Oppositional Defiant Disorder: losing my MIND, need a good thearapist/DX

[Anonymous]

Anonymous wrote:The one key thing is that the behavior is only at home. When the teachers give a demand, he is okay. That indicates that it is a home issue. Sounds like family counseling needs to come first.

My child has ODD and this is actually quite typical. It's hard to diagnose because of the stark contrast. We had to have home visits to get a dx. I know blaming parents and mothers in particular is a favorite American pastime, and certainly environmental factors can't help, but saying that kids with ODD act out in all environemts is not only false, but quite rare. Some kids only act out at home, some with a target parent or target siblung, some only at school. Many have co-morbid mental health problems, like ADHD or depression.

OP, plese go get a dx, outcomes for these kids are bleak without intervention. I don't have anything local for you, we started this journey when we lived on the west coast, but a great book to read is The Explosive Child. Best of Luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son is very difficult, but more so at school. Is there any difference between school and home? Is he always angry? What keeps him calm and happy?

For my son, the neuropsych testing was not very helpful as we already knew that anxiety and ADHD were driving him. Even with his behaviors, he is not considered odd. Medication was key (Zoloft first, then added Concerta). We have also had success with a social skills group (Alvord and Baker) and family therapy. However, individual therapy is still not something he is ready for- he is 9. It ends up being too much of what he hates- talking about his feelings.

He is great at school and from what I read on ODD that can be quite typical. He is not angry when he is doing what he wants, but the SECOND my DH or I ask him to do something even minor he meltdown. Hes happy as can br as long as hes dictating the shots. Hang your backpack up results in rage. He gets irritated at the most minor of things. Today was the way his brother was breathing (allergies and stuffy).

So, we walk on eggshells. Tonight in order to get him in the shower, i didn't ask him to get in the shower, i coaxed him upstairs and into the bathroom ans then asked him to get in thr shower. A tantrum ensued, but at least we were in the bathroom, not downstairs, which getring up the stairs for a shower is half the battle. We basicslly operate around him. It is is mentally taxing. I love my son, but im ashamed to admit, im beginning to not like him very much.

OP, the behavior that you're describing could fit a myriad of disorders from LDs, ADHD, bi-polar, ASD, generalized anxiety, etc. Again, step away from Dr. Google.

Second, you and DH need to read The Kazdin Method. It was based on research with kids diagnosed with ODD, but it applies to all kinds of kids b/c many disorders result in the same kind of irritability and rigidity that you're describing.

Third, if you're in DC or MD, take Dr. Shapiro's parenting class. If you're in VA, try Dr. Hackney's parenting class. Or go to KKI's behavioral clinic in Columbia, MD. You need to learn how to parent a "spirited child."

Fourth, seriously, first thing tomorrow call Children's and KKI and get on a waitlist. Neuropsych evaluation and/or developmental pediatrician--it doesn't really matter at this point you need a global overview. Take the first appointment that comes up and cancel the other. This is really the most important thing. You can google disorders until the cows come home. It doesn't get you any closer to figuring out what's going on. Your kid sounds like he's suffering. I'm sure he'd not like everything to be so hard either.

[Anonymous]

Anonymous wrote:There is abook called 1,2,3 Magic. It gives you a technique for home discipline using warnings and timeouts. The fact that it doesn't happen in school suggests he is reachable using begavioral tchniques.

This kid is beyond 1, 2, 3 Magic. I know it's a well intentioned suggestion.

[Anonymous]

Our DD has ODD as well. Symptoms are the same as you are seeing, except our DD really favors DH; she took YEARS to explode at him but did it to me on a daily basis since about age 4. Very taxing, so my sympathies are with you.

We have had some luck with Dara Goldberg, a therapist in Bethesda. Our psych is Dr. Shari Thomas, also in Bethesda, but you sound like you have a psych. Have you considered a sensory component? Dr Thomas figured out that our child is sensory seeking, which explained a lot. We spend a ton of time at the park on swings, running and then at home letting her play basketball or jump on a trampoline.

A therapist can help you with a behavior plan. We used a chart with rewards, but she was 4 at the time. We are VERY clear about expectations, very consistent in our parenting.

This is a long road. Be clear about what you expect, but read up on extinction bursts because the behavior will get worse before it improves!

[Anonymous]

ODD is one of the symptoms of FASD. And it doesn't take a lot of alcohol to affect the brain of a developing fetus---FASD can occur in situations where the pregnancy was a surprise.
The good news is that a small dose of the anti-seizure drug lamictal can work wonders in preventing meltdowns.

[Anonymous]

Anonymous wrote:ODD is one of the symptoms of FASD. And it doesn't take a lot of alcohol to affect the brain of a developing fetus---FASD can occur in situations where the pregnancy was a surprise.
The good news is that a small dose of the anti-seizure drug lamictal can work wonders in preventing meltdowns.

What is wrong with you? The kid does not have FASD. Are you searching for another rock to throw at OP?

