ADHD & ODD: Confronting the Challenges of Disruptive Behavior

Discussion in 'Parenting News' started by DS3, Sep 27, 2011.

  1. DS3

    DS3 New Member

    I'll be honest. I have not had the time yet to sit down and read this, but it seems interesting and as soon as I do have the time, I will read it. If someone wants to post a cliff-note version in the mean time, it would be appreciated. LOL! (Make sure you click through all the pages, I noticed that the article is 6 pages long).

    ~some days I am so busy that I don't get to do anything that I want...~:twister2:



    DS3

    Link: http://www.consultantlive.com/articles/adhd-odd-confronting-challenges-disruptive-behavior
  2. InsaneCdn

    InsaneCdn Active Member

    Requires membership to see beyond page 1... and I'm not up to researching whether or not I want to join.

    Two things are initially interesting, though...

    1) The premise that ALL ADHD is neuro-chemical in its basis, and therefore can be helped by medication. Does this mean that if a person dxed with ADHD does not respond to meds, that the person does not have ADHD? Possible, but I haven't seen anything quite this pointed before.

    2) The overlap between ADHD and ODD being explored - without looking at the other items frequently co-morbid with ADHD and whether or not these (especially if not dxed or not handled properly) could result in ODD behavior as a result... rather than the ODD being linked directly to the ADHD

    Haven't read the whole article... will be interesting to see what others think!
  3. keista

    keista New Member

    #1 that has actually been a long standing theory. HOWEVER several members on this board have stated that meds did not work for their young children, but once passing puberty, meds DID work. So, while the "med test theory may be valid, it's not an instant diagnostic "tool" Meds would have to be ineffective over a lifetime to "prove" that it's not ADHD and that is only helpful for research purposes, not treatment purposes.

    #2 "could result in ODD behavior as a result... rather than the ODD being linked directly to the ADHD" This is why I and many others on this board don't think ODD, in and of itself, as a "real" dx. It is NOT a biological disorder, but environmental. ADHD itself does not cause OOD, but how the child with ADHD responds to their environment and how the caregivers respond to the child, may elicit ODD type behavior.

    IMO long term (10-15) year studies also need to be done, because what *looks* like ADHD with ODD in a 5 or 6 y/o (even passing diagnostic criteria) may in fact be co-morbid with other dxes or something else entirely.
  4. TeDo

    TeDo Guest

    Insane, I kind of got the same impression. Gfg carried the ADHD & ODD labels for 3 years only to find out it was ASD all along. So many things manifest so similarly it's hard to differentiate sometimes.
  5. Malika

    Malika Active Member

    I'm interested in this TeDo. Could you say a little more about how ADHD with ASD manifests differently? How would you (briefly and simplistically, I know) describe your son's behaviour and "presence"?
  6. TeDo

    TeDo Guest

    Malika, the symptoms of both are very alike. The biggest difference with my gfg is that he had mild delays in communication and social skills when he was young (developmental). He had some odd behaviors that I didn't realize back then such as lining his Matchbox cars up in an imaginary parking lot and no one was allowed to disturb them. He also avoids eye contact with people he doesn't know WELL. He also perseverates on topics that do change every few months. He used to talk about fishing ALL the time. Now it is golfing (his new hobby). During soccer season, he talks about that constantly. That is what is "different" between ASD and ADHD in our case. There are many more similarities (with ADHD and ODD combined) than differences in our case which made diagnosis harder.

    Does this answer your question or did I read your post incorrectly?
  7. InsaneCdn

    InsaneCdn Active Member

    ADHD has very high co-morbitity rates with all sorts of other dxes... from learning disabilities (dyslexia, dysgraphia, dyscalcula, etc.), to motor skills issues (per CanChild, 50% of kids with ADHD also have DCD), to auditory issues and other things where the co-morbidity rates are not known.

