ADHD & ODD
Hyperactivity Disorder & Oppositional Defiant Disorder
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ADHD (Attention Deficit Hyperactivity
Disorder) AADD (Adult
Attention Deficit Disorder) ODD (Oppositional Defiant Disorder)
This section is relevant to
Rugby League and more particularly to the area of ‘Junior
League’. Due to the very nature of the symptoms associated with both ADHD & ODD, the game has many
advantages and opportunities for the individual suffering these types of disorders. They may be drawn toward
League themselves, feeling it answers many of their troubles, or their parents/guardians may feel it an
appropriate sport to in which become involved.
Rugby League has structure & discipline; it requires
physical effort & energy; it offers teamwork & a sense of purpose, of belonging, of self, of worth.
Parents may feel that their ADHD child could benefit from these qualities &
attributes of the code. They may feel their child’s hyperactivity is best suited to a highly energetic,
physically demanding & exhaustive sport. They may also believe that their child’s scholastically poor
achievements are compensated by a sport that offers a future.
The reasons are many and varied, though the likelihood of
children & adolescents being involved & playing the game is quite distinct. It is therefore necessary to
understand the disorder and the associated symptoms and how best to manage them should they become a problem.
Further to this, the resultant behaviours & personality development could determine how the player presents
as an adult, particularly if league becomes their career.
Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder is
disorder’ affecting 3 – 5% of the world’s population under the age
of 19. It is currently considered to be a chronic & persistent disorder for which there is no medical cure.
It presents primarily during childhood & is characterized by forgetfulness, hyperactivity, inattentiveness,
poor impulse control & distractibility.
In the last ten
(10) years it has become increasingly diagnosed in adults, though a degree of skepticism & conjecture has
occurred as a result. It appears that about 60% of all those diagnosed with ADHD as children carry it through to
- Difficulty with attention & focus
- Short term memory slippage
- Organisational problems – belongings & ideas
- Weak planning & execution
as simply ADHD, there are three (3) types present under the one heading. They are ADHD (predominantly
hyperactive – impulsive type), ADHD (predominantly inattentive type) and ADHD (combined type). It appears that
hyperactivity & inattention are the defining differences or key components.
For a diagnosis of
ADHD (inattentive type), the following symptoms need to have been present for at least six (6) months and
considered functionally disruptive & inappropriate for the developmental stage:
1. Often does not give close
attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping
attention on tasks or play activities.
3. Often does not seem to listen
when spoken to directly.
4. Often does not follow
instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to
behavior or failure to understand instructions).
5. Often has trouble organizing
6. Often avoids, dislikes, or
doesn't want to do things that take a lot of mental effort for a long period of time (such
schoolwork or homework).
7. Often loses things needed for
tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Often forgetful in daily
For a diagnosis of ADHD
(hyperactivity – impulsivity type) the following symptoms have had to be present for six (6) months;
functionally disruptive & inappropriate for the stage of
1. Often fidgets with hands or
feet or squirms in seat.
2. Often gets up from seat when
remaining in seat is expected.
3. Often runs about or climbs
when and where it is not appropriate (adolescents or adults may feel very restless).
4. Often has trouble playing or
enjoying leisure activities quietly.
5. Is often "on the go"
or often acts as if "driven by a motor".
6. Often talks excessively.
1. Often blurts out answers
before questions have been finished.
2. Often has trouble waiting
3. Often interrupts or intrudes
on others (e.g., butts into conversations or games).
In addition to these
symptoms, there are also specific criteria for an accurate diagnosis:
Six (6) or more of the symptoms of each need to be present
Some symptoms causing impairment need to have been exhibited before the age of seven (7)
Some impairment from the symptoms needs to be present in at least two (2) different settings (eg. at
There must be clear evidence of significant impairment in social, school or work
The symptoms should not occur in the presence of another concurrent disorder, particularly a pervasive one
as a psychotic illness or schizophrenia. This also
applies to Depression, Anxiety Disorders, Bipolar or
In excess of 50% of
children with ADHD will carry these behaviours & symptoms through to adulthood. The impact on their
families, social relationships & occupations is
Ruby Wax - ADHD
The diagnosis for AADD
(Adult Attention Deficit Disorder) is the same for those younger people with ADHD. The difference being that
they must have been diagnosed or have suffered from ADHD as a child in order for that diagnosis to apply as
Symptoms are sometimes
difficult to diagnose or are misdiagnosed in adults. Often, when a child with ADHD has received treatment,
they develop ‘coping mechanisms’ that somewhat deal with their ongoing symptoms. Also the
manifestation of symptoms can be different in the adult setting. Hyperactivity is also not as observable as
with children, being exhibited in different ways.
ADHD in adults can
cause moderate to extreme malfunctioning at home, in social settings, work or school. It is usually
characterised by inattentiveness, impulsiveness & restlessness. Adults have problems structuring their
lives and planning simple daily tasks.
It can result in relationship breakups, job loss, and trouble with people or
work due to the person’s forgetfulness, inattentiveness & disorganisation rather than ‘direct
The most prominent
neurological characteristic of AADD is that of impaired or impoverished ‘executive functioning’.
This is the area of the brain that oversees & controls the ability to monitor a person’s own behaviour by
planning & organising. There are frequent behavioural problems & learning deficiencies and all these
can create significant emotional disturbances.
The person with AADD
often ‘self medicates’ with alcohol or drugs.
