ADHD & ODD - Which came first?

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Registered: 07-03-2003
ADHD & ODD - Which came first?
Sun, 07-13-2003 - 8:59pm
When we read about ADHD, we read about ODD - that ODD and ADHD often occur together - but which came first? I bet the ADHD. It seems to me that the ODD is a logical consequence of the (especially untreated) ADHD. The child can't sit still, can't follow the rules, becomes impulsive, draws negative attention, and then REPEAT over and over until the child feels really bad about himself and the adults feel bad about him - what else could happen? It just snowballs right into chaos.

I'm not sure about giving this ODD label. If the child is being successfully treated for the ADHD, after a while, will the ODD go away? In other words, when the child can slow down, start paying attention, and decrease their impulsive tendancies - then adults and other kids will like them better, they'll start getting positive messages and this snowballs the other way (hopefully) to where the child is able to comply and "be good."

Does the ODD label add just another unnessary negative label on a kid?

Avatar for keke0116
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Registered: 03-26-2003
Tue, 07-15-2003 - 6:24am
I think it depends on the form of ADHD and how that is being handled.

In the case of Kevin (my 11 y.o.) he was diagnosed as ODD-alone when he was 5. At the time, we were told to 'expect' more down the road as ODD rarely travels alone. But, at the time, there was no other 'label' attached. SO, we dealt with ODD issues for years. We struggled the most from ages 8-9, and just before he turned 10, we had a full evaluation conducted which revealed the ADHD ... but for Kevin, it's the impulsivity type. He isn't hyper, and the attention-issues are secondary to the impulsivity. He never really had 'issues' in school, so his self-image and self-esteem weren't being challenged there. He comes from a loving and supportive home, so he didn't 'develop' ODD because of anything we did (or didn't do.) When we medicated him (Concerta) for the ADHD, it was interesting in that many of the ODD behaviors (the rages, the violence) subsided, but I think that was because the meds helped with his impulsivity issues, and when they were under control, he was better able to control the outbursts resulting from ODD.

ODD symptoms include:

1 often loses temper

2 often argues with adults

3 often actively defies or refuses to comply with adults' request or rules

4 often deliberately annoys people

5 often blames others for his or her mistakes or misbehaviors

6 is often touchy or easily annoyed by others

7 is often angry and resentful

8 is often spiteful or vindictive

Now, I can certainly see how a child with ADHD/ADD can lose his temper (out of frustration for not being able to do or act the way other kids do) or argues with adults (for not being understood) or is angry and resentful (who wouldn't be?) SO, I can absolutely see that a child with ADHD (especially undiagnosed and/or untreated) could 'develop' patterns of behavior that fall under the ODD label. But, I also know of many kids that were diagnosed as ODD-alone ... and, many of those were diagnosed at young ages (before what I would think would have caused a situation where they were building up resentment for not being understood.)

Perhaps in our case Kevin had 'ADHD' and it wasn't really detected since it wasn't 'obvious' like a child who is hyper ... and perhaps the impulsivity was there all along. He also has some auditory processing issues and 'perhaps' not always understanding (or processing) directions and such was frustrating to Kevin (who is also extremely bright) and that created a situation which lead to the anger and resentment. Hard to say.

It's an interesting question ... and certainly something to think about. In our case, however, I don't think that the ODD was a spinoff from anything else, but perhaps as the years went on and other things 'developed' the ODD got worse ... since it did get better when the other areas were detected and addressed.



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Registered: 03-26-2003
Tue, 07-15-2003 - 11:30am
Hmmm...hard to say. Good question. Justin (7) was diagnosed with "ADHD (with the H and particularly high on impulsivity) and possible early ODD". Looking back, I'd say in his case they developed together. If, in fact, he does have both. Or maybe the ODD symptoms are just the result of the ADHD. I'm in the process of reading Dr. Amen's book; anyone know if he addresses ODD?