New here and looking for direction...

Discussion in 'General Parenting' started by rachelfran, Aug 5, 2007.

  1. rachelfran

    rachelfran New Member

    Based on what I've read online - it seems my son has ODD...
    I will be calling my pediatrician but wanted to check here as to the path for diagnosis and what I can expect to follow?

    Thanks!
    Rachel
     
  2. Big Bad Kitty

    Big Bad Kitty lolcat

    Hi and welcome!

    Okay, the pediatrician may or may not have a diagnosis (diagnosis) for your son. He may send you to a psychiatrist. We suggest to have your son get a multi disciplinary evaluation, and to prepare a parent report. Information on those items can be found here:

    http://www.conductdisorders.com/community/threads/parent-input-multi-disciplinary-evaluation.10/

    It is very helpful if you make a signature as the other board members have, it helps us to keep everyone straight.

    Now, none of us can diagnose your child, but it is safe to say that ODD is rarely a stand alone diagnosis. Most children have something else along with it. I suggest you keep an open mind, and remember that we are here to help you through the process. We are glad you found us, but sorry that you had to. Hugs!
     
  3. Sara PA

    Sara PA New Member

    In some cases, ODD-like behavior is a symptom of a disorder, not a disorder in and of itself.
     
  4. Marguerite

    Marguerite Active Member

    From my experience, a lot of what gets called ODD is what is observed on the surface after another underlying disorder has caused problems for that child. A number of disorders can do this - often treating the underlying disorder can make a big difference. Also, trying to see what it is that the child is having trouble with, can also help.

    We have a book we recommend here - "The Explosive Child" by Ross Greene. There is some discussion on this in the Early Childhood forum. It's like a bible for some of us. You should be able to get it from the library, too, if you want to read it before you fork out bucks for it.

    You don't say how old your child is - that also can have a bearing.

    Basically, sit down and watch your child. Think about past events. Make sure you have your own notes recording interesting stuff like this, anything you think could be relevant. Err on the side of generosity. But think - is your son impulsive? Does he have a short fuse? Does he get angry first and ask questions later? Is it possible his understanding is not up to scratch? Have you had his hearing checked? Does he have difficulty sticking at one thing? Or can he immerse himself in something to the absolute exclusion of everything else?

    Does he have trouble changing tasks? By this I mean, if he's playing in the backyard and you call him in for a meal or a bath, and INSIST, is this likely to cause him to get upset? If he's working on schoolwork - maths, for example - and he's told to put down his pen and stop work on the maths, here comes some English pages - does he get upset? Does he take a lot longer than others to get started?

    You can help him by minimising the impact of these things. Help him and he realises that's what you're there for. Keep blocking him and trying to lead him by the nose, and he will pull back like a stubborn donkey.
    With task-changing, for example. I give difficult child 3 a time warning - "Son, it's now 8.15 am. At 8.30 I need you to be working on your maths on the computer. You have 15 minutes to finish that game, or get it to a pause point where you can save it and go back after lessons." At 8.30 I will give him a few minutes' leeway if I think he's playing fair and simply hasn't had an opportunity to save the game. But take too long - I threaten to pull the house fuses. This will trigger a meltdown if I go this far, and it's only a recent thing I've been able to do, because there will be a meltdown on one day, with an apology (unprompted) half an hour later, followed by a week of not putting a foot wrong. But it took us a long time to get this good.

    The aim of my exercise is to get him to work effectively and productively on his schoolwork. That half-hour from 8.30 to 9 am it actually to help get him started. His lessons officially begin at 9 am, so he's already in work mode and sometimes has begun his lessons a few minutes early. If he's worked well all day, finished his quota and more by, say, 3.15 pm (he's supposed to work until 3.30 pm - our rules) then I'll give him that extra time off, rather than get him to start new work. Or I might get him back on the computer tutor again. At the end of the day we talk about how well (or otherwise) he was able to work, but keep it positive, even if he had a bad day. "Tomorrow you will be able to concentrate better, we'll find a way to help you."