    ADHD plus "other stuff" can and does lead to ODD if the "other stuff" is not found and dealt with at an appropriate age. BTDT. Solved the "other stuff" and the ODD went away. But the ADHD actually had NO link to the ODD, as far as we could tell.

    For argument, take a kid who is not ADD/ADHD, but has other issues like learning disabilities etc (as above)... and fail to deail with those issues, and I'd be fairly certain that the result will be ODD... without the ADHD.

    Of course, people on this board already know these things. It just takes the research world at least 20 years to catch up with parents!
  8. Malika

    Malika Active Member


    Yes, thank you TeDo, that's very clear.
  9. DS3

    DS3 New Member

    Now you got me thinking, since my GFG is ADHD/ODD, but does everything in your post. Perhaps I'm reading it incorrectly...
  10. InsaneCdn

    InsaneCdn Active Member

    DS3 -

    At 4 years old, the probability is that you're not going to get a really solid dx just yet. Not impossible - but unless its something really obvious (sometimes ASD stuff is really that obvious, but not always), dxes come in dribs and drabs and spurts.

    Keep an open mind. Try approaches that are common for ADHD... but if they don't work well, also try approaches that work for ASD. See for yourself what works, what doesn't. Start a journal, or a parent report, to capture what you've tried and with what results.

    We'd have NEVER guessed APD until much later. The DCD? saw that at 3 but didn't know what it was. ASD was on again/off again repeatedly - now its "off" - clinically significant findings (some traits) but doesn't meet diagnostic cutoff.

    Just to really confuse you (just kidding)... many dxes that are stand-alone, are also traits of ASD. ADHD, DCD, OCD, SID, just to name a few. A kid can be all of those and NOT be ASD, or only have some traits of some of those (plus other stuff) and definitely be ASD.

    In other words... welcome to the journey of discovery!
    (just wish the GFGs didn't drive us around the bend while we try to "get there")
  11. TerryJ2

    TerryJ2 Well-Known Member

    Interesting article. I haven't read the entire first page yet, but this jumped out at me: Socrates: "Our youth now love luxury. They have bad manners and contempt for authority and disrespect for their elders. Children nowadays are tyrants."[SUP]2
    :)


    [/SUP]
  12. TeDo

    TeDo Guest

    No, I don't think you are reading incorrectly. That is a description of my gfg. Those are the things that were kind of "causing" the ADHD and ODD in our case, although I think the ADHD is still separate because he is sooooo hyper without his Straterra. In our case, the ODD was the result, not the cause of the behaviors we were all seeing.
  13. InsaneCdn

    InsaneCdn Active Member

    TeDo - that is exactly our experience with the ODD dx as well.
  14. DAYDAY05

    DAYDAY05 New Member

    is there anyone who has a child with ADHD and ODD i need some advice!
  15. DS3

    DS3 New Member

    Seems to be the case for me as well if I am thinking about it correctly (still drinking my coffee this morning). You're saying because of the ODD behaviors, they got the dx of ADHD right?

    We first got the dx of ADHD then the dx of ODD, but they have went hand in hand for a while. GFG is still really hyper even with his Adderall. Next time we see his Psych I'm going to have to see if this is 'normal' or if he need a different medication.

    :coffee:
  16. DS3

    DS3 New Member

    You may want to check out the forums and find where your GFG would fit, and then post some information about what is going on. Many people here are very nice and willing to give advice. Go introduce yourself in your own thread. :) Welcome to the boards. If you want to chat, you can message me as my GFG is ADHD/ODD.
  17. TeDo

    TeDo Guest

    DS3. Gfg1 was diagnosed with ADHD when he was 3. He was diagnosed with ODD when he was in 3rd grade. This last January, it was changed to ASD. His defiance was because because of his rigid, literal, black-and-white thinking; inability to see the other person's point of view; inability to generalize; and strict adherence to routines.

