Oppositional Defiant Disorder Diagnosis

[Anonymous]

At age 7 can't you still get a 504 or IEP under developmental delay?
I agree getting a 504 or IEP would provide some more understanding for the staff and would put some of the responsibility back on this school if this comes up again. Hopefully it won't but it's really hard to predict at this age and it's better to have more help than less help and worry about the stigma.

Unfortunately, an ODD is more stigmatizing than ADHD, anxiety or ASD for some educators who believe it's just code for badly behaved manipulative child whose parents make up excuses.

I would keep the KKI appointment. You could cancel at the last minute if you have financial concerns or if things are going really smoothly and you're no longer concerned.

We have a child who had major behaviors in early elementary but no longer had them with a different teacher the following year or any subsequent year but we are still on high alert. DC is also social and gets along well with classmates, but had issues with the teacher.

[Anonymous]

Our DS was (almost) diagnosed several years ago with ODD. I knew it was not ODD and got another evaluation from a different psychiatrist. Turned out he has Bipolar I with anxiety. That is still the correct diagnosis several years later--and has nothing to do with ODD at all. I think ODD is over diagnosed when experts often don't know what actually is the matter, especially because they do not really know your child or understand their behavior. I had more opportunity to closely monitor him. Glad I pushed harder for a correct diagnosis.

[Anonymous]

Anonymous wrote:Our DS was (almost) diagnosed several years ago with ODD. I knew it was not ODD and got another evaluation from a different psychiatrist. Turned out he has Bipolar I with anxiety. That is still the correct diagnosis several years later--and has nothing to do with ODD at all. I think ODD is over diagnosed when experts often don't know what actually is the matter, especially because they do not really know your child or understand their behavior. I had more opportunity to closely monitor him. Glad I pushed harder for a correct diagnosis.

OP here: Thanks for this. I am going to do some pushing. ODD just seems like an easy label for the bad behavior he was having in school even though he doesn't really fit that diagnosis, as it's not constant and his behaviors come and go.

[Anonymous]

Have you thought about getting him counseling to try to get him to talk about why he got so upset with the previous teacher? Personally I would go that route instead of OT.

[Anonymous]

I have a similar sounding 7yo 1st grader who also changed classes this school year. He’s by no means perfect in the new class, but the extreme behaviors are gone. We’re in the process of identifying if it is anxiety, adhd or both. His first teacher would have put him in the ED class if she could. Now he has a different teacher and a 504 plan. A bad teacher match, especially at such a young age, can be huge.

[Anonymous]

PP here - my DS has same behaviors with the first teacher and also was fairly school specific with the extreme behaviors (school and on the walk in to be specific). Turns out another staff member heard the first teacher complaining about him in the hallway. I’m sure he felt awful in there. He changed classes early October and it’s been a world of difference.

[Anonymous]

This is PP with the 10 yo diagnosed late with ASD. I wanted to add that dismissing adhd and anxiety based on teacher and parent questionnaires is pretty suspect. Hopefully you get a lot more answers in March.

Question tho from the perspective of getting an IEP.... have you started the process with the school? Usually they will want to do their own evaluation which can take some time to schedule. You are under no obligation to disclose the ODD diagnosis but the fact that he is in the process for evaluating for an IEP may mitigate any issues that arise. You can always bring any results from KKI in later.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who was he hitting/kicking/throwing stuff at? What was going on when he ran out of the room? If peers, I would t really say he is “well liked” right?

OP Here: He wasn't throwing items at anyone he was throwing them on the ground from the desk when he was upset. He hit a child who got in front of him in line when they were coming in from recess. He would leave the classroom when he was upset, put on the spot, or it was too noisy and hide in the bathroom. The kids are 7 so he is well liked as this doesn't happen everyday and he has a pretty solid friends group, playdates every weekend etc.

This sounds like ADHD or anxiety. Psychoeducational testing misses a lot of things that a neuropsych picks up. While ASD is a possibility you should discuss at the neuropsych exam, based on other information you've provided it doesn't sound like it. It sounds like he has some sensory issues, which is one diagnostic criteria for ASD, but also occurs with ADHD and anxiety.

Does your kid have any trouble on the playdates? Does he engage in joint play with the other kid, or is it parallel play? Does he have any particularly intense, narrow interests? Does he engage in any type of repetitive activity or motion. This is not just classic arm flapping, but any kind of repetitive motion of the body such as running, twirling, jumping or playing with a fidget? If it's no to all that, ASD is unlikely. Whether to do any specific testing for ASD is a matter of the neuropsychologist's professional judgement together with your own reports or concerns about his behavior.

OP, hugs to you. My kid had behavior issues in PreK and K that were like this...teachers weren't the greatest. Much better in 1st and 2nd, finally got ASD/ADHD diagnosis in third. But he didn't have trouble w/ playdates, engaged in joint play, and has wide ranging interests...so I'd take PPs list w/ a grain of salt. Severe meltdowns and out-of-proprtion reactions in response to a slight or offense were the big things w my kid...