    I'm giving you this info in a home schooling environment because for us, it's what we've found works best and we have the option to do it. I know tis is not the case for everybody.

    A common problem for kids in mainstream, on the difficult child range - homework. A well-known trigger. There are many reasons for this and it's vital to work them out fast, so you don't get sucked into the problems at school as well. If a kid can do homework well and is benefiting, then that's great. But in my experience, that's rare, especially with difficult children. By the end of a school day they're tired, irritable and have been trying to hold it together all day. They need to let out all their frustrations, and presenting them with homework at tat time is often a disaster. And even later, when they've maybe worked off their energy but are really tired, also often doesn't work. We found that if we asked the school how much time the child should be doing homework and supervised to make sure that amount of time and no more was spent on it, then sat down with the teacher to discuss, "IS the amount he can do in this time really worth all the hair-pulling and angst?" you can often get a teacher to allow, in the IEP, a reduction or elimination of most homework.

    It really depends on a lot of things. Even a diagnosis isn't always giving you the true picture. You are the parent, you know your child better than anyone. What you deal with is the picture. A diagnosis is a label you can use to open doors here or there, it doesn't always communicate fully.

    difficult child 3's teacher in Grade 1 rang me before she began the classes for the year. "I hear he's autistic - I have a son who's autistic. I think you'll find I have a better understanding than most teachers."
    "Quite likely," I told her. "I'm glad you have some understanding - but be careful, difficult child 3 is not what you expect."
    I collected him at the end of the first school day. She met me on the steps. "He is VERY different, isn't he?" she said.
    She learnt a lot that year - most of it from scratch.

    Keep us posted on how you go.

    Marg
     
  5. Liahona

    Liahona Active Member

    Just wanted to add my welcome to the board.
     
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hi there. It would help us a lot if you'd do a signature, like mine below.
    So...has your child ever seen a Psychiatrist, neuropsychologist, or had a multi disciplinary Evaluation? It is possible, but rare for ODD to stand by itself. Most of the kids who display ODD behaviors have other problems causing the ODD and, if treated, the ODD can greatly improve or even go away. Happened to my son.
    Do you have any psychiatric or substance abuse problems on the family tree on either side? Any neurological problems? Personally, I wouldn't trust a Pediatrician for any sort of accurate diagnosis. I'd ask for a referral elsewhere. Welcome.
     
  7. Nancy

    Nancy Well-Known Member Staff Member

    Welcome Rachel. My difficult child has ODD too. Many teens have ODD behavior, but there is a big difference between ODD behavior and ODD the disorder. Why don't you tell us a little bit more about your son, his age, his behavior, when this started, any other behaviors that you are worried about, how he is doing in school, what his friends are like.

    My daughter has been ODD from the very beginning. She just told her therapist last week that when we make rules or tell her to do something it makes her want to do the opposite. Boy is that ever true.

    Nancy
     
  8. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Another just popping in to say welcome! I'm glad you found us.
     
  9. rachelfran

    rachelfran New Member


    Thanks for all the welcomes....

    My son just turned six ... He's recieved speech, Occupational Therapist (OT), PT & play therapy for two years during the school year... At the end of his kindergarten year the play therapist dropped that service - citing that he was fine in a small group of three - which is what the service was... His teachers told me he was fine with a small group but has a larger issue with big groups.. He needs his space and doesn't like other kids getting too close.. He was in inclusion for kindergarten which was great for him ... He had no real issues until the last couple of weeks of school when he got physical a couple of times and the teacher called me about it... Academically he's done great... though homework wasn't fun - he did it, generally and overall, excelled. He will continue in inclusion for 1st grade as the teachers suggested he has low self esteem so would benefit from the added adults on the room in the inclusion class... The mainstream 1st grade has up to 25 kids with only 1 teacher.

