Types of help to get

Discussion in 'General Parenting' started by Erlitut, Nov 20, 2014.

  1. Erlitut

    Erlitut New Member

    Hi,

    I'm brand new. I found this forum today and have spent some time reading through old postings. I'm a little hesitant to post a question that maybe has been answered a zillion times and I just have not found the answer yet, so I appreciate your patience -- and am fine if you just point me in the right direction.

    My "difficult child" is an 8 year old boy. Having read Dr. Greene's book (as well as a few others) in the past, and today reading through this forum, my lay-person self-assessment -- which I am very clear would not be a "real" diagnosis, but just to describe our situation as concisely as possible -- would be "mild ODD." I've read the description of ODD in this forum's FAQ area and in plenty of other places, and he has all those traits. I say "mild" because compared to the stories I'm seeing on this site (and the examples in Dr. Greene's book), our situation is not that bad.

    Without going into details, here is my question. I've seen a lot of folks mentioning on this forum that diagnosis should be done by a neuropsychologist, and I've found a few with websites here in my area (San Diego). But I've also found some family therapy & child psychology websites that claim to specialize in defiance issues in children, and I am assuming that starting with a therapist/psychologist might be simply easier.

    Given that I don't think our situation is "that bad," could a good therapist be helpful? If the therapist thinks there might be a clinical problem, would they tell me if they think a neuropsychologist assessment is necessary? Or should I be distrustful of them, regardless of competence? Has anyone had a good outcome with "just" a therapist?

    I know that not all therapists are the same. We did once visit a therapist who was a bad fit for us because it was very "touchy feely" with lots of talk about our feelings and very little in the way of actionable changes. I now know better and would work to find a therapist who focuses on coping strategies and solutions, rather than rocking my 8 year old in a blanket while singing to him (I'm serious).

    Thanks for any thoughts here!!

    P.S. -- I know I'm not telling you much about my child, in the interest of brevity. If my question is just too difficult to answer without more info about him, I'm happy to provide it.
     
  2. InsaneCdn

    InsaneCdn Well-Known Member

    Hi, and welcome.

    Just my opinion here but... it usually is NOT wise to go with somebody who "specializes" in defiant kids. They tend to look at problems through their pre-assumed specialty lens... and miss other possibilities.
    You need somebody who can do a comprehensive evaluation. This could be a neuropsychologist, but there are others - ours was done by a PhD psychologist with a specialty in comprehensive testing.
     
  3. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Agree with IC.

    I would do it the other way around. Do the intensive neuropsychologist testing. Obviously something is wrong and ODD is usually not a very useful diagnosis nor does it explain why the child is so defiant. Also, it rarely stands alone as the only issue. If the neuropsychologist evaluation is done, suggestions on what to do will be made. If your son can get by with just a therapist, he will tell you and will likely have a good referral for you. If there is more, he will tell you that as well.

    I'm not a big fan of doctors who claim to have only one area of specialty either as they tend to see their issue in every child. Every single child on this forum is probably defiant, but the defiance or ODD is caused by primary ADHD or autistic spectrum disorder or something else and that main issue needs to be treated before any form of behavioral therapy will work. in my opinion it is best to find a professional, and in the U.S. the go-to is normally a neuropsychologist, who tests in all areas of function and for all disorders rather than narrowing his/her focus to one area of behavior.

    Good luck!
     
  4. Erlitut

    Erlitut New Member

    I should clarify - the place I found does not only claim to have one area of specialty, but lists "child behavior problems" (with many examples, including oppositional defiance) among many other areas of focus. I have not called them yet but here is their website:

    [This forum understandably won't let me post the URL, but it's "familtherapyinstitute"]

    But I am wondering if I should do as MidwestMom suggests and seek out the neuropsychologist first. I will start Googling around for that. Thanks for the responses!!!
     
  5. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Welcome,
    My husband and I started with a child psychiatrist and then started with a therapist. Eventually we had the neuropsychologist done which was also very helpful. I think it is a good idea, when possible, to go the route of a multi-discplinary approach. I don't think starting with a tidoc is a bad place to start.
     
  6. InsaneCdn

    InsaneCdn Well-Known Member

    While we're at it, can you tell us more about your son?
    Is he your birth-child, or adopted?
    If adopted, what do you know about family history, and how old when he came to you?
    If not adopted, what kinds of issues and challenges run in the family tree? Any issues with the pregnancy or birth? Milestones? When did the issues start showing up?
     
  7. Erlitut

    Erlitut New Member

    My son is my biological son. He has been "strong willed" since birth. There are no issues of any significance in our family -- no trauma, etc. My husband & I are happily married, with all needs met. There is some family history of alcoholism, but nothing else of note in our family histories. difficult child is very quick to lose his temper when he does not get his way, with epic tantrums that have nearly broken his bedroom door down (nothing else broken, so far, thank goodness, but there have been times when I feared he might huck a toy through his window). He is a "control freak" and likes things to be on his terms. He had trouble in school initially (1st grade), but did fine in his private K, so halfway through 1st grade we moved him to a private school which has a MUCH smaller class size and much more challenging academic options, and he is doing very well there (not exactly a easy child at school, but generally "normal" behavior). So, a lot like that article in the forum FAQ area.

    Having read through a lot of this forum I'm feeling a bit shy to be posting since our problems are clearly not as severe. But it's still a challenge and can make life in our house unpleasant (lots of "dammit, we should never have had kids!" comments, trying to avoid being mad at each other since it's no one's fault, etc.), and I have a sense of needing to take it seriously before puberty hits.

    He has a "easy child" sister (I'm getting used to these abbreviations -- she is far from perfect but seems to be pretty normal) who is 6.

