Children with ADHD often have difficulty paying attention, following rules, listening to adults, and controlling impulses. In many children these behaviors are a result of inattention or overactivity, and are not willful behaviors. However, many children with ADHD often demonstrate behavioral difficulties above and beyond what would be expected from ADHD alone. Studies show that between 50-65% of children with ADHD meet criteria for a disruptive behavior diagnosis such as Oppositional Defiant Disorder or Conduct Disorder Disruptive behaviors commonly seen in children with ADHD and co-occurring behavior disorders include:
Willful defiance of rules
Refusal to comply with adults
Yelling and screaming
Verbal and physical aggression
Stubbornness
Lying, stealing, and other "sneaky" behaviors
Higher rates of co-occurring disruptive behavior disorders are seen in children with ADHD who are:
Male
ADHD-combined type
Lower socioeconomic status
Oppositional Defiant Disorder and Conduct Disorder
Disruptive behavior disorders include ODD and CD. Children with co-occurring ADHD and ODD or CD typically have more severe social, behavioral, emotional, and academic problems than children with ADHD alone. The difference between ODD and CD is in the severity of symptoms. Symptoms can get worse with age, thus causing ODD to progress into CD. Oppositional defiant disorder occurs when a child behaves in a negative, disobedient and defiant manner consistently for at least six months. To be diagnosed with ODD a child must have a minimum of four of the following symptoms:
Often loses temper
Often argues with adults
Often defies rules or requests
Often annoys people on purpose
Often blames others for his or her mistakes or misbehaviors
Is often annoyed easily
Is often angry
Is often spiteful
In order for a symptom to be considered occurring “often”, the behavior must be exhibited more frequently than peers. The behavior must also cause impairment in the child’s social, academic or occupational functioning. Conduct disorder is a more severe pattern of antisocial behaviors. 25% of children with ADHD may have CD. Conduct disorder is diagnosed when a child or adolescent:
Exhibits more serious behaviors and actions
Is physically cruel to animals or people
Destroys property
Lies frequently
Steals
Skips school
Treatment
Both ADHD and ODD as well as ADHD and CD can be treated. Treatment is often two-pronged, focusing on behavior at home and behavior at school. Behavioral support at school can help with academic and social problems at school, while parent training can teach parents how to work with their child or adolescent. More information on the treatment of ADHD and behavior management can be found on the ADHD Treatment page.
