Oppositional Defiant Disorder Diagnosis
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Anonymous
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Our 7 year old DS was just diagnosed with ODD after having private psycho-educational testing done. He has been having serious issues with behavior this school year (tantrums, leaving class, hitting, kicking, screaming, throwing things, etc.) so we got him tested to see what was going on. This issues are fairly school specific. He has had a classroom switch recently and the problems have almost completely dissipated. We already had him evaluated prior to the switch and the diagnosis is partially based on information from his previous teacher. They said doesn't have ADHD, anxiety, or any other disabilities, and his IQ was in the 91st percentile. They did say he could benefit from some fine motor skill OT focusing on handwriting. He's already in private OT.
I'm wondering if it was just a bad classroom fit. I do know he does get irritated when forced to do certain things and acts out when bored. I want to make sure I'm advocating for him in the best way possible and am questioning that since we now have a diagnosis if he would be better served with a 504 or IEP. He's getting all A's academically however his behavior in his old class was preventing him from accessing the curriculum and he was suspended. It might be nice to have the OT integrated in the school day as well. We have a neuropsych appointment scheduled in March at KK, is it worth keeping that? |
Anonymous
| I am no expert but that seems OFF. ODD is very rarely diagnosed these days and it ALWAYS accompanies another diagnosis, which is part of the reason it is rarely diagnosed - ie., you want to see if remediating/understanding the ADHD, LD, anxiety or ASD helps. Also, clearly, something is goin on. That is some serious aggression and it is unlikely that it is "nothing", right? Did you do the ADOS? I am not sure what I would think. At the least, you have behavior issues, perhaps that do not fit into a diagnosis. And it sounds like the class switch has been great for him. Do you need an IEP? You may want one in case these issues appear in his next class. |
Anonymous
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Given that it's such a serious diagnosis, I would keep the KKI appointment. It seems that you have questions, as if you don't quite agree... and that's ok. That's why I think a second opinion in the form of another eval is warranted.
This child doesn't show any of these issues in the new classroom or at home? I would definitely want a second opinion. |
Anonymous
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OP here: I'm questioning the diagnosis because it hasn't lasted for more than 6 months. It's only been since school started in September, and it seems to have improved since the switch.
DSM-5 criteria for diagnosis of ODD show a pattern of behavior that: Includes at least four symptoms from any of these categories — angry and irritable mood; argumentative and defiant behavior; or vindictiveness Occurs with at least one individual who is not a sibling Causes significant problems at work, school or home Occurs on its own, rather than as part of the course of another mental health problem, such as a substance use disorder, depression or bipolar disorder Lasts at least six months |
Anonymous
OP Again: We didn't do the ADOS, would that be part of the neuropsych testing we have upcoming or do I have to specifically request that? I'm thinking that I'll keep the KK appointment in March and have his new teacher do the evaluation portion. I'm interested in seeing if his behavior continues to improve in school as he didn't have any issues in K or 1st. I'm also not entirely convinced he doesn't have underlying anxiety issues. |
Anonymous
| I would keep it for sure. I don't think that sort of serious issues can be explained with just a "bad fit." at the very least I would wonder if there is some serious anxiety ... in your shoes, I would keep the appointment. |
Anonymous
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KKI also diagnosed my son with Oppositional Defiant Disorder. Frankly, I never believed it as an sole diagnosis. To no surprised, DS was later diagnosed with ADHD (combined type), processing disorder and executive issues. The combination of ADHD, the poor exclusive social environment that he was in and his high IQ basically created a child who was his own nightmare. Counter-intuitive to what we were advised by the professionals, we became extremely tough on his behavior and buckle down on a strict routine. He was rewarded when he behaved well and was punished when he did not. It was hard being consistent all the time for years. His self-confidence took a huge hit, but it was plunging anyway with his social environment at school.
We realize that he has ADHD but frankly the world does not care what diagnose a child has; they only care what the result is, and when you have a naturally curious and capable child, his "gift" gets ignored and forgotten due to his poor behavior. Fast forward 3 years and I think we are finally making some headway. We spend a lot of time talking to him about his emotions. We are also stern with him. He has matured and become more responsible. He is now in the gifted center in 4th grade and am told by his teacher that he is incredibly kind, helpful and grounded. Nothing is perfect and he has mostly good and a few bad days, but the routines we have drilled into him has incredibly helped. Oppositional Defiant Disorder was handled with military-like consequences and regiments in our house, and that has worked for our son. |
Anonymous
| I would keep it and wait a month or two and then decide. The classroom/teacher could be the issue as not all seven year olds can express their needs or feelings but just in case its not, keep the appointment for now as they are hard to get. |
Anonymous
The ADOS is for autism. You are not describing autism. There is one or a few parents on here who believe everything is autism and can be fixed with an ASD diagnosis. |
Anonymous
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Mom of a child with ODD here. I'd keep that KKI appointment. ODD is one of those things that I find flares up with change and is so hard to treat that the more minds you have on it, the better.
FWIW, our DD has also improved with clear routines, clear expectations and firm parenting. Also counseling. Lots of it! We are somewhat fortunate that her issues come up at home (and mostly to mom), so it does not affect her school day. It does affect homework, tho... DD was diagnosed several years ago, yet does not have any of the typical accompanying diagnoses beyond anxiety. |
Anonymous
| 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. |
Anonymous
They should do an ADOS if, at the intake appointment, there is any question about Autism. You can specifically request it. With kids who are very verbal and don't exhibit classic stimming and avoidance of eye contact in the initial appointment, may have ASD dismissed out of hand without further testing. It would be appropriate to press on doing the ADOS if you have questions about autism, regardless of whether they "see" it at the intake appointment. Can I ask what type of testing you did? Was it primarily questionnaires for the parents and teacher or did they do a full day of testing? |
Anonymous
Nothing screams autism to me but it also doesn't scream not autism either. Not enough information. An ASD diagnosis does help if the primary things trigger outbursts are ambiguity and unpredictability in the environment and transitions. Those are things that typically set off kids with autism and schools should be equipped to understand that and work with it. |
Anonymous
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OMG please stop it with the useless posts on corporal punishment.
#1: if this actually IS an ODD diagnosis (and not a relationship/environmental issue) I'd expect to see it in multiple locations, not just school. #2: Actual ODD should be treated with evidence-based approaches, which likely do not include harsh punishments. |
Anonymous
OP, I'm guessing it's anxiety and impulse control/emotional regulation issues exacerbated by a bad teacher. I would not want to be going for an IEP or 504 plan with a diagnosis of ODD, because that's enormously stigmatizing and more importantly, likely incorrect. It could be that things are smooth sailing from here on out. If he's doing OK in the new classroom, I'd hold off for the rest of the year and work with private therapists. I have a similar story but for a much younger kid. His anxiety and motor delays, coupled with terrible classroom management and aggressive teachers, resulted in awful behavioral issues. I have no doubt he would have gotten an ODD diagnosis if we'd sought it. (Luckily at 4 he qualified for an IEP under the more general developmental delay category, so we didn't have to go that route.) With time and more importantly MUCH BETTER teachers, his behavior has done a complete 180. He's still a sensitive, passionate, nervous, clumsy, kid! But he does not have ODD. |