    As for the Adderall in your situation, if it doesn't seem to be helping at all, you might want to consider asking about non-stimulant alternatives. Stimulants (they tried 3) did NOT work for gfg1 but the Strattera is working wonders. Otoh, I have heard some people have had negative experiences with Strattera. It's almost a crapshoot with meds when it comes to individual effectiveness. I have since heard from MANY parents here that stimulants and ASD are not a good combination.

    Good luck. Keep questioning, researching, and pushing for anwers. When you have a clear picture of what all is really going on, life gets better.
  18. DS3

    DS3 New Member

    GFG was dx'd with ADHD at 3.5 and ODD at 4. The Neruo-Psych says he's an extreme ADHD/ODD. Didn't fall on the ASD Spectrum at all. So we'll go for this for now. It's hard because he is so young. Perhaps when he's older we'll find out something else. On the plus side, ABA is starting next week (had the interview this week), and his OT eval is next week. Plus the IEP is in progress. Between them all, I'm hoping for a clearer picture. :)
  19. buddy

    buddy New Member

    I did the register, it is free, says you have to be a health care professional but doesn't seem to be anything you have to prove so if you are not just do the general related health care options, smile! anyway, no matter a degree or not, folks on this site are all health care professionals, the web site just doesn't have a category for warrior parents (stealing your term, ok?)
    Seems like a really interesting site, thanks.
    I am readng it now...much like another thread posted recently where a seminar with a bent toward parental issues being a cause, just a quick first impression that they mentioned that here too for ODD and CD. All parents need help with kids like this but in many cases you gotta wonder which comes first, I never want my gfg's school to see an ODD diagnosis on his med. forms....I hear from many of you and what I have read that it is really biasing (is that a word??) ...and he has enough labels that cover those kinds of behaviors already.
  20. TeDo

    TeDo Guest

    You are DEFINITELY doing all the right things. Have you read the book Explosive Child? It was through trying Plan B that I learned how very differently gfg1 thought. That revelation is what caused me to have him reassessed. Otoh, because I realized that punishing gfg1 for skills he didn't have was like punishing a diabetic for having an insulin reaction. When I started putting my efforts into teaching those missing skills, I found I wasn't punishing very much and gfg1 and I were both happier.

    As long as what you are doing is working, the diagnosis doesn't matter (well, it kind of does but...). The end goal should be improving gfg's "quality of life" and making sure he learns the skills he will need to survive as an adult. Do whatever you gotta do, but only as long as it works.
  21. buddy

    buddy New Member

    Overall, I think it is a hopeful article. Focuses on what might cause these symptoms, important factors to assess and then what to focus on for treatment. It does give opinions about when medication may be called for (for the neurobiological co-morbid issues, for underlying issues, for resulting depression/anxiety/aggression issues).
    I of course read it with a bend toward our home situation (adoption, neurological trauma, autism) so the things that jumped out at me will be different than others but here are some of the things I found interesting:



    They discuss whether ADHD and ODD have a common pathway or are separate issues and discuss some of the ideas that support both ideas. They say the benefit of identifying ODD early is what we all know now, that early appropriate intervention is better than waiting. One way it is described evloving is when a 2 yr old goes through the normal oppositional stage, it continues without their developing the ability to self regulate whether due to internal factors, environmental factors and/or adhd.
    As I read some of this I agreed certainly, but thought of my son's frequent-at times nearly constant- negative interactions from adults in his life and thought it should say parents AND teachers. I know he wears them down and that is why even when I am frustrated with them for being so grumpy with him, then expecting him to cooperate, I stay their cheerleader and remind them that they have the opportunity to make a life long difference in this kid if they can just hang in there.