    Within the last few months we've noticed a huge increase in the amount of aggression shown toward myself, max's dad and his sister. He loses his temper easily and whenever he is told no - gets violent. Kicking, hitting, pinching, scratching - not uncommon. He also says some very nasty things - like - what will happen if i hit you with this (fill in with whatever is handy). Usually I just brush off the comments but they can be mean and scary - especially to an outsider.

    I've always been relieved that the worst of the aggression rears it's head at home and not in school but i don't know about 1st grade... I'm worried that as the work gets harder - he will get worse...

    There are no mental health issues in our family and no medications taken on a regular basis by anyone... Max is mildly asthmatic and will, occassionally use a nebulizer... but that's all.

    His other behavior - which could be something but has never been diagnosed - his is obsession with time... he is always asking how long things are or how many minutes are left until a particular time... If you don't know the answer - he gets angry and if your answer doesn't jive with what was said earlier - he'll call you on it and get angry....

    That's all off the top of my head -- while I'm here at work so I can't go on and on but wanted to fill in some of the missing details... I really appreciate any and all suggestions ...

    Should I be calling a psychologist off of our mental health portion of our medical plan?

    thanks!
    Rachel
     
  10. smallworld

    smallworld Moderator

    Rachel, welcome!

    I assume Max had speech and developmental delays that the various therapies through K were addressing. With those symptoms, social discomfort and a quirky obsession plus the recent increase in aggression, I'd recommend a thorough evaluation with a developmental pediatrician, a neuropsychologist or a multidisciplinary team at a children's or university teaching hospital. We're not doctors and can't diagnosis over the internet, but we can point you in the right direction, and I would not recommend a psychologist, who may concentrate on the behavior rather than the underlying cause behind it. While you may be looking at a mental health issue (anxiety comes to mind) as part of the diagnostic picture, it sounds much more to me as if Max should be evaluated for an Autistic Spectrum Disorder. The professionals I listed above can evaluate for Autism Spectrum Disorders (ASD).

    Again, welcome. You will find a lot of support here.
     
  11. busywend

    busywend Well-Known Member Staff Member

    It is my experience that schools do not offer the services your son has recieved unless there are obvious signs of the disability. What has the school district's evaluation suggested as a possible diagnosis?

    I think you should go the Nueropsych route, too. I would encourage you to check with the local chilren's hospital for a full team evaluation. With interventions perhaps you can prevent your son from ever displaying that aggression at school. Once he does - it is tough to come back from.
     
  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I agree with the neuropsychologist. I have no real idea what's wrong, but he has several red flags for high functioning autism. Obsessions are a big problem with these kids! NeuroPsychs do intensive testing, much more than other professionals. My son's first and wrong diagnosis. was ADHD/ODD. Anyways, good luck.
     
  13. Marguerite

    Marguerite Active Member

    I agree, definitely follow through and query a number of things here. That obsession with time - out of curiosity, what sort of display do you have on your microwave oven? What timer do you use when cooking? And does he, or has he ever, been found standing there watching it count down, or simply flash up the numbers?

    Are there any other situations where he seems to have his attention caught by letter or number displays? Anything else that holds his attention so thoroughly that you have difficulty pulling him away from it?

    He's doing well academically - that's really good news, but is also found in a number of 'disorders' already described. I put quote marks around that because to a certain extent, it is a matter of attitude. We had a TV program on last night, dealing with ADHD. At one point one of the experts described ADHD as a learning disability which really made easy child 2/difficult child 2 angry. "I don't consider myself disabled," she said.
    "Nevertheless you are," husband replied. "The college system and the education system in general needs the disability label in order to put in place the support we use. You don't consider it a disability because we've always emphasised the gifts you have; but it has to be taken on balance."
    "That's what I mean!" she said. "Calling it a disability, constantly, is not balanced!"

