We’re very early into the process of having our 7.5yo diagnosed. She sounds very similar to your daughter. I really appreciate your post as well as the responses. I hope you find the right combo soon.

It gives me hope to see what others have implemented and found success.

Anonymous wrote:Op here-- i also find the Ross Greene method hard to implement, and admit that that might be my own executive functioning issues coming into play. I just find our situation so completely overwhelming, and his methods requires so many conversations with a kid who refuses to talk about her behavior and emotions, and frankly, has next to no insight or awareness to their severity.

We started by “plan cing” in Greene’s terms almost everything. Which means letting go of expectations that the kid can’t meet. We weren’t able to start trying to plan B or add in expectations until this dramatic reduction in demands and changed approach had really lowered the temperature all around. Things felt less overwhelming then. To be clear, my kid did basically nothing but screens for a couple of months while we built trust, but we were in a pretty dire place.

Anonymous wrote:

Anonymous wrote:NP. Does she like to role play, does she want to be in control of playing as well as in control of you and her sibling and her friends? Does she have fast mood swings from happy to upset or mad and back to happy?

No, she does not like to role play (and dislikes imaginative play in general). Yes, she wants to be in control, always. I've considered PDA. As for mood swings, it is not entirely clear. I wouldn't say mood swings are a huge problem, but rather that she is very inflexible and constantly irritable, so we are always delaying with bad moods. Sometimes she will explode and then get over it and seem fine in 30 minutes, while the rest of us are still reeling, but I'm not sure if that is technically a mood swing. I'm curious what you're thinking!

We have considered if she might be autistic, and discussed it with various therapists, teachers, and her psychiatrist. Although she has some qualities that would put her in the autism category (inflexible, no imaginative play, sometimes very literal (most people have ultimately felt that she would not receive an autism diagnosis as she is socially fairly neurotypical, doesn't have any particular interests, has hit all of her milestones on time. She isn't even quirky, really. I also questions a PANS diagnosis.

She does well academically and doesn't seem to have any significant learning differences. Not sure if that is important information when making suggestions!

PP here. I was thinking about PDA. I have a DC with PDA and for years the entire family was in crisis. It's much better now, DC is 10, has started Focalin, we have changed some parenting techniques, he has matured a bit. We still have better days and worse days (for whatever reason this weekend has been pretty bad but things had been going better for a while before that). Your DC may not be PDA but may just have "regular" demand avoidance and some of the same strategies can work for that too. Also "regular" anxiety causing the need for controlling everything and everyone in her orbit.

As for strategies, neither consequences nor rewards work for us. We are more indirect, use more words rather than fewer (this is the opposite of strategies for autistic children fwiw) and don't (try not to take) anything personally, including No, refusal or bad language or name calling. Whether PDA or just regular demand avoidance, a No is an indication of stress, overwhelm, anxiety, and struggle. The poor behavior may be hard for the whole family - it's hard for the kid too (I try to keep this in mind but don't always remember in the moment). We found the Declarative Language Handbook somewhat helpful although not a silver bullet, ymmv. A softer, slower approach overall.

I’m so sorry. My child has similar difficulties but never actually got the ODD diagnosis though it was discussed once. A month ago I would have told you therapy and patient training had made a huge change and we were doing well but we have had a lot of sickness and my kid doesn’t sleep at all when they are sick and then their (and my) behavior goes way downhill. I’ve been pretty defeated recently. I try every day to facilitate a good interaction however short with DC. Their biggest currency is our relationship. Have you ever read about theraplay? I read about it years ago and won’t remember the details but I remember a section about painting nails being effective because you have a soothing physical interaction that is very focused on your child. My child also really loves back rubs. None of these are fixes/ please don’t think I am suggesting they are! But they are little threads of connection that keep us from breaking totally apart. Good luck I’m thinking of you!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. Does she like to role play, does she want to be in control of playing as well as in control of you and her sibling and her friends? Does she have fast mood swings from happy to upset or mad and back to happy?

No, she does not like to role play (and dislikes imaginative play in general). Yes, she wants to be in control, always. I've considered PDA. As for mood swings, it is not entirely clear. I wouldn't say mood swings are a huge problem, but rather that she is very inflexible and constantly irritable, so we are always delaying with bad moods. Sometimes she will explode and then get over it and seem fine in 30 minutes, while the rest of us are still reeling, but I'm not sure if that is technically a mood swing. I'm curious what you're thinking!