    This is huge for my gfg and I hate it (the process that is) It is so hard to establish a new rule or routine in our house but once it is established, even if he hates it, he always does so much better. I am sure that is just common sense for neuro-typical households, but for me I have to consciously think about it because the process of establishing limits can be so physically demanding that it is tempting to just let things slide. I always pay for it if I do that though, so it is really rare I change a pattern once established.
  22. buddy

    buddy New Member

    This is interesting. All kids are so different, and so far for mine even in puberty it is clear the stim. meds are working to keep him safe and to have a chance of focusing. In working on our med situation, our new psychiatrist (who has 3 gfg's of her own! and just purchased the partial hosp/outpatient program she manages) said they have found that the stim. medications that act calming and help a child to focus actually can become much more stimulating and can cause irritation and opposition as a child goes through puberty-and the neurons and chemical changes in the frontal lobe finish developing -thru the mid twenties-. She has been part of lots of research including at Mayo Clinics and specializes in kiddos with multiple dx. She only takes these kids as patients now.
  23. DS3

    DS3 New Member

    I found this part to be the most inspirational. We are NOT bad parents. Yes we do need help, but as the quote states, we're often drawn into bad parenting styles because of our children. Heck we could even be drawn into it because parenting today isn't the same as parenting when we grew up. With more technology also means more isolation for new parents and parents of problematic children. As the saying goes, "It takes a village to raise a child" but in todays day and age, you just don't see that. You see new mothers basically being handed a new-born with no real coping skills on how to handle that said child. Often, we are so distracted by what is going on all around us that no one takes the time to help those who need it most. ~sigh~ Sorry, just been reading this book which really explains a lot to me and has helped me cope with some feelings that I have. It's titled "I'm Okay, You're a Brat!" (And yes, the author has children.) Great read for anyone interested.

    SO back on topic (That's my ADHD talking there as I get off topic :) ) In today's day and age, the parents are often blamed. (going back to my book again) The truth is that parents have very little if any influence as to how their children grow up. Most influences come from the people they meet at school or outside of the house, their choices in decisions, etc., and at the very bottom of the totem pole ranks the parents. So we cannot blame the parents. Not if their involvement (no matter how much it may be) is ranked at the bottom of the list. I hate that the parents are blamed. Well we can influence some stuff, we cannot be accountable for their actions if they can comprehend the repercussions of their actions. It's not like they are robots. We can't program them to be such and such or to be have in a certain way. They are responsible for their own actions.

    Ok. Think I'm done for now. Perhaps I can stay a little more focused later.
  24. InsaneCdn

    InsaneCdn Active Member

    With all due respect... I disagree.

    This is how the outside influences want you to believe, because it maximizes THEIR impact.
    YOU don't have to go that way.
    The answer is... to build really strong family bonds, if you can. (there's kids where that doesn't work... I know).
    It means putting high priority on relationship building - rather than on fire-fighting. And yes, when we're presented with several dozen fires a day, how to get out of fire-fighting mode?

    There is significant research out there that kids with strong family attachment do better in all aspects of life.
    To do that, requires things that are not available to all families.
    As a society, we have not made child-raising a priority - the adults get on with their lives, and the kids take what they get.
    We have... absent dads (some moms), shared custody, shift-work, "away" work, two-parents-working, and so on... and no way to prevent any of this.

    But the things that build the bond take TIME. It means family meals together - twice a day, most days, if possible (breakfast and supper). It means family activities, family interests. It means spending specific time with each child, just feeding the relationship.

    Doing those things is really tough even if you have an intact nuclear family with some work flexibility and two kids that are not extremely hard to handle. (yes, two... it really helps. Each parent can take one... ). How on earth you do these things in other scenarios, I do not know.

    What I CAN tell you is, it works.
    Relationship building was one of the key things (meds adjustment and additional dxes and accommodations for school was another) that turned our GFG around.
  25. DS3

    DS3 New Member

    I'm going to start a new thread on this in the general parenting and do some quoting from my book to tell you why I believe you are wrong Insane. I think it gets way off topic if we continue it here. Look for it in a little bit. :)


    Yeah... Not going to post anymore since we sorted it out in PM. Well, unless my curiosity about what others think on the topic gets the better of me...
    Last edited: Oct 6, 2011
  26. InsaneCdn

    InsaneCdn Active Member

    DS - sent you a PM.

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