ADHD & Oppositional Defiant Disorder: What’s The Difference?

ADHD/ADD (Attention-Deficit/Hyperactivity Disorder) and Oppositional Defiant Disorder (ODD) are two distinct clinical disorders that can co-occur.[i]

ADHD/ADD is characterized by challenges in attention, hyperactivity, and impulsivity, affecting an individual's ability to concentrate and regulate behavior. [ii] On the other hand, ODD is primarily identified by a pattern of oppositional and defiant behaviors, marked by frequent arguments, defiance, and hostility towards authority figures. [iii]

While ADHD and ODD have unique features and diagnostic criteria, they may share some overlapping symptoms and behavioral patterns. For instance, children with ADHD/ADD may interrupt others and struggle to follow the rules, which can contribute to oppositional behaviors. Similarly, some individuals with ODD may struggle with attention and self-regulation, resembling symptoms associated with ADHD/ADD. [iv]

Though conventional thinking is that they are separate disorders, we have found that ODD is frequently a byproduct of the child’s daily life experience with ADHD, whereby they’re frequently being criticized for their behavior or lack of ability to complete tasks. By helping ADHD symptoms, we commonly see ODD resolve.

For decades, the Drake Institute has used advanced treatment technologies to create customized treatment protocols for patients with ADHD and other brain-based conditions. Brain map-guided neurofeedback and neurostimulation help our ASD and ADHD patients reduce their symptoms and help them develop to their full potential.

For more information about how the Drake Institute treats autism spectrum disorder, ADHD, and several other brain-based conditions, please fill out the consultation form or call us at 800-700-4233.


What Is ADHD & ADD?

ADHD is a neurodevelopmental disorder that can significantly impact a child's daily life. The atypical development of the ADHD and ADD brain leads to difficulties in paying attention, focusing, and in some individuals, controlling impulsive behaviors.

While the actions of individuals with ADHD and ADD may appear as if they aren't trying hard enough to sit still or concentrate, the underlying issue is not a character flaw nor poor parenting, but an underlying neurodevelopmental glitch causing brain dysregulation.

There is no blood test or laboratory test for diagnosing ADHD and ADD; instead, analyzing brain function through qEEG brain mapping is essential to understanding the source of the problem and designing an effective treatment for it.

At the Drake Institute, we use a combination of qEEG brain mapping, neurofeedback, and neurostimulation to help patients achieve a reduction of symptoms and improved capacity for succeeding with their life’s demands.[v]

Symptoms Of ADHD

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, and may also include hyperactivity, and impulsivity. These symptoms can significantly impact daily life, affecting academic or work performance, social interactions, and emotional well-being. Below are the symptoms related to the different presentations of ADHD:

ADHD: (Inattentive Presentation)

  • Inattention
  • Easily distracted
  • Lack of sustained focus on non-preferred tasks
  • Difficulty finishing tasks such as homework without supervision
  • Poor short-term memory (i.e., difficulty following a series of instructions)
  • Often forgetful, such as forgetting homework or turning it in
  • Poor listening skills

ADHD: (Hyperactive-Impulsive Presentation)

  • Impulsive (acting without thinking of the consequences, blurting out answers, interrupting, having trouble waiting one's turn)
  • Hyperactive (fidgety and/or difficulty sitting still)

ADHD: (Combined Presentation)

  • Inattentive symptoms along with hyperactivity/impulsivity

ADHD: (Unspecified ADHD)

  • Significant clinical impairment but does not meet full criteria of ADHD symptoms

What Is Oppositional Defiant Disorder (ODD)?

Oppositional Defiant Disorder (ODD) is a clinical disorder characterized by a persistent pattern of anger, defiance, and hostile behavior toward authority figures. [vi]

Children with ODD often display frequent temper outbursts, refuse to comply with rules and requests, and deliberately provoke others. This disruptive behavior significantly impairs their daily functioning and relationships, particularly with parents, teachers, and peers. [vii]

The causes of ODD are not completely understood, but a combination of genetic, environmental, and social factors is believed to contribute to its development. Children with a family history of ODD, conduct disorder, or other mental health conditions may have an increased risk of developing the disorder. Additionally, exposure to adverse experiences, such as inconsistent parenting, family conflict, or trauma, can also play a role in ODD development. [viii]

At the Drake Institute, we have learned that many cases of Oppositional Defiant Disorder are actually a side effect of the ADHD life experience. The ADHD child is frequently being criticized for not meeting daily expectations, but unfortunately, their brain’s dysregulation limits their abilities to be successful so they feel that the outside world is being unfair or mean to them.