We have considered if she might be autistic, and discussed it with various therapists, teachers, and her psychiatrist. Although she has some qualities that would put her in the autism category (inflexible, no imaginative play, sometimes very literal (most people have ultimately felt that she would not receive an autism diagnosis as she is socially fairly neurotypical, doesn't have any particular interests, has hit all of her milestones on time. She isn't even quirky, really. I also questions a PANS diagnosis.

She does well academically and doesn't seem to have any significant learning differences. Not sure if that is important information when making suggestions!

DP. Based on what you said it’s not like an autism diagnosis would help figure out the right therapies!

signed,
“autism mom” who would love some magic autism therapy for emotional regulation

Op here. What is DP?

Basically what you are saying is what all of the experts have said-- an autism diagnosis doesn't really change what we need or help us figure out what we need, and we need to focus on finding solutions instead of figuring out labels-- but we haven't had any luck. I am wondering if I should ask about Concerta instead of Focalin, mostly because it lasts longer and she is somewhat more manageable when her ADHD meds are in her system.

Op here-- i also find the Ross Greene method hard to implement, and admit that that might be my own executive functioning issues coming into play. I just find our situation so completely overwhelming, and his methods requires so many conversations with a kid who refuses to talk about her behavior and emotions, and frankly, has next to no insight or awareness to their severity.

Anonymous wrote:

Anonymous wrote:NP. Does she like to role play, does she want to be in control of playing as well as in control of you and her sibling and her friends? Does she have fast mood swings from happy to upset or mad and back to happy?

No, she does not like to role play (and dislikes imaginative play in general). Yes, she wants to be in control, always. I've considered PDA. As for mood swings, it is not entirely clear. I wouldn't say mood swings are a huge problem, but rather that she is very inflexible and constantly irritable, so we are always delaying with bad moods. Sometimes she will explode and then get over it and seem fine in 30 minutes, while the rest of us are still reeling, but I'm not sure if that is technically a mood swing. I'm curious what you're thinking!

We have considered if she might be autistic, and discussed it with various therapists, teachers, and her psychiatrist. Although she has some qualities that would put her in the autism category (inflexible, no imaginative play, sometimes very literal (most people have ultimately felt that she would not receive an autism diagnosis as she is socially fairly neurotypical, doesn't have any particular interests, has hit all of her milestones on time. She isn't even quirky, really. I also questions a PANS diagnosis.

She does well academically and doesn't seem to have any significant learning differences. Not sure if that is important information when making suggestions!

DP. Based on what you said it’s not like an autism diagnosis would help figure out the right therapies!

signed,
“autism mom” who would love some magic autism therapy for emotional regulation

Anonymous wrote:So I found (or refound) the Ross Greene stuff after we had tried everything else. PCIT, CBT, DBT. All of it. I totally hear you that the method seems particular and difficult to implement. But recognizing for us that kids do well if they can, and that my kid was not able to meet expectations for a long while helped so much. In retrospect, I think my kid was deep in autistic burnout/fight or flight mode. (Asperger Experts guy talks about this a lot.) Without this model, I don’t think I could have removed my expectations in the way that I did. We are about 9 months out. My kid is now going to school, brushing his teeth, not being aggressive, doing chores, self-regulating screens. It isn’t perfect and he still won’t engage in a lot of the conversations which makes it challenging, but using pieces of this model have helped us so much. I do think that there are some kids - esp some bright autistic ones - for him consequences do not work, who will not have an extinction burst. For us, trying something very different brought us a lot of peace. That said, I know how deeply awful this all is. And how scary!

that’s great and I am happy for you! but still not totally understanding what you actually did. maybe I just lucked out with our behavior psychologist and OT, but figuring out acheivable goals was always a big piece of the plan. And positive incentives, backwards-chaining, etc, were always more important than consequences.

Anonymous wrote:NP. Does she like to role play, does she want to be in control of playing as well as in control of you and her sibling and her friends? Does she have fast mood swings from happy to upset or mad and back to happy?

No, she does not like to role play (and dislikes imaginative play in general). Yes, she wants to be in control, always. I've considered PDA. As for mood swings, it is not entirely clear. I wouldn't say mood swings are a huge problem, but rather that she is very inflexible and constantly irritable, so we are always delaying with bad moods. Sometimes she will explode and then get over it and seem fine in 30 minutes, while the rest of us are still reeling, but I'm not sure if that is technically a mood swing. I'm curious what you're thinking!

We have considered if she might be autistic, and discussed it with various therapists, teachers, and her psychiatrist. Although she has some qualities that would put her in the autism category (inflexible, no imaginative play, sometimes very literal (most people have ultimately felt that she would not receive an autism diagnosis as she is socially fairly neurotypical, doesn't have any particular interests, has hit all of her milestones on time. She isn't even quirky, really. I also questions a PANS diagnosis.

