Some of the therapists at Alvord & Baker in Rockville have PCIT training, I believe.

PPs who have had success with PCIT, who did you work with? This sounds like a great fit for my child.

Anonymous wrote:When DC was 6, he developed extreme defiance seemingly overnight. Physical violence, couldn’t attend school kind of stuff. Ultimately was diagnosed and successful treated for pandas, but for a three month period all hell broke loose. We did PCIT - among a million other therapies, meds, counseling sessions etc- and PCIT was the only thing that helped.

Did you work with a therapist who trained you? Even with treatment for anxiety and ADHD, we're still dealing with defiant behavior and outbursts that are very difficult to manage. if school had not closed, we were close to school refusal situation. DC is 10.

Anonymous wrote:When DC was 6, he developed extreme defiance seemingly overnight. Physical violence, couldn’t attend school kind of stuff. Ultimately was diagnosed and successful treated for pandas, but for a three month period all hell broke loose. We did PCIT - among a million other therapies, meds, counseling sessions etc- and PCIT was the only thing that helped.

plus a million. we did a PCIT-like therapy and it was life changing. It wasn’t PANDAS for us, but a sharp uptick in violence due to adhd/asd/anxiety. I have no doubt he would have gotten an ODD dx at that point if I had sought it out.

When DC was 6, he developed extreme defiance seemingly overnight. Physical violence, couldn’t attend school kind of stuff. Ultimately was diagnosed and successful treated for pandas, but for a three month period all hell broke loose. We did PCIT - among a million other therapies, meds, counseling sessions etc- and PCIT was the only thing that helped.

Anonymous wrote:I don’t believe that ODD should be a stand alone diagnosis. I believe it is a description of behaviors that certain kids exhibit while they are in crisis because what is actually going on (anxiety, undiagnosed ADHD, major life trauma) is not known or understood. So I would focus on figuring out what the underlying problem really is.

And meanwhile, read Dr. Ross Greene.

-mom with a kid with ADHD/anxiety/giftedness who was prescribed antipsychotic drugs at age 7 by providers who didn’t want to take the time to figure things out

+1 and get parent training like Shapiro’s class and therapy for you because this is a hard road.

I don’t believe that ODD should be a stand alone diagnosis. I believe it is a description of behaviors that certain kids exhibit while they are in crisis because what is actually going on (anxiety, undiagnosed ADHD, major life trauma) is not known or understood. So I would focus on figuring out what the underlying problem really is.

And meanwhile, read Dr. Ross Greene.

-mom with a kid with ADHD/anxiety/giftedness who was prescribed antipsychotic drugs at age 7 by providers who didn’t want to take the time to figure things out

Food allergies. Keep track of everything they eat and drink for two weeks. You'll be amazed at how influenced some children can be.

Proper diagnosis and medication along with residential treatment in a wilderness type program.

Thanks! Was there a specific behavioral therapy approach? Do you have recommendations for therapists in this area? Thanks!

Anxiety and OCD for us too. Aggressively treat any co-morbid conditions and then see what remains. We also worked with a behavior therapist which was very helpful.

Mine was never officially dx'd with ODD but like pp, all serious ODD evidence, in retrospect, was a result of the anxiety.

I think you need the help of a behavioral therapist, and the medication angle, possibly. Also, very clear guidelines, written out, about behavior rules and consequences. Refusing to engage in discussion about said rules and consequences is important, because it gives the kid false hope that they might win the argument. Repeating over and over that the adults are in charge. Trying to wait until everyone is calm to discuss the issue and giving everyone a cool down space. Trying to spend time truly connecting with the child with a preferred activity to build the relationship. It can be very hard to remain calm with a kid that is pushing your buttons and testing limits. If you can, switch off with another adult. Get yourself a support group. Seek respite care however you can, through family members or agencies. Good luck.

DC was diagnosed with ODD at 13 yo in conjunction with a primary and very clear diagnosis of anxiety. In retrospect, I think the defiance was largely a product of the anxiety that was still dominating DC’s life. Plus some of that defiance was generally part of being a young teen. A few years later, DC is much less defiant. My conclusion is that a few things helped: time to mature, more consistent parenting (predictable and logical consequences for poor behavior), and medication changes for the anxiety (lexapro was okay then Zoloft was better) with a mood stabilizer (lamictal). It was a tough period but things slowly improved. Good luck.

If your child was dx'ed with ODD or otherwise was frequently defiant, what helped? Thanks so much.