[Anonymous]

NP. I have a kid who is similar in many ways but had ASD/ADHD/Anxiety Dx.s. Whatever the truth is, just be sure that you do not rely on a school Dx. Maybe I am so tired that I lost track of the thread, but I am assuming if you are going to KKI next (which you definitely should not cancel due to the difficulty and wait involved in those appts and your open questions), that you did not have a good neuropsychologist issue that Dx. Never ever rely on the school or a generalist to issue that type of Dx. Just speaking from my experience and from hearing the experiences of many others in relatively similar situations.

[Anonymous]

Anonymous wrote:NP. I have a kid who is similar in many ways but had ASD/ADHD/Anxiety Dx.s. Whatever the truth is, just be sure that you do not rely on a school Dx. Maybe I am so tired that I lost track of the thread, but I am assuming if you are going to KKI next (which you definitely should not cancel due to the difficulty and wait involved in those appts and your open questions), that you did not have a good neuropsychologist issue that Dx. Never ever rely on the school or a generalist to issue that type of Dx. Just speaking from my experience and from hearing the experiences of many others in relatively similar situations.

We got psychoeducational testing done at Mt. Washington Pediatric Hospital. I might request they do neuropsych as well and see if that waitlist is shorter, but I'm not sure I trust their diagnosis. He was evaluated by a doctoral student in training. Her supervisor was there for the results meeting and I'm sure she checked over her data but I think I might prefer someone with more experience if we get additional testing done.

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. I have a kid who is similar in many ways but had ASD/ADHD/Anxiety Dx.s. Whatever the truth is, just be sure that you do not rely on a school Dx. Maybe I am so tired that I lost track of the thread, but I am assuming if you are going to KKI next (which you definitely should not cancel due to the difficulty and wait involved in those appts and your open questions), that you did not have a good neuropsychologist issue that Dx. Never ever rely on the school or a generalist to issue that type of Dx. Just speaking from my experience and from hearing the experiences of many others in relatively similar situations.

We got psychoeducational testing done at Mt. Washington Pediatric Hospital. I might request they do neuropsych as well and see if that waitlist is shorter, but I'm not sure I trust their diagnosis. He was evaluated by a doctoral student in training. Her supervisor was there for the results meeting and I'm sure she checked over her data but I think I might prefer someone with more experience if we get additional testing done.

The post above is from the OP by the way.

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. I have a kid who is similar in many ways but had ASD/ADHD/Anxiety Dx.s. Whatever the truth is, just be sure that you do not rely on a school Dx. Maybe I am so tired that I lost track of the thread, but I am assuming if you are going to KKI next (which you definitely should not cancel due to the difficulty and wait involved in those appts and your open questions), that you did not have a good neuropsychologist issue that Dx. Never ever rely on the school or a generalist to issue that type of Dx. Just speaking from my experience and from hearing the experiences of many others in relatively similar situations.

We got psychoeducational testing done at Mt. Washington Pediatric Hospital. I might request they do neuropsych as well and see if that waitlist is shorter, but I'm not sure I trust their diagnosis. He was evaluated by a doctoral student in training. Her supervisor was there for the results meeting and I'm sure she checked over her data but I think I might prefer someone with more experience if we get additional testing done.

NP. I don't think it's worth getting private testing done if it is done entirely by a doctoral student in training. I will say that our school's psychoeducational testing was also done by a doctoral student supervised by a doctor at GW but we didn't have to pay for it. However, you will find with most neuropsych practices some parts of neuropsych testing is administered by a doctoral student but they should clearly tell you which tests. And personally, I would never pay private practice/take no insurance prices for having a grad student with little experience administering tests like the full WISC in a neuropsych eval.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. I have a kid who is similar in many ways but had ASD/ADHD/Anxiety Dx.s. Whatever the truth is, just be sure that you do not rely on a school Dx. Maybe I am so tired that I lost track of the thread, but I am assuming if you are going to KKI next (which you definitely should not cancel due to the difficulty and wait involved in those appts and your open questions), that you did not have a good neuropsychologist issue that Dx. Never ever rely on the school or a generalist to issue that type of Dx. Just speaking from my experience and from hearing the experiences of many others in relatively similar situations.

We got psychoeducational testing done at Mt. Washington Pediatric Hospital. I might request they do neuropsych as well and see if that waitlist is shorter, but I'm not sure I trust their diagnosis. He was evaluated by a doctoral student in training. Her supervisor was there for the results meeting and I'm sure she checked over her data but I think I might prefer someone with more experience if we get additional testing done.