They are more likely to suffer from depression & anxiety disorders due to their relationship difficulties
& breakdowns and similar occupational losses.
The following is a list
of the common symptoms and behaviours associated with Adult ADHD.
1. A sense of underachievement,
of not meeting one's goals (regardless of how much one has actually accomplished).
2. Difficulty getting organized.
3. Chronic procrastination or
trouble getting started.
4. Many projects going
simultaneously; trouble with follow through.
5. A tendency to say what comes
to mind without necessarily considering the timing or appropriateness of the remark.
6. A frequent search for high
7. An intolerance of boredom.
8. Easy distractibility; trouble
focusing attention, tendency to tune out or drift away in the middle of a page or
often coupled with an inability to focus at times.
9. Trouble in going through
established channels and following "proper" procedure.
10. Impatient; low tolerance of frustration.
11. Impulsive, either verbally or in action, as an
impulsive spending of money.
12. Changing plans, enacting new schemes or career
plans and the like; hot-tempered
13. Physical or cognitive restlessness.
14. A tendency toward addictive behaviour.
15. Chronic problems with self-esteem.
16. Inaccurate self-observation.
It is suggested that
individuals who exhibit at lease twelve (12) of these behaviours and who have done so since childhood, in the
absence of any psychiatric or medical condition, should be considered for a provisional diagnosis of
The multiple symptoms
& behaviours need to be exhibited in multiple settings for the preceding six (6)
Anyone involved in the
game of Rugby League can
probably relate to having played with or against, or had dealings with, someone who has exhibited many of
these characteristics. Some are similar to Bipolar Disorder, some similar
to a Personality Disorder. Some of those who use & abuse Alcohol & Drugs and constantly
frequent clubs & bars may also display similar symptoms.
Those with AADD are
often in trouble with the establishment for many and varied reasons, not least of which is their
impulsiveness and distorted perception and their overarching debilitated executive functioning. These are
those individuals for whom league clubs and the respective administration constantly have to explain
Oppositional Defiant Disorder is a controversial diagnosis which is described as an
‘ongoing pattern of disobedient,
hostile & defiant behaviour toward authority figures which supposedly goes beyond the bounds of normal
1. A pattern of negativistic, hostile, and defiant
behavior lasting at least 6 months, during which four (or more) of the following
1. often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful or vindictive
2. The disturbance in behavior
causes clinically significant impairment in social, academic, or occupational functioning.
3. The behaviors do not occur
exclusively during the course of a Psychotic or Mood Disorder.
4. Criteria are not met for
Conduct Disorder (see below), and, if the individual is age 18 years or older, criteria are not
met for Antisocial Personality Disorder (refer to ‘Personality
Note: Consider a criterion met only if the behavior occurs more frequently
than is typically observed in individuals of comparable age and developmental
‘controversial’ disorder, though its symptoms & the behaviours exhibited are extremely serious,
irrespective of where it originates or whether it should be classified as a mental illness or disorder. It is
similar to ‘Oppositional Defiant Disorder’, though more
It pertains to children
& adolescents under the age of 18. After this it would be most likely considered ‘anti-social personality disorder’. It describes ‘repetitive behaviour where the rights of others
and societal norms are violated’. Some of the symptoms
exhibited are bullying, over-aggressive behaviour, cruelty to people & pets, truancy, physical
aggression, destructive behaviour, lying, stealing and vandalism.
The diagnostic criteria
used to define ‘Conduct Disorder’ are set out below:
1. A repetitive
& persistent pattern of
behaviour in which the basic rights of others
or major age-related societal norms or rules are violated, as manifested by the presence of three (or more)
of the following criteria in the past twelve (12) months, with at least one (1) criterion present in the past
six (6) months.
1. Aggression to people or animals
Often bullies, threatens or intimidates others
Often initiates physical fights
Has used a weapon that can cause serious physical harm to others (eg. bat, knife, brick or stone,
Has been physically cruel to people
Has been physically cruel to animals
Has stolen while confronting a victim (eg. mugging, puse snatching, extortion, armed
Has forced someone into sexual activity
2. Destruction of Property
Has deliberately engaged in fire setting with the intention of causing serious
Has deliberately destroyed other’s property (other than by fire)
Deceitfulness or Theft
Has broken into someone else’s house or car
Often lies to obtain goods or favours or to avoid obligations (ie. ‘con
Has stolen items of nontrivial value without confronting the victim (eg. forgery,
Serious Violation of Rules
Often stays out at night despite parental prohibitions, beginning before the age of
Has run away from home overnight at least twice while living in parental or parental surrogate home
without returning for a lengthy period)
Is often truant from school, beginning before the age of 13
2. The disturbance in behaviour
causes clinically significant impairment in social, academic or social functioning.
3. If the individual is 18 years
or older, the criteria is not met for ‘Anti-social Personality
Many believe these
disorders are the result of ‘poor parenting’ and/or ‘role
modelling’ or the absence of discipline and/or appropriate & necessary ‘boundaries’.
Certainly there is evidence to suggest this indeed may be somewhat true. Others attribute children’s
behaviour, particularly hyperactivity, as being the result of poor or inappropriate dietary
Irrespective of your
opinions regarding the cause, the symptoms and the condition it persists and requires intervention and
treatment. The overhauling of society’s behaviour & thinking and the re-education and proactive,
pre-emptive, preventative primary health care needed may ultimately improve the problems associated in the
longer term, though in the interim it is essential we address the issue with our current means of
©2008 Waldel Pty Ltd