What do I say?

[JLady]

We go back to the pediatrician today. My son has now been on the medication (vyvanse) for 4 weeks and is doing well. I do not like the emotional state he was in but he seems to be a lot better this week. The doctor keeps insisting that he see a psychiatrist which we are doing next week.

The thing that really bothers me is the doctor saying my son is ODD. I understand the ADHD stuff and the medicine is really helping him with that but I totally disagree with the ODD diagnosis. Each time I say something, like about the emotions, the doctor says get him to a psychiatrist! It's ODD. ODD isn't emotional is it? Difiance isn't in tears! The is the opposite of how the child has been.

This week in school he has been getting in a little bit of trouble but nothing major. Just regular kids stuff in my opinion... Things like telling a girl not to stare at him, talking in the hallway.... but the other day he did hit a girl because she coughed on him. I think that has more to do with having a brother that is 8 years older than ODD.

So I don't know what to say to the doctor when we go this afternoon. Any advise? My confidence level in this doctor is very low but I'm trying to give him a chance. I've been wrong before.

 

[slsh]

JLady - just my opinion - if the pediatrician handles medical issues well and you have confidence in him other than the "ODD" issue, I wouldn't address it with him. You're getting your kiddo into a psychiatrist and that doctor will be the one to address the mood and behavior issues. In my experience, our own pediatrician wouldn't know ODD or a mood disorder from the man in the moon, but he absolutely would refer a kid out to a specialist, which is what your pediatrician has done. Most peds just are not equipped to address these kinds of issues.

Again - just my opinion.

 

[smallworld]

So the pediatrician put your son on Vyvanse for ADHD, but wants your son to see a psychiatrist for emotional issues? And the psychiatrist is going to do his own evaluation and come to his own conclusions about diagnosis? And then the psychiatrist is going to take over your son's emotional/behavioral care and medications?

So do you really care what the pediatrician says?

FWIW, most good child psychiatrists don't give the ODD diagnosis. They prefer to look for underlying causes that fuel oppositional behaivors. Believe me, my son is as oppositional as they come (fueled by extreme anxiety and mood issues), and he's never received the ODD diagnosis.

As an aside, I would be concerned if my son hit another child in school. It may have more to do with his emotional state or his medications not being right than with having an older brother. But that's JMHO.

 

[eekysign]

I think the problem is more that JLady doesn't feel like her son NEEDS a psychiatric consult----if I'm reading your post right, hon? The doctor "keeps insisting" her son needs it, but it's all "just regular kid stuff" to her.

My take on it is that if you keep having to bring up emotional issues to your pediatrician, so many times that he starts throwing around ODD and "insisting" you need to see a psychiatric---you probably do. Peds don't really DO emotions, they refer to specialists (psychs) for that sort of thing. I guess, what did you expect to get from your pediatrician when you bring up emotional problems in your child? Honest questions, not sarcasm or anything---what did you hope to get from your pediatrician that you're not getting?

My position is: in the end, what's the harm? More information is always better than less, and your psychiatric appointment certainly won't hurt your child, it can only help. So go! Maybe he'll tell you the pediatrician was wrong.

 

[JLady]

I honestly don't know what my son needs. I don't know how to handle the situations. Yes, he hitting others concerns me. I did make the appointment with the child psyc. hoping for better results. What I really want is someone to explain to me what to expect. If this is normal, tell me it is normal. If it isn't, tell me it isn't. Don't just throw some initials up in the air and tell me whatever hits the floor first.

I mentioned something about my ex and aparently that was a mistake. Perhaps I should just go into detail... this is an annomys site right? My ex was very abusive and we were only married a short time. He hurt me and the older children. I often wonder why God blessed me with this third child so much younger than the other two and so much more difficult but I'm sure He has His reasons. (what a terrible thing for a mom to say huh?)

The pediatrician asked about my son's dad and I explained that he was a small baby when we left. We now live 200 miles from his dad and there is a very good reason for that. He had visitation every other weekend and when my son would come home he would say things like "mommy, why don't you love me? Daddy says you don't love me" "Mommy why are you a Xitch?" and he would tell me about how he saw his dad hit his girlfriend. Things like that. Once I told the doctor this... he immediately jumped to ODD and didn't have much else to say. I know it was a bad situation and I feel horrible about ever putting my children in it. It is embarrasing that as old as I am I should have seen the signs and didn't. I moved the kid away to get away from the influence. It's like once the pediatrician heard abuse.. he was done with us. He said that stuff is detremental to a child as young as my son. Duh! That stuff is detrimental to anyone! That is why we moved away.

I just am so blah today and don't know what to think. I'm all consumed again with this.

 

[klmno]

I agree that you need to get more evaluation done than just by the pediatrician. If the pediatrician is scripting medications while still telling you that you should get a specialist (psychiatrist) involved, that alone says that the pediatrician isn't comfortable continuing this, which would make me less than comfortable with it.

 

[BusynMember]

Even if your ex never sees your son, he unfortunately has his genes. More about that later. It doesn't mean your son will be an abuser. Not all all.
Your pediatrician really wasn't trained in childhood disorders. I've learned not to trust them to diagnose, even ADHD. In fact, our pediatrician refuses to diagnose those types of disorders saying, "I wasn't trained to do that." He refers people to other types of professionals. in my opinion if you have gone to your doctor for help with your child, then you are seeing troubling behaviors, and you, as Mom, are probably right. Something is probably not quite right. Are you scared of what you may hear? You sound a little apprehensive...
ODD isn't a very useful diagnosis. I think all of our kids have gotten it--all it means is what we already know: They are defiant. It doesn't tell us why there are defiant or what disorder is causing the defiance. I would personally want a neuropsychologist evaluation. I find them better and more intensive then even a Psychiatrist. How was your child's early development? Did he speak on time and appropriately? Does he have a lot of friends, know how to play in a give-and-take way? Does he make good eye contact? Does he cuddle with you? Any mood disorders on either side of the family tree? Substance abuse? Answering these questions will help us help you