Remember that ADHD symptoms are the normal baseline for the child, so the child begins to feel that the outside world is not approving of them when they’re just being themselves. As a result, they develop unhealthy defense mechanisms which result in oppositional defiant behavior. As we help improve the child’s ADHD, frequently the oppositional defiant behavior melts away.

Symptoms Of Oppositional Defiant Disorder (ODD)

ADHD and ODD symptoms can sometimes appear similar. However, Oppositional Defiant Disorder is characterized by a consistent pattern of oppositional and defiant behaviors in children and adolescents.

Symptoms include frequent arguments with authority figures, refusal to comply with rules and requests, deliberately annoying others, and displaying anger and resentment.

Children with ODD may be easily angered, vindictive, and have difficulty managing their emotions and reactions appropriately. These behaviors significantly impact their relationships with parents, teachers, and peers, causing disruptions at home, in school, and in other social settings.

Early identification and intervention are essential to address ODD symptoms and improve functioning and social interactions. More specific symptoms include: [ix] [x] [xi]

  • Frequent temper tantrums
  • Argues with adults
  • Persistent questioning of rules
  • Speaking harshly or unkindly
  • Hurtful & revengeful behavior
  • Angry and irritable mood
  • Doing things to annoy or upset others
  • Blames others for their own mistakes or misbehavior

How Are ADHD & ODD Diagnosed?

Diagnosing ADHD and ODD involves a comprehensive evaluation that considers a child's behavioral and emotional patterns, as well as their social and academic functioning.

It can include gathering information from parents, teachers, and other caregivers to assess the child's behavior in various settings.

The diagnostic process aims to identify specific symptoms and behavioral patterns associated with each disorder, allowing healthcare professionals to identify ADHD and ODD accurately.

Below are the individual diagnostic processes for each condition:


Diagnosing ADHD involves a comprehensive assessment that considers the child's behavioral, academic, and social functioning. Healthcare professionals use standardized criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to identify the specific symptoms and patterns associated with ADHD.

The evaluation process can include gathering information from parents, teachers, and caregivers to gain insights into the child's behavior across various settings.

The diagnostic process for ADHD aims to determine whether the child displays predominantly inattentive symptoms, predominantly hyperactive-impulsive symptoms, or a combination of both.

Accurate diagnosis is important for developing effective interventions and support to help children with ADHD succeed academically, socially, and emotionally. [xii] [xiii]


Diagnosing Oppositional Defiant Disorder (ODD) involves a careful evaluation of the child's behavior, focusing on their persistent pattern of oppositional and defiant actions toward authority figures.

Healthcare professionals utilize criteria outlined in the DSM-5 to identify the specific symptoms and behavioral patterns associated with ODD. The assessment process can involve gathering information from parents, teachers, and caregivers to understand the child's interactions and conduct in various settings.

Additionally, it is essential to rule out other potential behavioral or emotional disorders that may present with similar symptoms. Accurate diagnosis is crucial for developing specific treatment protocols to address the disruptive behaviors seen in children with ODD and support their emotional and social development. [xiv] [xv]

How Are ADHD & ODD Similar?

ADHD and ODD share certain similarities in their behavioral manifestations and impact on a child's functioning. Both conditions are clinical disorders that typically emerge during childhood, and their symptoms can persist into adolescence and adulthood.

One common feature between ADHD and ODD is the presence of difficulties in self-regulation. Children with ADHD may struggle with impulsivity, hyperactivity, and inattention, while those with ODD often exhibit defiant and oppositional behaviors, challenging authority figures, and resisting rules and requests. In some children, ADHD can be the driving force of the ODD behavior.

Moreover, both disorders can significantly affect a child's relationships with parents, teachers, and peers, leading to disruptions at home, in school, and in other social settings. The challenges posed by ADHD and oppositional defiant disorder can also have an impact on academic performance and overall social interactions and friendships. Additionally, children with ADHD and ODD may experience difficulties with emotional regulation, leading to outbursts of anger or frustration.

What causes ADHD and ODD can be multi-factorial, with genetic, biological, and environmental factors in play. [xvi] [xvii]

How Are ADHD & ODD Different?

There are many similarities between the two disorders, but what is the key difference between ADHD and ODD?

ADHD primarily involves challenges in attention, hyperactivity, and impulsivity. Children with ADHD may struggle to focus on tasks and follow instructions, and some are challenged to remain seated and control their impulses. The child with ADHD may not be oppositional or defiant at all.

