ODD to broad of a diagnosis

[SmallTownMom]

While reading many of the posts on here I have noticed that many parents do not agree with an ODD diagnosis. That is descibes how that children are acting but not why they are acting that way.
My 9 year old son was given an ODD and ADHD diagnosis just a few months ago and we have just started risperadone .75mg a day. His psyciatrist used ther term EFD (Executive Function Disorder), have any of you heard about that? I don't know where to start to get to the reasone my son acts this way. We live in a small town in Canada and the wait to see a counsler is months. Any ideas?

 

[buddy]

EFD indicates issues with the frontal lobe of the brain. Some use adhd and executive function disorder equally. Bottom line is the child/person has challenges with the part of the brain that helps us organize, to stop/start things (impulse control and procrastination), and many other things, it really can be very impactful but it is also something where specific skills can be learned to help and often medication can help.

A child or an adult with attention deficit hyperactivity disorder (ADD/ADHD) might be hyperactive, inattentive, and/or impulsive. Clinicians have always understood hyperactivity and impulsivity. The understanding of inattention, though, has shifted from primarily “the inability to stay on task” to a broader concept called executive function disorder (EFD), which involves a pattern of chronic difficulties in executing daily tasks.
[h=2]What is executive function?[/h]The steps of executive function:

Around the time of puberty, the frontal part of the cortex of the brain matures, allowing individuals to perform higher-level tasks like those required in executive function. Think of executive function as what the chief executive officer of a company must do -- analyze, organize, decide, and execute. Very similarly, the six steps of executive function are:
1. Analyze a task
2. Plan how to address the task
3. Organize the steps needed to carry out the task
4. Develop timelines for completing the task
5. Adjust or shift the steps, if needed, to complete the task
6. Complete the task in a timely way
[h=2]When executive function fails[/h]What is executive function disorder (EFD)? It follows naturally that someone with issues with executive functioning may have problems with analyzing, planning, organizing, scheduling, and completing tasks at all -- or on deadline.
A child without problems with executive function may appear like this: A middle-schooler'steacher assigns the class a book to read, and writes the due date for the book report on the board. A student must be able to determine where to get the book and how long he thinks it will take to finish reading it. If the teacher has a specific book-report format, the student will have to keep it in mind as he reads the book and takes notes. He needs enough time to write a rough draft, get help from teachers or parents, if needed, and write a final draft by the due date. If the student has good executive function skills, the work will get done on time. If he has EFD, it won’t.
Recognize the signs and symptoms of executive function disorder (EFD). Children and adults with EFD have problems organizing materials and setting schedules. They misplace papers, reports, and other school materials. They might have similar problemskeeping track of their personal items or keeping their bedroom organized. No matter how hard they try, they fall short.

 

[InsaneCdn]

How much testing was done? i.e. a couple of "talking" appointments? Or 6-8 hours of tests, interviews, feedback from school, etc.? Because... it makes a huge difference.

Executive function challenges are part and parcel of lots of developmental dxes... from Autism Spectrum Disorders (ASD) to ADHD... it is a challenge. But... it doesn't explain everything going on with your son, any more than ADHD does.

If I remember right, you're already chasing down The Explosive Child... that book is a shift in mindset. It help me validate my gut feel, and gave me language to use in dealing with others. The basic premise of the book is that "Kids do well if they can"... NOT "kids do well if they want to".

You might want to do a signature line... helps us remember the details (how old your son is, for example, the family situation... just something so we remember "you")

Do you have access to Occupational Therapist (OT) or Speech Language Pathologist (SLP) resources there?

I'd be tempted, if there is pediatric Occupational Therapist (OT), to get that evaluation... usually faster than the comprehensive stuff. Sensory and/or motor skills issues can be a huge problem. May have either, or both. Half the kids with ADHD have motor skills problems - so it's not unusual.

 

[SmallTownMom]

Thanks I did look at that web site yesterday, I know my son shows deffinite signs of EFD, but that doesn't seem to explaine his ODD symptoms.

 

[SmallTownMom]

Insanecdn, .. there are no Occupational Therapist (OT) here at least not in this town. We have had 3 1-2 hour appointment at a Chidrens Phyciatric Hospital. They have talked with and interviewed his teachers.
I was also send a link to some videos from the author of "The Explosive Child", he talks about the things he has written in that book.

How do I do a signature line?

 

[InsaneCdn]

Exactly.
My difficult child? They told us at the LAST round of evaluations... that his executive functioning is so poor as to be extreme. As though THAT was news to us... but it didn't explain HIS "ODD" either.

Our answer - not necessarily yours - was a combo of Developmental Coordination Disorder (DCD), Auditory Processing Disorders (APD), and fatigue.
And half the fatigue comes from the Developmental Coordination Disorder (DCD) and Auditory Processing Disorders (APD).
Just getting the right dxes... cut the behavior problems in half. Because... HE had been right all along. After 10 years of being told you're telling lies when you tell the truth, and being told you're good when you tell people what they want to hear... he was one confused kid.

The Auditory Processing Disorders (APD) diagnosis got him some extra accommodations at school, including a personal FM system that raises the teachers voice above the background noise. (He got the Developmental Coordination Disorder (DCD) diagnosis earlier, and already had accommodations... but it wasn't enough). School tells us that kids in HS do NOT take kindly to these systems, they "don't want to be different". Reality? That is true, UNLESS you happen to be the kid who really needs it... so, if they use the system? they need it.

 

[InsaneCdn]

Signature line... top right, "profile".
Then, on the left... "edit signature"

 

[InsaneCdn]

Sometimes there's an Occupational Therapist (OT) in one town, that covers 100 miles around... some of our smaller centers here are like that. One town has Occupational Therapist (OT), another town has PT, somewhere else there might be a Speech Language Pathologist (SLP)... not quite local, but better than the "big trip"...