She does well academically and doesn't seem to have any significant learning differences. Not sure if that is important information when making suggestions!

So I found (or refound) the Ross Greene stuff after we had tried everything else. PCIT, CBT, DBT. All of it. I totally hear you that the method seems particular and difficult to implement. But recognizing for us that kids do well if they can, and that my kid was not able to meet expectations for a long while helped so much. In retrospect, I think my kid was deep in autistic burnout/fight or flight mode. (Asperger Experts guy talks about this a lot.) Without this model, I don’t think I could have removed my expectations in the way that I did. We are about 9 months out. My kid is now going to school, brushing his teeth, not being aggressive, doing chores, self-regulating screens. It isn’t perfect and he still won’t engage in a lot of the conversations which makes it challenging, but using pieces of this model have helped us so much. I do think that there are some kids - esp some bright autistic ones - for him consequences do not work, who will not have an extinction burst. For us, trying something very different brought us a lot of peace. That said, I know how deeply awful this all is. And how scary!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We have been there. Some children do not respond to consequences or incentives. The thing that saved us was Ross Greene. Check out his books, podcast, the B Team group on Facebook. It was a radically different approach for my also therapy resistant, very difficult kid. Sending all the empathy - this is so hard.

I’m glad this worked for you but that b team Facebook group I have mixed feelings about. It got so complicated and so involved with each challenge that it was like - impossible to action. I felt like if his methods were so good it shouldn’t be this hard to extrapolate how to put them into practice.
All that being said it’s a good recommendation and if it helps you and op then awesome.
It’s all super hard

I agree with you about Ross Greene. The idea that kids need to build skills makes sense, but as far as I can tell, there is no theory on how to build the skills. It’s a good mental framework to have a more productive and positive attitude as adults towards kids’ behavioral challenges, but not much by the way of guidance. In contrast, PCIT has a lot that in my experience really helps- like how to give commands, planned ignoring, praising extremely small steps, repairing the relationship through child-directed interactions. My child responded extremely well to positive and negative incentives to change behavior as well. I’m not sure how I would have taught him those “lagging skills” directly.

(btw to clarify - I would love to hear from people for whom it worked. I’m not dissing it. I just don’t understand it.)

Anonymous wrote:

Anonymous wrote:We have been there. Some children do not respond to consequences or incentives. The thing that saved us was Ross Greene. Check out his books, podcast, the B Team group on Facebook. It was a radically different approach for my also therapy resistant, very difficult kid. Sending all the empathy - this is so hard.

I’m glad this worked for you but that b team Facebook group I have mixed feelings about. It got so complicated and so involved with each challenge that it was like - impossible to action. I felt like if his methods were so good it shouldn’t be this hard to extrapolate how to put them into practice.
All that being said it’s a good recommendation and if it helps you and op then awesome.
It’s all super hard

I agree with you about Ross Greene. The idea that kids need to build skills makes sense, but as far as I can tell, there is no theory on how to build the skills. It’s a good mental framework to have a more productive and positive attitude as adults towards kids’ behavioral challenges, but not much by the way of guidance. In contrast, PCIT has a lot that in my experience really helps- like how to give commands, planned ignoring, praising extremely small steps, repairing the relationship through child-directed interactions. My child responded extremely well to positive and negative incentives to change behavior as well. I’m not sure how I would have taught him those “lagging skills” directly.

NP. Does she like to role play, does she want to be in control of playing as well as in control of you and her sibling and her friends? Does she have fast mood swings from happy to upset or mad and back to happy?

Anonymous wrote:We have been there. Some children do not respond to consequences or incentives. The thing that saved us was Ross Greene. Check out his books, podcast, the B Team group on Facebook. It was a radically different approach for my also therapy resistant, very difficult kid. Sending all the empathy - this is so hard.

I’m glad this worked for you but that b team Facebook group I have mixed feelings about. It got so complicated and so involved with each challenge that it was like - impossible to action. I felt like if his methods were so good it shouldn’t be this hard to extrapolate how to put them into practice.
All that being said it’s a good recommendation and if it helps you and op then awesome.
It’s all super hard

Anonymous wrote:No advice but I’m right there with you. My one child is almost literally killing my will to live. I have another child who is a complete delight and it’s heartbreaking how their life is also being ruined by our one disaster of a kid. Special needs boarding school may be the only solution.

Same. I’m ready to consider ir for my 11 year old. It’s been 7 years of hell.