Is it a Disruptive Behavior Disorder or ADHD? Knowing the Difference and How to Support Your Child
Written By: Madison Reyna, Clinical Trainee at ACS, On-Campus Counseling Program
IT IS COMMON FOR CHILDREN
with Attention deficit/hyperactivity disorder (ADHD) to exhibit some disruptive behaviors. However, ADHD symptoms can be misdiagnosed as a disruptive behavior disorder, especially in children of color (Fadus et al., 2020).
Disruptive behavior disorders are typically presented as difficulties in self-control, emotion regulation, and inability to regulate behavior. Disruptive behavior disorders make it difficult for children to get along with others and are in constant conflict with their peers, family, and authority figures (Kaminski & Claussen, 2017). Two common disruptive behavior disorders are Oppositional defiant disorder (ODD) and Conduct disorder (CD). ODD is characterized as being disobedient towards authority, displaying argumentative behavior, having a short-temper, and having calculated behavior (Fadus et al., 2020). Conduct disorder is characterized as a repetitive and persistent pattern of behavior where a child does not acknowledge the basic human rights of others or breaks age-appropriate societal norms or rules (Newcorn et al., 2015). Other DBDs in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition, Text Revision (DSM-5-TR) include Intermittent explosive disorder (IED), Kleptomania, and Pyromania (American Psychiatric Association, 2022). IED is characterized as recurrent behavioral outbursts where a child cannot control their aggressive impulses, kleptomania includes pleasure from setting fires, and pyromania involves stealing for gratification or relief (APA, 2022).
Why is this an issue?
Children of color, particularly African American and Latine youth, are more likely to receive a diagnosis of a Disruptive behavior disorder rather than ADHD (Dohrmann et al., 2022; Fadus et al., 2020). This can be problematic, as these children may not receive the necessary treatment for the underlying issues they are experiencing. Behavioral issues can be a result of such things like a response to a traumatic event, changes in a child’s environment, or a neurodevelopmental disorder (Dohrmann et al., 2022; Fadus et al., 2020). Additionally, having a diagnosis of a DBD on a child’s record can influence how others respond to them. This hostility and negative reaction from others can lead to youth falling behind academically and towards a higher likelihood of engaging in future criminal behavior (Fadus et al., 2020).
What can you do as a parent?
There are things you can do as a parent to prevent your child from receiving an inappropriate diagnosis. It is important to advocate for your child, especially in the African American and Latine community. One of the most important things to do is to educate yourself on the differences between ADHD and Disruptive behavior disorders. To gather more information about your child’s behavior, talk to teachers who interact with your child and note any differences in environment or explanations for their behavior. Additionally, if you are worried about potential bias, you may be able to find psychologists that match the racial/ethnic background of your child. Although this may be difficult as the number of BIPOC clinicians are limited, there are many places that have more experience working with minoritized populations. If financial barriers are present, insurance may cover assessments or sessions with a therapist. There are also clinics that offer sliding scale fees who will work with you to choose a payment option appropriate for you. Furthermore, psychotherapy for your child, and potentially yourself, may be helpful to improve behavioral issues and teach emotion regulation skills that will have an important impact on their behavior. Parent management training and child psychotherapy have been found to be effective for children with behavioral issues (Kaminski & Claussen, 2017). Finally, the most important thing to do for your child is to be present in their lives as much as you can. Nothing is more essential than your child feeling supported and understood.
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References
American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision).
Dohrmann, E., Porche, M. V., Ijadi-Maghsoodi, R., & Kataoka, S. H. (2022). Racial disparities in the education system. Child and Adolescent Psychiatric Clinics of North America, 31(2), 193–209. https://doi.org/10.1016/j.chc.2022.01.001
Fadus, M. C., Ginsburg, K. R., Sobowale, K., Halliday-Boykins, C. A., Bryant, B. E., Gray, K. M., & Squeglia, L. M. (2020). Unconscious bias and the diagnosis of disruptive behavior disorders and ADHD in African American and Hispanic youth. Academic Psychiatry, 44(1), 95–102. https://doi.org/10.1007/s40596-019-01127-6
Kaminski, J. W., & Claussen, A. H. (2017). Evidence base update for psychosocial treatments for disruptive behaviors in children. Journal of Clinical Child & Adolescent Psychology, 46(4), 477–499. https://doi.org/10.1080/15374416.2017.1310044
Newcorn, J. H., Lalonde, M. M., & Leikauf, J. (2015). ODD and conduct disorder. In A. Tasman, J. Kay, J.A. Lieberman, M.B. First, and M.B. Riba (Eds.). Psychiatry (pp. 1350-1366). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781118753378.ch69