Poor Behavior Struggles

[Anonymous]

We have a nine year old girl diagnosed ADHD /ODD and undiagnosed anxiety, and for lack of a better description her ADHD manifests like that more typical of boys her age. She is hyperactive and incredibly impulsive. She often ignores instruction and has zero sense of time.

She behaves well at school.

At home, it is a disaster. We are completely overwhelmed, exhausted, and disheartened by her. It's heartbreaking to feel this way about your kid, but there are very few positive moments. She is obnoxious and irritable. She responds unkindly, offers no thanks, is always unhappy with everything. If we ask her to do anything, the answer is always no. We can threaten consequences, and that sometimes works, but feels so negative all of the time. If we do give a consequence, she never, ever learns from it and alter future behavior. Whenever we say no to something, she blows it up in to a huge fight, so we feel that our choices are to either give in to her or face an enormous battle. She has seen four different therapists, done various group and individual therapies and nothing has made any difference. She has very little insight to her own behavior and completely refuses to discuss anything related to. Her behavior or feelings. She takes Focalin and Guanfacine. We tried Ability and Lexapro, which were both disasters.

She had no behavioral issues until she was 5.5 years old, and they have continued to worsen since then. Her anxiety kicked in around 7.5 and has also continued to worsen.

Neurotypical parenting strategies do not work. She has a younger sibling who is manageable, warm, friendly, and kind. We are just really struggling because she is deeply unpleasant kid and we feel so trapped. We are an otherwise healthy family, she has experienced no trauma that we know of, and we just want to feel more positive towards our kid. We are obviously extremely depleted, but of course I also worry about how disregulated she must feel to act in such extreme ways, too. When she has an outburst, she seems psychotic, says terrible things, and makes very little sense.

I'm not really sure what I'm seeking, but i swing between feeling that perhaps we need to offer more structure at home (although I think we feel that we do? She has a pretty routine schedule, but perhaps in misguided attempts to avoid fighting with her we have bent the rules too often?) to considering institutionalizing her, to trying to convince myself to let it all go and that maybe we are too high strung. Really though, I guess aim just looking for some understanding about really, really hard kids and empathy about how terrible it feels to dislike you kid so often.

[Anonymous]

My good friend has a kid with ODD. Everything is transactional. My friend did a parenting class/support group for ODD kids and met other parents to commiserate with as well as learned specialized parenting strategies.

I'm sorry you are going through a tough time. Take it one day at a time. Find something that is just for you (e.g. coffee with a friend once a month).

[Anonymous]

I remember feeling this way at 9 and at almost 11 our home life is far far improved (we’ve had school behavior struggles though).

We used Tracie Bush two years ago - it did help us a lot - not sure if it would help you but might be worth a try? I’m intrigued that she does well at school - does she do well socially with friends?

[Anonymous]

Anonymous wrote:I remember feeling this way at 9 and at almost 11 our home life is far far improved (we’ve had school behavior struggles though).

We used Tracie Bush two years ago - it did help us a lot - not sure if it would help you but might be worth a try? I’m intrigued that she does well at school - does she do well socially with friends?

OP here. She used to have issues at school, but I think some maturity had g
Helped her understand that being "that kid" at school doesn't help you make friends, and she is socially motivated. She has a couple of friends and I would say she is mediocre socially. She can sometimes be shy or withdrawn and doesn't always make great first impressions, can sometimes be overally hyperactive and impulsive, too (depending on whether the ADHD or anxiety is stronger in that moment) but she does have friends, so she isn't a complete disaster socially.

We have not tried Tracie Bush specifically, but we have done PCIT training which wasn't helpful. She holds it together and can seem very normal, which sometimes makes us feel even more isolated because nobody knows how awful it is, how much hostility, and how heartbreaking and stressful our lives are, daily. Even therapists and her psychiatrist underestimated her initially we have spent much time explaining to professionals how severe her behavior can be.

[Anonymous]

Op - I have almost the same kid. Same age - a boy. Same sibling. Adderall and guanfacine. It is so so discouraging. No advice (the book ‘raising lions’ and their YouTube videos did help a bit). Mainly just solidarity

[Anonymous]

Sorry OP.

I have a 9 yo DD who is often a disaster when off her medication. She has ADHD which presents as hyperactive, impulsiveness, and extreme emotional dysregulation. Until medicated she was highly oppositional. She has mild anxiety.

DD was a disaster at school and at home but now she is medicated during the school day. The meds have also reduced her oppositional behavior at home, I assume because she isnt working so hard to behave during the day. She is on concerta.

We did parent coaching and two rounds of therapist before medication, and the only thing that has worked is medication. I honestly believe that the only reason I have a relationship with my child that is loving is because of the medication- before that I spent all my time trying to protect my other kids from her or trying to protect her from hurting herself.

Even now, when things are doing well with her behavior, we visit the doctor for a medication adjustment - DD knows what the right thing to do is, but doesn’t have the impulse control to do it without medication.

It’s humbling and scary to realize it’s just biology (at least for DD). So my advice to you would be to keep trying to find a medication combination that works better - clearly the current regimen isn’t working for her.

Wishing you the best.