    I've reached out to the neuropsychologist I found online and will see what he says. Depending on what he says I may also reach out to our pediatrician, who I really like and have told about our problems, but again, I think it may be that our problems are not "severe" enough for him to have recommended treatment. But I'm following my gut: I'm sure we'll all survive if we do nothing, but we could be much happier if we could find a way to teach him some better ways to cope with his anger and not getting his way.
     
  8. InsaneCdn

    InsaneCdn Well-Known Member

    My kid at 5 wasn't too hard to handle. By 9... trouble. By 14... major trouble.
    Small kids = small problems (only in a relative sense: some small kids have pretty big problems, but usually, problem size grows with kid)

    We had to do our own research, ahead of the medical and school systems. WE had a pretty good idea of what we were dealing with. At least it has shaped our approach, even if it hasn't always been accepted by the medical side of things,

    Here's some things to consider or research:
    Sensory integration disorder / sensory processing disorder
    Auditory processing disorder (in particular, auditory figure ground)
    Social skills challenges
    Sleep issues (some kids get enough hours of sleep, but it isn't good quality sleep, so they really are not rested; may be intermittent)
    Anxiety (co-morbid with all sorts of other problems, or may stand on its own)

    The fact that he does better in a smaller class size is what triggered the above list, just based on my own experiences. There may be other possibilities as well. But just for example, take a kid who has sensory processing disorder (SPD) and Auditory Processing Disorders (APD), and you tend to get anxiety. Take those three, and there are often quality of sleep issues. The four together = behavior problems. He may be overloaded on some front that you don't know about, rather than being a 'bad kid', which is what an ODD diagnosis tends to focus on.
     
  9. TerryJ2

    TerryJ2 Well-Known Member

    Welcome, Erlitut.
    You are wise to deal with this before he gets older. It only gets worse and harder to handle.
    Nearly smashing down a door sounds like overkill. He needs a therapist so he can express his feelings in a safe place, and the therapist can give you parenting tools. No matter who the therapist is, tell him or her what your expectations are. It sounds like you want a behaviorist. And tools. And action. Say it out loud to the therapist.
    A neuropsychologist test would be extremely useful. With alcoholism in the family, there is probably some neurological or behavioral issue that was being self medicated. My adopted difficult child has divorces and alcoholism on both sides of his family tree. I did not know then what I know now about how alcoholism masks sensory issues, anxiety, and bipolar, for example.
    I'm so glad that your son is doing well at his new school.
    If it turns out there is something going on when you finish the testing, you should request a 504. That will give him a quiet place to take tests at school, for example, or an extra day or two to turn in homework if he doesn't understand it.
    Also, you may want to try warning him--in a good way--of what is going to happen ever hour or so. "Dinner will be ready in an hour. That means a half hour of homework and a half hour of TV." Then, "We're having dinner in a half hour." "Fifteen minutes." Give him time to transition.
    Or, "We're going to the grocery store. That means you get to push the cart for me." So that he has an expectation.
    Or, if he's like my son, he'll scream "NO!" no matter where I said we were going. Sometimes, I just had to drag him into the car. Sometimes, I didn't go out at all. I had to prioritize.
     
  10. ReachingOut

    ReachingOut New Member

    Interesting advice. You ladies are so wise. Thanks for sharing.
     
  11. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Not all people who come here have children who are violent and running away from home at five. Some are just difficult enough to make home life very difficult. There could be many reasons for it...ADHD, high functioning autism, a childhood mood disorder, Learning Disability (LD) issues...that's why I suggested a neuropsychologist. Behavioral therapy alone is usually not helpful to children whose parents make it to this site and then it ends up being wasted money. Therapists can not diagnose childhood disorders. Pediatricians don't know much about neurological glitches and psychiatric issues either. It simply is not their specialty. Our pediatrician would not even guess on what was wrong with my son. He referred us out. He was also a very skilled pediatrician for illnesses, but that was his training...strep throat and such.

    The normal therapist's go-to behavioral therapy, such as charts and 1-2-3 magic and time outs don't tend to work with most of our children because they are not just being defiant. There is more to it. There is a reason they are defiant that is co-existing alongside t he ODD and causing it. Without treatment of that disorder, whatever it is, the child can not comply either due to impulsiveness, "differently-wired" thinking or intense inner rage that trumps the discipline and gets the child angrier. I think it is good advice to get early treatment. The earlier, the better the later prognosis. You do not want to start messing with this when he is a teen. By then, he could have taken it up ten notches from what it is now. If it is bad enough to be causing strife in your marriage, you and your husband should be good to yourselves and your son and see if he can be diagnosed and then helped so that peace can come to all of you. Makes no sense in my opinion to live in chaos when there is help ;)

    Take care.
     
  12. Confused

    Confused Active Member

    I just wanted to welcome you here, and give you my support. Everyone is right here, every story may not be the same but being strong on getting an unbiased testing is the best place to go. Go to a Neurologist too, they can send for an EEG( I think other doctors can too), other testing,ask the pediatrician to get blood work done...check for allergies etc. Try documenting everything from before it happens, during and after. Your already off to a great start. Hugs

    ***My son is extremely violent, broken 2 windows, doors, toys, electronics , cut things up, bit us etc. Also when told No but even when its somethings else at times. So yes, do everything and go everywhere now. There will be lots of testing and therapy ( we should be starting soon I hope once we have a diagnose)
     
  13. Erlitut

    Erlitut New Member

    I appreciate everyone's responses! I've reached out to both the neuropsychiatrist and the psychologist I found online and I feel much better informed now when I go talk to either of them. Given that it's the holidays I probably won't have much of an update for a few weeks but I'll let this forum know how we fared and I'm sure I'll be back in the meantime when things heat up again. Yay, the holidays ...

    Thank you.
     
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