 

[buddy]

Can you explain the specific ODD symptoms, I bet lots of us here have kids who do the same things and maybe we can share what we found it was caused by....that might help??? If you are comfortable that is.

I can come up with a ton of examples of ADHD issues, motor issues, sensory issues, efd issues that would make a kid look totally ODD but it might never touch what you are concerned about. Just a thought....

 

[SmallTownMom]

I see the top right "profile"
but then I don't see the |"edit signature"
Ill keep looking

 

[SmallTownMom]

yeah! I found the signature button..

 

[keista]

My experience with ODD:

About 3 months after starting treatment with prozac for depression and anxiety, I was back to the psychiatrist's office AGAIN complaining that things still weren't right, and that DD1 seemed to be getting more......well......oppositional. We had already upped her dosage once, and there was a new psychiatrist in the clinic. This new psychiatrist upped the dosage again and added a new diagnosis - ODD. This was at the beginning of my journey so , OK. As I was scheduling her next appointment, I overheard another mom discussing her kid's latest diagnosis - ODD. hmmmmmmmmmmmm That month, no improvement, in fact, things were getting worse. Both with her moods AND behavior. Went back with the same complaints and was assured it was ODD and I had to give the medications more time to work. While checking out, MORE parents were discussing their kids' new diagnosis - ODD. Then a flyer caught my eye about parenting classes for parents of kids with ODD - Only $50 per person! Hmmmmmmmmmmmmmmmmmmmmm some more. I had discussed the new diagnosis with the counselor that was coming to the house - she worked with the same clinic. She kind of dismissed it as an issue for DD1 (she was working off her own diagnosis) then I started sharing with her what I was overhearing and told her I'd be very curious to know exactly how many kids at that clinic were now afflicted with that "condition".

Anyway, I started researching prozac and story after story online fit DD1's behavior to a 'T', so I went back in to discuss getting her off of prozac because I thought her problems were a bad side effect of the medication. psychiatrist insisted that it could not possibly be and that DD1 definitely had ODD (well yeah, NOW) and here, check out this website which I think will help greatly (of course, not telling me that the equipment and service would cost hundreds of $$$$$$ I still believe he must have been an investor or founder of that system/website). Instead, I fired him and got her off the prozac. Miraculously, she stopped being ODD. Still was crazy depressed and had anxiety, but definitely NOT oppositional anymore.

Things that make you go hmmmmmmmmmmmmmmmmmmmmmmmmmmmm.

 

[Bunny]

difficult child has a diagnosis of ODD, and while the description of ODD suits him perfectly, I'm not sure if that really is the problem. I have asked the psychiatrist about other things and he keeps telling me that those other suggestions are not what it wrong and that he's just being oppositional and defiant and that anxiety and ODD are the only "proper" diagnosis's for him. Some days, I'm not so sure about that because I think there is alot more driving the oppositional and defiant behavior that we just haven't uncovered yet.

Yes, it is a broad diagnosis and I think that it's the label that they give to kids when they can't figure out where the oppositional and defiant behavior is coming from.

 

[InsaneCdn]

Bunny... if your psychiatrist is hung up on the ODD diagnosis... I'd be looking for a new psychiatrist.

Ours is great. She'd have swung a Pervasive Developmental Disorder (PDD)-not otherwise specified diagnosis if I had been on-side... but I didn't see it. Supported our search for answers even when she didn't have them to give. Works with us on medications - up or down or switch. A GOOD psychiatrist is worth a lot. A poor fit of a psychiatrist is almost dangerous.

 

[keista]

Bunny, ditto what Insane said. See my story above.

in my opinion the best diagnosis is the one that "feels right" If it doesn't "feel right" to you, the mom, then it probably isn't right. It's a process and it takes time. I'm averaging 2 years with my kids. Even with DD1 I thought I had it right for about a year, and then not so much any more. Finally got to what "feels right".

 

[Bunny]

Keista, I think that what I have with difficult child is actually the beginning of the emergence of a personality disorder, but the psychiatrist says that that is something that is not diagnosed in kids because their personalities are still developing. He's not a teen yet (he will be 13 on Friday) and he thinks that it's far too early to slap that kind of label on him. For the most part I do agree with his reasoning for being so cautious about saying it's a personality disorder, but it's very frustrating to be simply be told that he's defiant and oppositional. No kidding!!

 

[keista]

Bunny I agree with both you and the psychiatrist on holding off on that diagnosis. Last summer, DD1's psychiatrist started suggesting borderline as well and she was only 10. She got her new proper diagnosis in December. I'll not repeat what I keep trying not to repeat.

Sorry for hijacking the thread. Now back to ODD in my opinion it is just way too broad to be a final diagnosis. Kinda like saying you were cut. OK do we need a kiss of sutures? The cut could have been from paper, cardboard, glass, scissors, a knife, a fence picket. And then how deep did the cut go? All of those were cuts (ODD) but the treatment varies widely.

 

[InsaneCdn]

What happens if you ask psychiatrist for advice about interventions (other than medications) that might apply "if" he were diagnosed with "zzz" or somesuch... can you try some of these things now, even if you can't get the diagnosis? If they help... you'd be ahead of the game.

 

[STRESSEDTOMAX]

Sometimes with my difficult child I definitely think a personality disorder may be involved. When he was in the hospital almost 5 years ago (he was 6) they said they thought he had a thought disorder but couldn't know for sure until he was older. All I can say is that when he is in one of his rages, to me he is definitely like another personality altogether, which really scares me. As for ODD, difficult child fit all criteria from about two on. I feel like I could take any disability better than ODD...there is just so much anger always coming at me and husband...from the minute he opens his eyes till the time he shuts them most of the time.