Oppositional Defiant Disorder Diagnosis

[Anonymous]

I posted before, though not the PP you asked about how did he get an ASD diagnosis.

DS did fine on play dates for the most part because those are one on one or at least small group and parent mediated. We also set them up with kids that he clicked with. In a setting with just random boys his age (he's 10 now), he has a hard time playing with them because of rules negotiation and lack of flexibility.

DS's specific interests change over time. For a year or so when he was little, it was vacuum cleaners. Now it's more conventional things like Minecraft. Lots of kids are interested in Minecraft, it's just DS has all of the Mojang books and has read them all and knows all of the details. He pressures me into playing with him and then calls me a n00b because I have no idea about these things.

DS also has extreme food preferences having to do with packaging, regularity, color, shape, texture, and smell....

[Anonymous]

I would be concerned about labeling the child with an ODDD diagnosis when that behavior seemed to be situational and during a limited amount of time. I think with ODDD, you would see the behavior across several domains (home, school, etc). Just my two cents.

[Anonymous]

Anonymous wrote:I would be concerned about labeling the child with an ODDD diagnosis when that behavior seemed to be situational and during a limited amount of time. I think with ODDD, you would see the behavior across several domains (home, school, etc). Just my two cents.

OP here: I completely agree. I’m going to just sit on this diagnosis and wait for him to get a full nerudopaych at KK. I spoke with the therapist who did the test about my concerns and she dismissed them and said ODD has “ebb and flow” and can go away and only return in certain situations which is questionable to me. She didn’t seem to think his sensory issues were related. I feel strongly it’s anxiety based as he’s had a lot of changes during the time period of his outbursts. I got remarried, his bio dad moved away, we moved to a different house, got a dog. We have a visit with his normal private therapist and I’ll see what her thoughts are.

[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?

He met the criteria under GARS and ADOS and a thorough eval...2e kid.

[Anonymous]

Does therapy usually work for ODD diagnosis. We are currently looking for a therapist for our ODD kid. The problems at school have escalated and we need to find something asap.

[Anonymous]

Anonymous wrote:Does therapy usually work for ODD diagnosis. We are currently looking for a therapist for our ODD kid. The problems at school have escalated and we need to find something asap.

Therapy can help, but it's often slow going. You want to keep checking at KKI to see if you can earlier appointment if someone else cancels.

[Anonymous]

My son sounds a lot like yours. He had a bad few months in elementary school when he had a terrible classroom placement and very inexperienced teacher. He became easily frustrated and acted out. We took him to a psychologist who labeled him ODD, but several years later I think it was the wrong diagnosis and his difficulties were purely situational. He’s HFA/ADHD. His teacher just had no clue how to manage a classroom. DS called her on it and teacher intentionally provoked him.

[Anonymous]

Anonymous wrote:My son sounds a lot like yours. He had a bad few months in elementary school when he had a terrible classroom placement and very inexperienced teacher. He became easily frustrated and acted out. We took him to a psychologist who labeled him ODD, but several years later I think it was the wrong diagnosis and his difficulties were purely situational. He’s HFA/ADHD. His teacher just had no clue how to manage a classroom. DS called her on it and teacher intentionally provoked him.

I hear what you’re saying, but “called her on it” is a bit obnoxious. It’s also just as possible that he has behavioral issues that will manifest in certain contexts.

[Anonymous]

I’m sure DS was obnoxious in class. I don’t doubt that at all, and he should have kept quiet rather than point out her mistakes and inconsistent discipline methods.

The teacher was new, just out of school, and afraid to ask for help from special ed staff to deal with challenging behaviors and rivalry among students. She thought admin would question her ability to teach.

[Anonymous]

Anonymous wrote:"He doesn't lie or provoke conflict among peers. He doesn't brag about being mean. He doesn't exhibit unprovoked anger. It's more like he has meltdowns when things he perceives as unfair happen to him and the tantrums just snowball into increasingly bad behavior. He is very sensitive and easily annoyed and sometimes doesn't comply with adult requests. He is well liked by his peers and has a lot of friends in school."

To me, the screams NOT ODD. My bet is ADHD, anxiety and/or ASD.

-Mom of child who's meltdowns much improved when put in a more appropriate educational setting and medicated for ADHD

My DD with anxiety and ADHD has a similar behavior profile--sensitivity, non-compliance, perceived injustices provoking tantrums --all improved once we got treatment.