    It really does make a difference, how you present it to the child. difficult child 1 came to me yesterday afternoon, told me that at his church, where he takes Sunday School, there is a small boy with a diagnosis of ADHD and whose mother is concerned about the pediatrician they see. He seems a bit strange. difficult child 1 asked who, and it turned out to be difficult child 1's first pediatrician. He IS strange. However, he did give difficult child 1 something important - he validated him. He told him that it is NOT his fault that he has more difficulty concentrating and staying on task in class. And once difficult child 1 realised this, his behaviour actually improved because he realised that he was NOT automatically a naughty child. His anxiety eased somewhat and he coped a little better. He still needed a lot of intervention, but we were able to see the bright, skilled boy underneath it all.

    Your son sounds as if he has a number of issues, including obsessiveness and anxiety. It also sounds like he's having problems socially, when in larger groups. I do think it would be useful to have Pervasive Developmental Disorder (PDD) considered so it can be assessed and hopefully ruled out, although this is sounding like Asperger's to me. If managed, Asperger's can be turned from a disability to a positive bonus. It depends on the child as well, but once they find the different way in which they learn best, they are off and running, academically. You still need to give them extra support in social situations and that CANNOT learn proper social interaction the way other kids do (by osmosis) but if taught carefully and handled gently (but firmly) they can do amazingly.

    Something else I'm wondering - does he treat adults and children all the same? No distinction between people? How is he with babies? Does he expect them to be able to talk to him as fluently as he talks to them? There are degrees of this, but if you've noticed ANY of this, then you will almost certainly have to change how you discipline him, because he is modelling behaviour shown to him. For example, a child like this will learn to hit back and punish what he perceives as naughtiness in others, if he is smacked as discipline. If you scold or shout, he will copy this and use it when he perceives he should act the same way (such as when parents misbehave, by not knowing the right time, for example).

    "The Explosive Child" explains this a bit better.

    He sounds like a really interesting kid, although quite a handful at the moment and probably an even bigger handful in the past.

    Keep us posted.

    Marg
     
  14. rachelfran

    rachelfran New Member


    I've called my brother who works at a local hospital to try and get us in to do a neuropsychologist consult... Can anyone tell me what is involved with that - exactly?

    I have not seen max staring at clocks or timers .. we have a digital display on the microwave but he doesn't look at it... The only thing that he really concentrates on are his video games... He had a melt down today because his sister was using the PS2 when he got home from camp... I told him that she could use it for the next hour and then it would be his turn... he went ballistic - screaming, crying, kicking & hitting me.... The kids who live upstairs - who he wants to visit everyday, were over and I told them that they would have to leave if he was going to behave this way... He likes them to visit to watch him play his video game... needless to say - this doesn't really interest them much but they feign interest so they can play with-his toys - which Max doesn't much use, at all.

    The obsessiveness and anxiety - hits a nail on the head for me.... tonite & last night - he was afraid to go to sleep and i had to lay down and rub his belly until he fell asleep -- this is new to us ... usually he goes to sleep on his own... He constantly wants updates as to how many minutes are left until midnight....

    Thanks again for all the help ...

    Rachel
     
  15. Marguerite

    Marguerite Active Member

    Rachel, a fiction book that might be of interest - it was also discussed recently in Watercooler - is "The Curious Incident of the Dog in the Night-Time" by Mark Haddon. The main character tells the story- Christopher. He has Asperger's Syndrome, although he sounds more like my difficult child 3 than difficult child 1. Don't think of Christopher as a blueprint for Max, because they ARE all quite different. But reading the book you might get 'feel' for the way a lot of these kids think. A lot happens around Christopher which he doesn't 'get' but which will have you smiling and nodding. The accidental humour this way is brilliant. The author is NOT writing from personal experience - he is not autistic in any way, I'm told. He's just a brilliant and entertaining writer.

    The video games - snap. He was probably thinking all the time at camp and all the way home, "Only x more minutes until I can get on the PS2. Only x-1 more minutes until I can get on the PS2. Only x-2 more minutes..."

    If you can, also Google the sample chapter of "The Explosive Child" (it's actually the first chapter) and read it. The girl described in that throws a tantrum which on the surface seems inexplicable. But when you can understand her thought processes, you can recognise the triggers. With these kids, helping them to avoid the triggers is NOT giving in to them, because you can use the methods to get what you want in a different way. But it DOES involve teaching them how to compromise.