On the other hand, ODD is characterized by a persistent pattern of defiant, argumentative, and hostile behaviors, particularly towards authority figures. Children with ODD often display frequent temper outbursts, refuse to comply with rules and requests, and deliberately provoke others.

Another key difference between ADHD and ODD lies in the nature of the disruptive behaviors. Some children with ADHD may act impulsively and have difficulty controlling their actions due to challenges in self-regulation, but not be oppositional, while those with ODD display oppositional behavior as a core characteristic. [xviii]

Can A Child Have Both ADHD & ODD?

Yes, it is possible for a child to have both ADHD and ODD at the same time. Many children with ODD have underlying ADHD, as the disorders can run together.

When a child has both ADHD and oppositional defiant disorder, their behavioral difficulties may be compounded, and the impact on their daily life and functioning can be more pronounced.

For instance, a child with ADHD may struggle with inattentiveness and impulsivity, making it challenging for them to follow instructions or complete tasks, and the addition of ODD-driven defiant behaviors and frequent temper outbursts can lead to an even more problematic life for the child and the parents. [xix]

Similarly, children with ADHD who exhibit behavioral problems and end up being criticized frequently for their behavior are more likely to develop ODD. The criticism feels unfair to them, as their impulsive behavior is normal for their brain functioning. Sometimes a child with ADHD will unconsciously seek and cause conflict because it stimulates their brain, and they become conflict-driven.

Can Children Outgrow ADHD & ODD?

The outlooks for children with ADHD vs. ODD can vary depending on the severity of their symptoms and the effectiveness of interventions and support they receive.

While some children may experience a reduction in symptoms and improved functioning over time, clinical disorders like ADHD and ODD are chronic conditions that do not typically go away without treatment.

Early diagnosis and treatment can play an important role in reducing symptoms, and the prognosis for both disorders is favorable with our brain map-guided neurofeedback and neurostimulation treatment.

How The Drake Institute Treats ADHD & ODD

Over the last 40 years, the Drake Institute has clinically pioneered the use of advanced treatment technologies to treat a variety of brain-based medical disorders such as ADHD, ODD, Autism Spectrum Disorder, PTSD, anxiety, panic disorder, depression, insomnia, and more. Using a combination of brain map-guided neurofeedback and sometimes neurostimulation, our Medical Director creates customized treatment protocols to address each patient's needs.

Brain Mapping

To develop our individualized treatment plans, we first complete a qEEG brain map analysis for each patient. Brain mapping helps us identify which specific regions or networks of the brain are dysregulated linked to symptoms.

To collect this data, 19 sensors are placed around the scalp in areas of the brain responsible for language, focus, memory, executive functioning, social/emotional understanding, and behavioral/emotional regulation. The 19 sensors measure and record brainwave activity that is processed through a normative database of neurotypical individuals.

When we compare the patient's results with those of neurotypical individuals, we can identify regions or networks of the brain that are dysregulated and causing symptoms. This information also allows us to determine how these areas are dysregulated so that we can develop specific treatment protocols that help improve brain functioning and reduce symptoms.


During neurofeedback training/treatment, sensors are once again placed on the scalp. The sensors record and display instantaneous brainwave activity visually in real-time on a computer screen with simultaneous auditory feedback as well.

During neurofeedback sessions, the patient is seeing the results of how their brain is working and with this information, they learn to improve their brainwave activity by guiding it toward healthier, more appropriately functional brainwave patterns.

We do not administer any drugs or perform invasive procedures during this process. Instead, the patient is improving their own brain functioning, guided by visual and auditory feedback.


As an adjunct to neurofeedback, we may also use neurostimulation guided by qEEG brain map findings to gently stimulate the brain into healthier functional patterns. In our experience, some patients may benefit even more from neurofeedback if we also use neurostimulation.

Contact The Drake Institute Today!

In the last forty years, Drake has helped thousands of patients with various disorders such as ADHD, ODD, autism, PTSD, anxiety, panic disorder, depression, insomnia, migraine headaches, irritable bowel syndrome, and hypertension reduce or resolve their symptoms and thereby achieve a better quality of life. Call us at 1-800-700-4233 or fill out the free consultation form to get started.





















Contact Us Today

To get the help you or a loved one needs, call now to schedule your no-cost screening consultation.

dr david velkoff headshot

“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”

More About What Makes Drake Institute Unique