional defiant disorder.Harvey E, Breaux R, Lugo-Candelas C.Early development of comorbidity between symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder.J Abnorm Psychol. 2016 Feb;125(2):154-167. doi:10.1037/abn0000090Noordermeer SDS, Luman M, Weeda WD, et al.Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder.Eur Child Adolesc Psychiatry. 2017;26(10):1155-1164. doi:10.1007/s00787-017-0972-4Noordermeer S, Luman M, Greven C, et al.Structural brain abnormalities of attention-deficit/hyperactivity disorder with oppositional defiant disorder.Biologic Psychiatr. 2017 Nov;82(9):642-650. doi:10.1016/j.biopsych.2017.07.008Cleveland Clinic.Attention-deficit/hyperactivity disorder (ADHD).Johns Hopkins Medicine.Behavior disorders.Riley M, Ahmed S, Locke AB.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.National Health Service.Symptoms of attention deficit hyperactivity disorder (ADHD).Johnston O, Derella O, Burke J.Identification of oppositional defiant disorder in young adult college students.J Psychopathol Behavior. 2018 Dec;40(4):563-572. doi:10.1007/s10862-018-9696-0Hood B, Elrod M, DeWine D.Treatment of childhood oppositional defiant disorder.Curr Treat Options Peds. 2015 Apr;2015(1):155-167. doi:10.1007/s40746-015-0015-7Nazarova V, Sokolov A, Chubarev V, Tarasov V, Schiöth H.Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.Front Pharmacol. 2022 Nov;13(1):1066988. doi:10.3389/fphar.2022.1066988Di Giuseppe M, Prout T, Rice T.Regulation-focused psychotherapy for children (RFP-C): Advances in the treatment of ADHD and ODD in childhood and adolescence.Front Pscyhol. 2020 Nov;11(1):1-4. doi:10.3389/fpsyg.2020.572917Center for Disease Control and Prevention.Parent training in behavior management for ADHD.NYU Langone.Cognitive therapy for attention deficit hyperactivity disorder.Powell L, Parker J, Weighall A, Harpin V.Psychoeducation intervention effectiveness to improve social skills in young people with ADHD: a meta-analysis.J Atten Disord. 2022 Feb;26(3):340-357. doi:10.1177/1087054721997553Storebø O, Andersen M, Skoog M, et al.Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years.Cochrane Database Syst Rev. 2019 Jun;2019(6):CD008223. doi:10.1002/14651858.CD008223.pub3Luo X, Huang X, Lin S.Yoga and music intervention reduces inattention, hyperactivity/impulsivity, and oppositional defiant disorder in children’s consumer with comorbid ADHD and ODD.Front Psychol. 2023 Sep;14(1):1150018. doi:10.3389/fpsyg.2023.1150018Harvard Health.Six relaxation techniques to reduce stress.Johns Hopkins Medicine.Imagery.Santonastaso O, Zaccari V, Crescentini C, et al.Clinical application of mindfulness-oriented meditation: A preliminary study in children with ADHD.Int J Environ Res Pub Health. 2020 Aug;17(18):6916. doi:10.3390/ijerph17186916American Academy of Child and Adolescent Psychiatry.Oppositional defiant disorder.
Cincinnati Children’s.Oppositional defiant disorder.
Harvey E, Breaux R, Lugo-Candelas C.Early development of comorbidity between symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder.J Abnorm Psychol. 2016 Feb;125(2):154-167. doi:10.1037/abn0000090
Noordermeer SDS, Luman M, Weeda WD, et al.Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder.Eur Child Adolesc Psychiatry. 2017;26(10):1155-1164. doi:10.1007/s00787-017-0972-4
Noordermeer S, Luman M, Greven C, et al.Structural brain abnormalities of attention-deficit/hyperactivity disorder with oppositional defiant disorder.Biologic Psychiatr. 2017 Nov;82(9):642-650. doi:10.1016/j.biopsych.2017.07.008
Cleveland Clinic.Attention-deficit/hyperactivity disorder (ADHD).
Johns Hopkins Medicine.Behavior disorders.
Riley M, Ahmed S, Locke AB.Common questions about oppositional defiant disorder.Am Fam Physician. 2016;93(7):586-591.
National Health Service.Symptoms of attention deficit hyperactivity disorder (ADHD).
Johnston O, Derella O, Burke J.Identification of oppositional defiant disorder in young adult college students.J Psychopathol Behavior. 2018 Dec;40(4):563-572. doi:10.1007/s10862-018-9696-0
Hood B, Elrod M, DeWine D.Treatment of childhood oppositional defiant disorder.Curr Treat Options Peds. 2015 Apr;2015(1):155-167. doi:10.1007/s40746-015-0015-7
Nazarova V, Sokolov A, Chubarev V, Tarasov V, Schiöth H.Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials.Front Pharmacol. 2022 Nov;13(1):1066988. doi:10.3389/fphar.2022.1066988
Di Giuseppe M, Prout T, Rice T.Regulation-focused psychotherapy for children (RFP-C): Advances in the treatment of ADHD and ODD in childhood and adolescence.Front Pscyhol. 2020 Nov;11(1):1-4. doi:10.3389/fpsyg.2020.572917
Center for Disease Control and Prevention.Parent training in behavior management for ADHD.
NYU Langone.Cognitive therapy for attention deficit hyperactivity disorder.
Powell L, Parker J, Weighall A, Harpin V.Psychoeducation intervention effectiveness to improve social skills in young people with ADHD: a meta-analysis.J Atten Disord. 2022 Feb;26(3):340-357. doi:10.1177/1087054721997553
Storebø O, Andersen M, Skoog M, et al.Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years.Cochrane Database Syst Rev. 2019 Jun;2019(6):CD008223. doi:10.1002/14651858.CD008223.pub3
Luo X, Huang X, Lin S.Yoga and music intervention reduces inattention, hyperactivity/impulsivity, and oppositional defiant disorder in children’s consumer with comorbid ADHD and ODD.Front Psychol. 2023 Sep;14(1):1150018. doi:10.3389/fpsyg.2023.1150018
Harvard Health.Six relaxation techniques to reduce stress.
Johns Hopkins Medicine.Imagery.
Santonastaso O, Zaccari V, Crescentini C, et al.Clinical application of mindfulness-oriented meditation: A preliminary study in children with ADHD.Int J Environ Res Pub Health. 2020 Aug;17(18):6916. doi:10.3390/ijerph17186916
American Academy of Child and Adolescent Psychiatry.Oppositional defiant disorder.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