[Anonymous]

Anonymous wrote:My good friend has a kid with ODD. Everything is transactional. My friend did a parenting class/support group for ODD kids and met other parents to commiserate with as well as learned specialized parenting strategies.

I'm sorry you are going through a tough time. Take it one day at a time. Find something that is just for you (e.g. coffee with a friend once a month).

Curious to know what class she did and if she liked it. Both my husband and I attempted our own individual therapies within the last year to help us manage the stress, but we both found that our therapists didn't fully "get" it. So now we both see parenting therapists, who seem to understand how hard our kid's behavior is, but still haven't been able to offer advice or solutions. I just wish there was an answer.

Obviously we are all here because our kids struggle, but man, my kid is just so, so hard in a way that offers so little positive feedback as a parent.

[Anonymous]

I think you (and your co-parent if there is one) would really benefit from DBT training. You need guidance on how to manage her optimally. Later, when she is older, she may benefit from this kind of therapy but it is most effective to start with the parents. If you are in the DMV I suggest you call Brit Rathbone and see if there is anyone in his practice that could see you.

[Anonymous]

Anonymous wrote:Sorry OP.

I have a 9 yo DD who is often a disaster when off her medication. She has ADHD which presents as hyperactive, impulsiveness, and extreme emotional dysregulation. Until medicated she was highly oppositional. She has mild anxiety.

DD was a disaster at school and at home but now she is medicated during the school day. The meds have also reduced her oppositional behavior at home, I assume because she isnt working so hard to behave during the day. She is on concerta.

We did parent coaching and two rounds of therapist before medication, and the only thing that has worked is medication. I honestly believe that the only reason I have a relationship with my child that is loving is because of the medication- before that I spent all my time trying to protect my other kids from her or trying to protect her from hurting herself.

Even now, when things are doing well with her behavior, we visit the doctor for a medication adjustment - DD knows what the right thing to do is, but doesn’t have the impulse control to do it without medication.

It’s humbling and scary to realize it’s just biology (at least for DD). So my advice to you would be to keep trying to find a medication combination that works better - clearly the current regimen isn’t working for her.

Wishing you the best.

Op here. Thank you for this. She is noticably better when on her meds, but they last exactly six hours in her system. We tried to do the afternoon booster dose, but then she wasn't sleeping at night. We actually tried Concerts when we first medicated her, but she seemed comatose, and Focalin was a better fit. Our psychiatrist wants us to try Zoloft but her on Lexapro was probably the worst six weeks of my life, and I'm incredibly wary to try another SSRI and possibly jeopardize how well she does at school. He would also try Lactimal, but we definitely have some PTSD from failed medication trials and not sure what the best next step is. I do wish we could have her under the influence of her stimulant med for a longer stretch during the day.

[Anonymous]

Anonymous wrote:I think you (and your co-parent if there is one) would really benefit from DBT training. You need guidance on how to manage her optimally. Later, when she is older, she may benefit from this kind of therapy but it is most effective to start with the parents. If you are in the DMV I suggest you call Brit Rathbone and see if there is anyone in his practice that could see you.

Yes DBT has been mentioned, and there is a parent DBT workshop on our list. We've been told that nine is young for a kid to start this and since she refuses to participate in any therapy or even discuss her emotions at all, she isn't a good candidate, but that we as parents could still benefit from learning the material.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My good friend has a kid with ODD. Everything is transactional. My friend did a parenting class/support group for ODD kids and met other parents to commiserate with as well as learned specialized parenting strategies.

I'm sorry you are going through a tough time. Take it one day at a time. Find something that is just for you (e.g. coffee with a friend once a month).

Curious to know what class she did and if she liked it. Both my husband and I attempted our own individual therapies within the last year to help us manage the stress, but we both found that our therapists didn't fully "get" it. So now we both see parenting therapists, who seem to understand how hard our kid's behavior is, but still haven't been able to offer advice or solutions. I just wish there was an answer.

Obviously we are all here because our kids struggle, but man, my kid is just so, so hard in a way that offers so little positive feedback as a parent.

They are in CT. It is a small parenting group facilitated by a therapist specializing in working with ODD kids. Just remember you are doing the best you can and give yourself some grace to not be "on" sometimes. Find anything that you can look forward to at least monthly that is just for you. Encourage your husband to do the same.

[Anonymous]

No advice but I’m right there with you. My one child is almost literally killing my will to live. I have another child who is a complete delight and it’s heartbreaking how their life is also being ruined by our one disaster of a kid. Special needs boarding school may be the only solution.

[Anonymous]

We have been there. Some children do not respond to consequences or incentives. The thing that saved us was Ross Greene. Check out his books, podcast, the B Team group on Facebook. It was a radically different approach for my also therapy resistant, very difficult kid. Sending all the empathy - this is so hard.

[Anonymous]

You need real therapy my friend - a behavioral psychologist who specializes in parenting. PCIT if it’s available.

[Anonymous]

Anonymous wrote:You need real therapy my friend - a behavioral psychologist who specializes in parenting. PCIT if it’s available.

oh sorry just saw you said PCIT didn’t work. Go back to the therapist, keep working on it.