Disrupting Disruption

Disrupting Disruption: Managing Disruptive Behavior Disorders in Children and Adolescents with ADHD

Two-thirds of children with ADHD have at least one co-occurring condition according to a recent health survey (see February 10 edition of ADHD in the News ). These findings reinforce existing data on children and adolescents. Information on the Statistical Prevalence page of the NRC website indicates that Oppositional Defiant Disorder (ODD) is the most common of these coexisting conditions, occurring more than 40 percent of the time. Another common coexisting condition, which is more severe than ODD, is Conduct Disorder (CD). Both ODD and CD share common symptoms, such as short temper, an argumentative disposition, anger, and an overall refusal to comply with rules or listen to authority figures. CD carries additional risks, such as higher likelihood of negative contact with the justice system. What can I do for my child who has ADHD and one of these conditions? Some basic strategies that will be useful to many parents include: Proper use of medications. Parent Training Family Therapy Psychosocial treatment/Behavioral Therapy. “ODD symptoms, and conduct problems usually can be treated effectively with medications that have been effective for ADHD…” write Jeffrey H. Newcorn, Jeffrey M. Halperin, and Carlin J. Miller, (cf. ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults, Chapter 9 (available through the CHADD bookstore). “…but individuals with comorbid ODD or CD may require higher doses for effective treatment.” This underscores the need for effective medication management and a proper diagnosis. The NRC offers an FAQ to help find a treatment provider who can help manage ADHD and coexisting conditions. Parent Training, such as CHADD’s Parent to Parent Program, can give parents tools to more effectively interact with their child. These classes teach skills and systems, such as effective use of rewards and punishments. Family therapy helps the child and the rest of the family. Having a child with ADHD, or ADHD and coexisting conditions, can take a toll on the parents, their marriage, and siblings. Family therapy can help in dealing with and overcoming some of the challenges ADHD plus can lead to. As for psychosocial treatments, What We Know #7: Psychosocial Treatment for Children and Adolescents with AD/HD offers comprehensive information. The focus is teaching children and adolescents skills they can master and apply across their lifespan. These skills can help achieve academic goals, behavioral goals, and social goals. General information on ODD and Conduct Disorder can be found in the NRC’s information sheetWhat We Know #5: AD/HD and Coexisting Conditions: Disruptive Behavior Disorders. It is not an easy road to walk when a child or adolescent has ADHD, and even more difficult when a disruptive behavior disorder is in the mix. The NRC offers further information and suggests resources that can help, and membership organizations such as CHADD can provide resources and support for parents who find themselves in this situation. Making use of all available information and resources can go a long way towards helping the child, and the rest of the family, cope with the challenges that arise. Have questions about what you just read? Our health information specialists are here to help. Contact us at 800-233-4050 or online.

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