    Marg
     
  16. rachelfran

    rachelfran New Member

    thank you for this helpful post -- i've already registered for the recommended books through the library and hopefully they come in soon... in the meantime i spoke with my son's counselor at camp - who I am surprised had not called me to tell me about max's outburts at camp when he can't partner with one of the only two friends he has in his group and how difficult it is to transition him from one activity to the next... he throws tantrums, cries and gets red in the face from anger... he did say he doesn't hit - which is a relief but all of these anger issues are new to us.. it's disconcerting to hear that it's happening with-out you being there... and knowing how this effects his day to day relationships is upsetting...

    thanks again,
    Rachel
     
  17. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Difficulty with transitions are also a big red flag for possible Autism Spectrum Disorders (ASD). How are his social skills? Does he understand how to have a normal conversation--that it's give and take and not just monologing on his part? Will he only talk about his own interests or does he understand social niceties? Did he have speech delays or motor skills or potty problems?
    My son would also probably throw a fit if he couldn't play his videogames--they are his Autism Spectrum Disorders (ASD) obsession. Videogames and computers are huge obsessions for Autism Spectrum Disorders (ASD) kids, moreso than the normal kid.
    I'd see a neuropsychologist. It's a very intensive evaluation and, in my opinion, every difficult child should have one. No other professional attempts to test all levels of function in so much detail. It can give you a world of info on why your child is acting out. If it's new, maybe it's the transitions and stimulation at camp.
     
  18. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Meg, big lol! THAT IS LUCAS! Our kids are joined at the hip. No matter WHAT Lucas is doing, he wants to know, "Exactly HOW many minutes until we can go home so I can play my game?" And if you say, "Five minutes" and it's seven minutes, he'll correct you! This is a kid who obsessed on numbers and letters before age two, and still does, in more sophisticated ways...lol.
     
  19. rachelfran

    rachelfran New Member

    this is very helpful... Max had some speech delays and enunciation difficulties and in general an immature speech pattern. He does conduct normal conversation but doesn't understand social niceties and queues - in my opinion. He does have some physical delays - mostly balance issues - though again nothing major or obvious to the casual observer.. he does get physical therapy during the school year....

    Generally, Max's social skills are poor... he's often playing by himself though will interact with-other kids for brief periods... He will look you in the eye and most folks he's come across do not think he's on the spectrum - including these various therapists and his kindergarten teachers - both gen ed and Special Education.

    I am still trying to get a hold of someone where my brother works to see if we can get an neuropsychologist evaluation...

    Rachel


    Originally Posted By: MidwestMom
    Difficulty with transitions are also a big red flag for possible Autism Spectrum Disorders (ASD). How are his social skills? Does he understand how to have a normal conversation--that it's give and take and not just monologing on his part? Will he only talk about his own interests or does he understand social niceties? Did he have speech delays or motor skills or potty problems?
    My son would also probably throw a fit if he couldn't play his videogames--they are his Autism Spectrum Disorders (ASD) obsession. Videogames and computers are huge obsessions for Autism Spectrum Disorders (ASD) kids, moreso than the normal kid.
    I'd see a neuropsychologist. It's a very intensive evaluation and, in my opinion, every difficult child should have one. No other professional attempts to test all levels of function in so much detail. It can give you a world of info on why your child is acting out. If it's new, maybe it's the transitions and stimulation at camp.
     
  20. Marguerite

    Marguerite Active Member

    Good luck with getting some intervention/assessment through your brother. In the meantime, I would make your own observations and adjust your parenting/management of your son with a working hypothesis of Autism Spectrum Disorders (ASD). However, use your own instincts, try this and that to see how it works for him. USe what he's fascinated with as a tool.

