Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) frequently occur together as common childhood behavioural disorders. While both ADHD and ODD can involve disruptive behaviours, the underlying causes and specific symptoms differ. We spoke to our expert N Roshni Rao, Counselling Psychologist, Hyderabad, who explained the connection between these neurodevelopmental disorders and their management measures.
Understanding ADHD and ODD
According to StatPearls, ODD is categorised as a childhood disruptive behaviour disorder primarily characterised by difficulties in regulating emotions and behaviours. Its prevalence shows considerable variation, estimated to range from 2% to 11%. ODD is more common in preadolescent males than in females (1.4:1); however, this male predominance is not found in adolescents or adults.
Also Read: ADHD In Children: Expert Lists Its Signs And How To Diagnosis And Treat It
According to a 2012 study, ADHD is a chronic condition that typically begins in childhood and impacts around 5% of children and adolescents globally, regardless of geographic location. Approximately 65-75% of individuals with ADHD continue to experience symptoms into early adulthood. The disorder manifests in diverse ways, with symptoms commonly involving inattention, hyperactivity, or impulsivity.
Rao said, “As a psychologist, navigating the intricate relationship between ADHD and ODD requires a nuanced understanding and tailored interventions. Let's dwell on a systematic approach to comprehending the connection between ADHD and ODD and implementing effective management strategies, illustrated through case studies.”
Case Study: Akshay (Name Changed)
“Akshay, a 9-year-old boy, presents with symptoms of impulsivity, inattention, and defiance both at home and school. The assessment reveals a diagnosis of ADHD combined type, with prominent oppositional behaviours indicative of comorbid ODD”, said Rao.
Recognising Shared Symptoms
“Both ADHD and ODD manifest in behaviours, such as impulsivity, irritability, and defiance. Akshay's inability to follow instructions, frequent outbursts, and difficulty completing tasks are characteristic of both disorders”, added Rao.
Identifying Underlying Factors
Neurobiological and environmental factors contribute to the development and exacerbation of ADHD and ODD symptoms. In Akshay's case, genetic predisposition, coupled with a chaotic home environment and inconsistent parenting practices exacerbates his behavioural challenges.
Tailored Treatment Planning
“Developing an individualised treatment plan for Akshay involves a multidisciplinary approach. Psychostimulant medication is prescribed to address ADHD symptoms, while behavioural therapy focuses on enhancing coping skills, emotion regulation, and social competence”, highlighted Rao.
Also Read: Oppositional Defiant Disorder: Symptoms And Causes You Must Know About
Case Study: Sania (Name changed)
“Sania, an 18-year-old girl, presents with a history of academic underachievement, social difficulties, and conflicts with authority figures. A comprehensive evaluation reveals a diagnosis of ADHD predominantly inattentive type, complicated by comorbid ODD”, said Rao.
Integrating Medication and Therapy
Sania's treatment plan combines medication management to improve attention and focus while Cognitive-Behavioural Therapy (CBT) targets her oppositional behaviours by teaching problem-solving strategies and enhancing interpersonal skills.
In a study involving children aged 6–17 years diagnosed with ADHD, Biederman et al. found comorbidities in 46% of children and 31% of adolescents with ODD, as well as in 25% of children and 42% of adolescents with CD (Conduct Disorder).
Family Intervention
Rao highlighted, “In both cases, involving family members in therapy sessions is crucial. Providing psychoeducation about ADHD and ODD helps parents understand the disorders and implement effective parenting strategies.”
She added, “For Akshay's family, Parent-Child Interaction Therapy (PCIT) fosters positive parent-child interactions and reduces conflict. On the other hand, for Sania, collaboration with the college can create an Individualised Education Program (IEP) that includes extended time for assignments and preferential seating to minimise distractions and support her academic success.”
Monitoring Progress and Adjusting Interventions
Follow-up appointments and regular monitoring of symptoms allow for adjustments to treatment strategies as needed. Both Akshay and Sania can benefit from ongoing support and adjustments to their treatment plans.
Bottomline
Rao concluded, “Managing ADHD and ODD requires an individualised approach tailored to a person's unique presentation and situation. By recognising the connection between these disorders, implementing evidence-based interventions, and fostering collaboration among individuals, families, educators, and mental health professionals, it's possible to effectively manage symptoms and improve overall functioning.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you are dealing with any mental health conditions to get the necessary treatment.]