If your child is one of the nearly 6.5 million American children with attention deficit hyperactivity disorder (ADHD), you already know that ADHD can make life complicated.

Kids with ADHD struggle with organization and have a hard time paying attention, which frequently leads to trouble at school and at home. But if your child is frequently uncooperative and lashing out verbally or nonverbally — you might be dealing with more than ADHD.

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Oppositional defiant disorder (ODD), characterized by defiance, disobedience and hostility, commonly occurs alongside ADHD. Some 40 percent of kids with ADHD have ODD. too.

Yet many parents, educators and health care providers are only now becoming aware there is often a link between ADHD and ODD. It’s a problem, because unaddressed ODD increases the risk of serious problems down the road.

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“If you totally ignore oppositional defiant disorder and it sticks around, you’re really asking for trouble,” Hans Steiner, MD, professor emeritus of child and adolescent psychiatry at Stanford University, told LifeZette.

The combination of ADHD and ODD increases the risk of substance abuse and trouble with the law. There is good news, however. “Overall, the prognosis is not bad,” said Dr. Steiner. Awareness can lead to treatment, which can effectively decrease symptoms, improve functioning and decrease the risk of poor outcomes later in life.

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Experts suspect that the impulsivity of ADHD may at least partly account for the high rates of ODD in children with ADHD. Children without ADHD may be able to squelch the “no” that comes to mind when you ask them to clean their room; kids with ADHD are likely to blurt out exactly what they think.

Of course, all kids exhibit these symptoms sometimes — especially during the toddler and the teen years. ODD is a pattern of disobedient, hostile, and defiant behavior that negatively affects the child’s life — and the parents’ live as well.

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Yet researchers and clinicians have noticed something interesting: Parents often unwittingly encourage defiant behavior in their children. When you give in to your tantrumming or defiant child, you’re effectively teaching him that temper tantrums and resistance are an effective means of getting what he wants. All parents give in sometimes; after all, you’re only human. Sometimes you don’t have the time or energy for another battle.

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The upside of this truth is that parents can effectively discourage defiant behavior too.

“The research shows that the most effective treatment for ODD is behavioral parent and teacher training,” David Anderson, director of the ADHD and Behavior Disorders Center at the Child Mind Institute in New York City, told LifeZette. “What we do is teach all of the adults in a child’s life the same skills that a therapist might use in the office to effectively manage behavior, and then help the child apply those in a wide range of situations.”

But first, it’s important to make sure your child’s ADHD is under control. Health care experts advise parents of these tips.

1.) Work with your health care providers to find an optimal treatment plan. It will be much easier to tackle disobedience and defiance if the inattention and impulsivity of ADHD are managed. Conveniently, many of the medications used to treat ADHD also improve ODD symptoms.

2.) Work with your child’s health care team to establish a behavioral plan. Mental health professionals who commonly work with kids and families dealing with ADHD and ODD can help you figure out what behaviors you want (or need) to target and then devise a plan for doing so.

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“You want to catch the child being good, doing the desired behaviors, as often as possible, and prompt them as needed. You also try to withdraw your attention when the child is unsuccessful and then use appropriate boundaries and consequences when significant misbehavior occurs,” Dr. Anderson said.

3.) Understand it takes time. A typical course of treatment for ODD lasts several months. “We tell parents that we tend to do treatment within about 12 or 20 weeks; then, there usually are maintenance sessions after that,” Dr. Anderson said.

4.) Educate yourself and find a support network. Because dealing with a child with ADHD and ODD can be so stressful, it’s a good idea to find some support for yourself as well, either through a support group or a close friend. Taking some time for yourself may even help you effectively manage your child’s behavior.

“When we’re so worried that a child may act out, we often end up being overly coercive,” Dr. Anderson said.

A better approach, he said, is to not anticipate bad behavior, but to calmly wait and reinforce good behavior as it occurs and administer consequences as necessary — and that’s a whole lot easier to do when you’re relaxed.