    A very useful reward I recommend you use - this is what difficult child 3's psychologist recommended for us, it was brilliant - tell him that if he can NOT have a meltdown for a whole day (at home - don't inflict school problems on the home front, you weren't there at school with him) then YOU will play on the PS2 with him for half an hour. We would do it the next day, because the worst meltdown time is when they're tired and heading for bed.

    Our guidelines - if difficult child 3 had enough of a meltdown to have to be sent to his room, then no gaming for that day.

    What this does - he has a HUGE incentive to really try to hold it together at home. And the payoff is enormous, as well as helping him with social skills. difficult child 3 & I would play a game like Mario Party, which works a bit like a board game. He would let me practice before a mini-game because I'm really not as skilled as he is. We would have a lovely play together.

    Sometimes we wouldn't have time on a particular day so we would have to hold off the game until another day. Game time, once earned, cannot be taken away. Not even the worst tantrum of all can eliminate the game together time earned the day before, for example. However, you might be able to say, "I don't want to play right now while I am angry, but I will play the promised game time with you later." Even if you have a chart on the wall where you note down earned game time, so HE knows that it won't be forgotten... although I found difficult child 3 could hold the information in his head, on how much game time had been accrued.

    And a warning - this may not work for you RIGHT NOW as well as it did for us, because I suspect a big part of difficult child's anger right now is, he knows there is something wrong and he is feeling very angry (a lot of it with himself; and a lot with everybody else for not following HIS internal rules which he's worked out by observation, so far) as well as frustrated. We found this happened with difficult child 1 when he was 6 - he got a diagnosis of ADHD at about then which helped him accept that it wasn't his fault, although ti did mean he had to work harder at some things. And it happened with difficult child 3 when he was 8 - he would come home from school and ask, "Why am I different?" He'd been diagnosed at 3 but simply hadn't had the language capacity at the time to understand it. It really did take until he was 8 before he 'got it'.

    Working with your child's issues like this can give him a push start in the directions he needs to go, even before you get a diagnosis. If later on you get a different label, you still have done something which works for your son because you've used his own issues to help him learn some measure of self-control. But you might find you need to tell him - "Honey, it's not your fault, but it IS your problem. Your brain is working a different way to a lot of other kids, which could be why you find others so frustrating at times. And they don't always understand the things that are important to you, and they will find YOU frustrating. We're trying to find out just what the situation is, so we can help your brain learn in the way it needs to learn."
    Don't describe it as a disability if you can avoid it - you do not want him thinking he is flawed or inferior. Similarly, try to avoid boosting his self-esteem to the point where he feels he is superior - other kids will really resent him if he comes across as, "I'm smarter than you," even if he is.
    We told our boys, "Some things are much easier for you, other things are much harder. You need to really concentrate to find a way to do the harder things, but enjoy being able to do the easy things because not everybody can. It balances out."

    Once he can understand that it's not his fault, his behaviour may improve. What is then left is the normal frustration of trying to mesh his way of thinking, to everyone else's way of communicating. This is something we all have to do, but for a lot of difficult children it is a huge task. It will tire him mentally and physically. On a day when he's really had to use his brain to make sense of the world, or if he's had a lot of new things to deal with, he will be much more tired and likely to be much more irritable. I developed a cue for difficult child 3 so I could say, "Honey, you're getting a bit loud and sound like you're shouting at me. I think you've had a very tiring, exhausting day. How about we plan for an early night for you? Or would you like to have a little quiet time now, to help you feel a bit better? How about yo go to a quiet place, maybe your room, and read a book for a little while? Or listen to some music?"
    Music can really help. There is a mathematical logic to music. Expose him to it, get a feel for what he's attracted to and what he rejects. Some good classical composers to begin with - Handel, Mozart, Bach (those old Moog synthesiser tracks are great) and Vivaldi ("The Seasons"). The soundtracks from the "Fantasia" films are also good, especially if they've watched them and enjoy them.

    By not getting cross every time we were able to short-circuit a lot of difficult child 3's anger, much of which, it turned out, was triggered by negative social interaction at school.

    Good luck. Let us know how you get on.

    Marg
     
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