[Anonymous]

I was 22:18 and I wasn't trying to be mean to OP but to offer potential explanations for her kid's otherwise inexplicable ODD behavior. OP's kid could be adopted, in which case FASD is very definitely a possibility to consider. OP could have had an "oops" pregnancy. Having dealt with similar rages in my FASD-affected kid, I know how exhausting and stressful it is to have to navigate those blowups on a daily basis.

[Anonymous]

Anonymous wrote:I was 22:18 and I wasn't trying to be mean to OP but to offer potential explanations for her kid's otherwise inexplicable ODD behavior. OP's kid could be adopted, in which case FASD is very definitely a possibility to consider. OP could have had an "oops" pregnancy. Having dealt with similar rages in my FASD-affected kid, I know how exhausting and stressful it is to have to navigate those blowups on a daily basis.

Most FASD kids have characteristic facial features which can be a tip off.

Again, I think the OP needs to get an evaluation, b/c the behaviors could match many things.

[Anonymous]

Read The Explosive Child. Not saying it will fix your problems but chances are high that you'll find some help and support.

[Anonymous]

I have a child with a mild case of ODD in conjunction with autism and ADHD. I never drank alcohol before or during my pregnancy. ODD is one symptom of FASD, but not all ODD can be attributed to it. It's also been linked to lead exposure, etc. We live in a world where we're bombarded with chemicals in the air we breathe, the water we drink, and the food we eat. Who really knows the cause?
I would certainly hate for people to assume my child acts the way he does because I drank - which I absolutely did not!

[Anonymous]

It's impossible to tease out from your post whether this is ODD, depression (which can present as extreme anger and lack of cooperation), a child who needs a different parenting style (doesn't mean you are a bad parent, just means this child needs something different), or a problem in the family system that might require family therapy.

[Anonymous]

OP, much of what you describe here sounds like a strong need for control--often associated with anxiety. To frame that issue, you might want to take a look at the work of Gordon Neufeld (neufeldinstitute.org), including his book HOLD ON TO YOUR KIDS and his many talks on children and anxiety, available on YouTube.

[Anonymous]

We are dealing with a 13 year old with ODD, although we do not have official confirmation yet.

He is seeing a therapist and a psychiatrist. We have also just completed a neuropsych with Dr. Black but have not yet received the results.

It's easy for people to come on here and blame the parents for not properly disciplining but unless you have gone through it you have no idea how difficult it can be.

[Anonymous]

OP, my child was also extremely difficult starting around age 2-3 and really traumatically difficult 4-6. He was similar to yours in that he was fine if he had total control of his environment--in fact he was quite independent and able to entertain himself. He had a great imagination and could be excited and happy to the extreme. But any transition threw him off and he didn't have the resources to deal with the big feelings. He was more of a meltdown kid than a tantrum kid but, like yours, he basically resisted every instruction. It really seemed like he was unable to take input/guidance/suggestions from another person. He was actually much worse at school than yours... he wasn't disruptive but totally self-absorbed and resistant. And unhappy!

We started weekly therapy when he was 4 and did it non-stop year-round until he was 8 or so. He was first diagnosed with generalized anxiety and eventually at age 6 with severe ADHD. I had to work a lot with the therapist myself to understand how to parent my son... and I read pretty much every book suggested in this thread and more. As others have said: TONS of structure, total consistency, simple rules and crystal clear expectations, advanced warning for (each and every!!!) transition--these were all critical and incredibly effective. They seem both "too easy" and like "too much work" ... I rolled my eyes at first and thought alternately "I already do that!" and "I can't give him a warning before every single XYZ" but ... well, we trained ourselves and it was shockingly effective. Basically this, friendly gentle voice: "Son, five minutes till we leave"... "son, one minute till we leave" ... "okay we leave... if any hesitation, immediately pick up kid and go". Gentle advance noticed and absolute enforcement are totally critical--zero negotiation. I had to follow through on EVERY RULE, every warning, and do so immediately. With things clearly more anxiety-based like refusing to go inside a birthday party... you take a different approach. A lot of support, a lot of positive talk, but always challenging kid to complete task. It may feel worse for a few days but it is INCREDIBLY reassuring to an anxious or adhd child to actually know what is coming and then succeed in getting through it. My son hates learning a new routine but once he accepts it, it is very comforting for him!

We have done a lot to work with this kid, but I want to tell you how incredibly worth it all the effort has been. From the beginning, for me, what killed me the most was how deeply unhappy my son was. Like he wasn't being given a chance to have a childhood! I am so relieved and happy to report that he is, at age 12, totally different. Or rather... what we have now is overwhelmingly his positive qualities and rarely the negative ones. But it took a ton of intervention and work from the whole family to get him here... to get him feeling comfortable with himself and happy most of the time. And, probably only you can understand how amazing this is to me, but my child is totally cooperative now. The defiance was so tied into his miserable feelings and unhappiness, his out-of-control feelings and need to regain control. Once he felt better about himself, he was totally receptive to instruction. It is taken years, but he is such a wonderful kid, so empathetic to others, and ... who knows, maybe stronger for his struggles.

Please get help, OP. It will be hard but it will make your life, and that of your child, so much better.

[Anonymous]

11:30 is a great post. +1 on all that.