[Anonymous]

Anonymous wrote:Some kids are O & D because their teacher sucks sms treats them badly. I have worked with elementary kids for many years and seen this more than a few times. The school will never admit a teacher sucks and treats kids badly. However, sometimes they will approve a transfer to another class. Sounds like that might be what happened to your kid. They might characterize it as a personality conflict, and although some other kids might tolerate the lousy teacher better than your kid that doesn't make the situation your kid's fault.

Nope sorry. I've worked with kids for many years too. You can't blame the teacher for this one. Yes, a bad teacher can cause anxiety, etc, but ity is abnormal for a teacher to cause a child without ODD to suddenly hit, tantrum, and do other aggressive things unless we are talking about 2 year olds or at least younger kids or sexual abuse, physical abuse or significant emotional abuse (not teacher yelling at class now and then). I think it does a huge disservice to this child to blame the teacher rather than get him the level of help he needs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:"He doesn't lie or provoke conflict among peers. He doesn't brag about being mean. He doesn't exhibit unprovoked anger. It's more like he has meltdowns when things he perceives as unfair happen to him and the tantrums just snowball into increasingly bad behavior. He is very sensitive and easily annoyed and sometimes doesn't comply with adult requests. He is well liked by his peers and has a lot of friends in school."

To me, the screams NOT ODD. My bet is ADHD, anxiety and/or ASD.

-Mom of child who's meltdowns much improved when put in a more appropriate educational setting and medicated for ADHD

My DD with anxiety and ADHD has a similar behavior profile--sensitivity, non-compliance, perceived injustices provoking tantrums --all improved once we got treatment.

Good job parent! Glad to hear that. The key is treatment because the child's behavior is a cry for help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"He doesn't lie or provoke conflict among peers. He doesn't brag about being mean. He doesn't exhibit unprovoked anger. It's more like he has meltdowns when things he perceives as unfair happen to him and the tantrums just snowball into increasingly bad behavior. He is very sensitive and easily annoyed and sometimes doesn't comply with adult requests. He is well liked by his peers and has a lot of friends in school."

To me, the screams NOT ODD. My bet is ADHD, anxiety and/or ASD.

-Mom of child who's meltdowns much improved when put in a more appropriate educational setting and medicated for ADHD

My DD with anxiety and ADHD has a similar behavior profile--sensitivity, non-compliance, perceived injustices provoking tantrums --all improved once we got treatment.

Good job parent! Glad to hear that. The key is treatment because the child's behavior is a cry for help.

Not OP - My kid has similar problems as stated above but the psychologist ruled out ADHD completely and says it is ODD and Parent-Child Relationship problems. He has been very defiant and lately has been more aggressive. What kind of therapy would help him in self regulation and control.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Some kids are O & D because their teacher sucks sms treats them badly. I have worked with elementary kids for many years and seen this more than a few times. The school will never admit a teacher sucks and treats kids badly. However, sometimes they will approve a transfer to another class. Sounds like that might be what happened to your kid. They might characterize it as a personality conflict, and although some other kids might tolerate the lousy teacher better than your kid that doesn't make the situation your kid's fault.

Nope sorry. I've worked with kids for many years too. You can't blame the teacher for this one. Yes, a bad teacher can cause anxiety, etc, but ity is abnormal for a teacher to cause a child without ODD to suddenly hit, tantrum, and do other aggressive things unless we are talking about 2 year olds or at least younger kids or sexual abuse, physical abuse or significant emotional abuse (not teacher yelling at class now and then). I think it does a huge disservice to this child to blame the teacher rather than get him the level of help he needs.

But the child in question has HFA/ADHD -- both of which absolutely can result in temporary behavioral issues caused by the environment. You have to question how useful it is to add on an ODD diagnosis in such a situation, where the behaviors disappear in a different setting. ODD should be consistent across time and different environments if it's a "real" diagnosis. If not, the oppositional behavior is a symptom of other issues.

[Anonymous]

OP Here: We have had a few sessions with a fantastic psychologist (out of network of course) for our son and she thinks that he most likely has anxiety exhibiting itself as ODD, she also thinks he might have ADHD. We are going to wait until our neuropsych testing at KKI and continue seeing her in the meantime. We've also met with her on our own to go over various parenting techniques.

He's been much better in his new class but is still somewhat reactionary. For example he was in a group of three in Science and his group mates thought he spilled a glass of water during the experiment when he didn't so he pushed one of them. He's also been having nightmares lately. It's a work in progress, and all these shortened weeks we've been having haven't helped since he thrives on structure but it's been going well considering.