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New here - What do we do to help our ADHD/ODD son??
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<blockquote data-quote="rlsnights" data-source="post: 417319" data-attributes="member: 7948"><p>Welcome to the board.</p><p></p><p>Have a few thoughts for you.</p><p></p><p>ODD is a description. It is not actually a diagnosis in the sense that it guides treatment. Because there isn't any accepted standard treatment for ODD except to give the parents a bill as you show them to the door. Ok maybe that is a teeny bit cynical of me. Or maybe not.</p><p></p><p>Anyway, until you know for certain that those ODD behaviors are not really something else like bipolar hypomania (easily mistaken for defiance and entitlement in kids), I would be cautious about using that label. Especially with his school.</p><p></p><p>If you can download and read The Explosive Child by Ross Green tonight/tomorrow then do that before you do anything else. It will help you by giving you ideas about how to think about what's happening in your home. Don't get too caught up in the A/because basket stuff unless the A basket (safety) issues are not a problem yet. If you have safety issues then those must be addressed first and anything else is gravy. For now.</p><p></p><p>If you haven't done family therapy or couples therapy in your trip down the HMO therapists list, then that is where I would suggest you put your time and money. You and husband need help. Just like in the plane, before you put the oxygen mask on the kid you put yours on first. Same idea.</p><p></p><p>I hate to tell you this but 6 therapists in 5 years is not a good trial of therapy. It takes time - often several months - for a therapist to build rapport with a difficult kid. I am not in any way implying that you were wrong to try 6 different tdocs. I have been very frustrated about finding a good therapist for my own kid off the HMO lists. But you may want to start a separate post asking for advice on how to find and choose/evaluate the performance of a therapist for your kid. You need to find someone who knows what they're doing before you bring your kid to see them - not just take someone off the list because your HMO says they are qualified.</p><p></p><p>1. I understand he is much better at school but has the school ever done any assessment of him? Does he have a 504 plan or IEP? If there hasn't been any assessment done there I would ask them to assess him for Special Education. Tell the school what behaviors are concerning you regardless of where they are most problematic. If he has problems that you think look like autism then say so. If he has been assessed and has an IEP, has has he had a speech and language assessment done? If not then I would call for an IEP meeting and ask that one be done. Kids on the spectrum and bipolar kids almost always have language processing issues. A lot of the time those problems are not obvious to the people around them but they are contributing to your difficult child's frustration and inability to accurately communicate with others and to understand what others are trying to say (verbally and non-verbally).</p><p></p><p>2. No matter which HMO you have, you are entitled to a second opinion. I suggest you contact your behavioral health provider and tell them you want a second opinion consult and your concerns. They should be able to give you a list of other child psychiatrists (please tell me he's seeing a psychiatrist and not a GP or pediatrician) and a referral.</p><p></p><p>3. You could pay for that assessment out of pocket. You could also ask your HMO to pay for a comprehensive neuropsychologist assessment. If you haven't done so I would do that before you pay $3000 unless you have that just laying around. The basis for requesting a neuropsychologist assessment is the autistic-like behaviors that concern you, the existing ADHD diagnosis and the family history of major mood disorder. Be sure to mention his gross and/or fine motor problems too.</p><p></p><p>4. You could follow this link and contact the people running the Pediatric Bipolar Disorder Study at UCLA. Ask them about whether he could be screened for inclusion in this study. They may say he doesn't meet criteria because he doesn't yet have a Bipolar diagnosis but they may also say - oh we have this other study going where we look at diagnosis of bipolar ... and then you will get everything you want for free in the $$ sense of that word. It will take time and pay attention when they tell you how much time they want from you/kid to participate in the study cause it can add up. been there done that.</p><p></p><p>This specific study involves neurocognitive testing to differentiate between ADHD and Bipolar.</p><p></p><p><a href="http://clinicaltrials.gov/ct2/show/NCT00961935" target="_blank">http://clinicaltrials.gov/ct2/show/NCT00961935</a></p></blockquote><p></p>
[QUOTE="rlsnights, post: 417319, member: 7948"] Welcome to the board. Have a few thoughts for you. ODD is a description. It is not actually a diagnosis in the sense that it guides treatment. Because there isn't any accepted standard treatment for ODD except to give the parents a bill as you show them to the door. Ok maybe that is a teeny bit cynical of me. Or maybe not. Anyway, until you know for certain that those ODD behaviors are not really something else like bipolar hypomania (easily mistaken for defiance and entitlement in kids), I would be cautious about using that label. Especially with his school. If you can download and read The Explosive Child by Ross Green tonight/tomorrow then do that before you do anything else. It will help you by giving you ideas about how to think about what's happening in your home. Don't get too caught up in the A/because basket stuff unless the A basket (safety) issues are not a problem yet. If you have safety issues then those must be addressed first and anything else is gravy. For now. If you haven't done family therapy or couples therapy in your trip down the HMO therapists list, then that is where I would suggest you put your time and money. You and husband need help. Just like in the plane, before you put the oxygen mask on the kid you put yours on first. Same idea. I hate to tell you this but 6 therapists in 5 years is not a good trial of therapy. It takes time - often several months - for a therapist to build rapport with a difficult kid. I am not in any way implying that you were wrong to try 6 different tdocs. I have been very frustrated about finding a good therapist for my own kid off the HMO lists. But you may want to start a separate post asking for advice on how to find and choose/evaluate the performance of a therapist for your kid. You need to find someone who knows what they're doing before you bring your kid to see them - not just take someone off the list because your HMO says they are qualified. 1. I understand he is much better at school but has the school ever done any assessment of him? Does he have a 504 plan or IEP? If there hasn't been any assessment done there I would ask them to assess him for Special Education. Tell the school what behaviors are concerning you regardless of where they are most problematic. If he has problems that you think look like autism then say so. If he has been assessed and has an IEP, has has he had a speech and language assessment done? If not then I would call for an IEP meeting and ask that one be done. Kids on the spectrum and bipolar kids almost always have language processing issues. A lot of the time those problems are not obvious to the people around them but they are contributing to your difficult child's frustration and inability to accurately communicate with others and to understand what others are trying to say (verbally and non-verbally). 2. No matter which HMO you have, you are entitled to a second opinion. I suggest you contact your behavioral health provider and tell them you want a second opinion consult and your concerns. They should be able to give you a list of other child psychiatrists (please tell me he's seeing a psychiatrist and not a GP or pediatrician) and a referral. 3. You could pay for that assessment out of pocket. You could also ask your HMO to pay for a comprehensive neuropsychologist assessment. If you haven't done so I would do that before you pay $3000 unless you have that just laying around. The basis for requesting a neuropsychologist assessment is the autistic-like behaviors that concern you, the existing ADHD diagnosis and the family history of major mood disorder. Be sure to mention his gross and/or fine motor problems too. 4. You could follow this link and contact the people running the Pediatric Bipolar Disorder Study at UCLA. Ask them about whether he could be screened for inclusion in this study. They may say he doesn't meet criteria because he doesn't yet have a Bipolar diagnosis but they may also say - oh we have this other study going where we look at diagnosis of bipolar ... and then you will get everything you want for free in the $$ sense of that word. It will take time and pay attention when they tell you how much time they want from you/kid to participate in the study cause it can add up. been there done that. This specific study involves neurocognitive testing to differentiate between ADHD and Bipolar. [url]http://clinicaltrials.gov/ct2/show/NCT00961935[/url] [/QUOTE]
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