NP. I don't think it's worth getting private testing done if it is done entirely by a doctoral student in training. I will say that our school's psychoeducational testing was also done by a doctoral student supervised by a doctor at GW but we didn't have to pay for it. However, you will find with most neuropsych practices some parts of neuropsych testing is administered by a doctoral student but they should clearly tell you which tests. And personally, I would never pay private practice/take no insurance prices for having a grad student with little experience administering tests like the full WISC in a neuropsych eval.

OP Here: This was fully covered under insurance so we only paid our co-pay. The doctoral student was supervised by a doctor at Hopkins.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who was he hitting/kicking/throwing stuff at? What was going on when he ran out of the room? If peers, I would t really say he is “well liked” right?

OP Here: He wasn't throwing items at anyone he was throwing them on the ground from the desk when he was upset. He hit a child who got in front of him in line when they were coming in from recess. He would leave the classroom when he was upset, put on the spot, or it was too noisy and hide in the bathroom. The kids are 7 so he is well liked as this doesn't happen everyday and he has a pretty solid friends group, playdates every weekend etc.

This sounds like ADHD or anxiety. Psychoeducational testing misses a lot of things that a neuropsych picks up. While ASD is a possibility you should discuss at the neuropsych exam, based on other information you've provided it doesn't sound like it. It sounds like he has some sensory issues, which is one diagnostic criteria for ASD, but also occurs with ADHD and anxiety.

Does your kid have any trouble on the playdates? Does he engage in joint play with the other kid, or is it parallel play? Does he have any particularly intense, narrow interests? Does he engage in any type of repetitive activity or motion. This is not just classic arm flapping, but any kind of repetitive motion of the body such as running, twirling, jumping or playing with a fidget? If it's no to all that, ASD is unlikely. Whether to do any specific testing for ASD is a matter of the neuropsychologist's professional judgement together with your own reports or concerns about his behavior.

OP, hugs to you. My kid had behavior issues in PreK and K that were like this...teachers weren't the greatest. Much better in 1st and 2nd, finally got ASD/ADHD diagnosis in third. But he didn't have trouble w/ playdates, engaged in joint play, and has wide ranging interests...so I'd take PPs list w/ a grain of salt. Severe meltdowns and out-of-proprtion reactions in response to a slight or offense were the big things w my kid...

Then how did he get an ASD diagnosis?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Who was he hitting/kicking/throwing stuff at? What was going on when he ran out of the room? If peers, I would t really say he is “well liked” right?

OP Here: He wasn't throwing items at anyone he was throwing them on the ground from the desk when he was upset. He hit a child who got in front of him in line when they were coming in from recess. He would leave the classroom when he was upset, put on the spot, or it was too noisy and hide in the bathroom. The kids are 7 so he is well liked as this doesn't happen everyday and he has a pretty solid friends group, playdates every weekend etc.

This sounds like ADHD or anxiety. Psychoeducational testing misses a lot of things that a neuropsych picks up. While ASD is a possibility you should discuss at the neuropsych exam, based on other information you've provided it doesn't sound like it. It sounds like he has some sensory issues, which is one diagnostic criteria for ASD, but also occurs with ADHD and anxiety.

Does your kid have any trouble on the playdates? Does he engage in joint play with the other kid, or is it parallel play? Does he have any particularly intense, narrow interests? Does he engage in any type of repetitive activity or motion. This is not just classic arm flapping, but any kind of repetitive motion of the body such as running, twirling, jumping or playing with a fidget? If it's no to all that, ASD is unlikely. Whether to do any specific testing for ASD is a matter of the neuropsychologist's professional judgement together with your own reports or concerns about his behavior.

OP, hugs to you. My kid had behavior issues in PreK and K that were like this...teachers weren't the greatest. Much better in 1st and 2nd, finally got ASD/ADHD diagnosis in third. But he didn't have trouble w/ playdates, engaged in joint play, and has wide ranging interests...so I'd take PPs list w/ a grain of salt. Severe meltdowns and out-of-proprtion reactions in response to a slight or offense were the big things w my kid...

Then how did he get an ASD diagnosis?

I also have a kid with ASD/ADHD and he never had problems with playdates either. One on one where he got "set up" to play with another kid, DS did fine: Has joint attention and was "very socially motivated" according to his ADOS evaluators. It was in the classroom and play ground among groups of peers that he had issues: He did not know how to approach other kids. How to make friends, etc. due to his low ability to read and understand social cues. Thus the Asperger's/ASD diagnosis.

DS also had repetitive behavior, mostly running around like a maniac which at the time we did not realize were stims.

And narrow interests specifically ceiling fans and elevators. But he also has other more "normal" interests too like electronics, computers, cars, video games, coding, chess and shoes (Nikes

Also, he never had meltdowns or tantrums. Does not have anxiety according to his neuropsych. Does really well academically... so if you know one kid with ASD, you know one kid with ASD.