Conduct Disorder - Is there any hope?

Discussion in 'General Parenting' started by jensfishin, Jul 17, 2010.

  1. jensfishin

    jensfishin Guest

    Hi there,
    My name is Jenn, recently (within the last three weeks) my son was diagnosed with early onset mild conduct disorder with some signs of ODD. I have been reading a lot online about this condition and am starting to feel a bit hopeless. Is this going to be okay? Will my son have to be institutionalized? Will he end up in jail?

    All I can think about is how bleak the future looks and I feel so sad.
  2. jensfishin

    jensfishin Guest

    Okay so here's my story...

    My son now ten has always had a certain amount of trouble in school. Many trips to the office starting in grade one. When he was in grade three he started acting out in "sexually inappropriate" ways (ie; thrusting his pelvis toward classmates, suggesting girls touch him, asking to touch girls breasts, and on and on). In addition to these behaviors he got into a lot of fights on the school playground and routinely had difficulties during lunch hour and walking home from school.

    This year (grade 5) after serveral suppensions (including one for a gay-bashing incedent) he orchestrated a game in which the "loser" had to remove their clothes and show their parts to the winner. The "loser" in his game was and 8 year old girl. The result was a ten day suspension, upon return he was accompanied by an EA during reccess and unstructured movement (walking to and from gym, library, washroom), he also was no longer allowed to have lunch at the school. We consider ourselves very lucky in this case, because there was a two year difference in age he could have been facing criminal the age of ten.

    Other important factors include:
    starting three small fires (two in our home)
    cruelty to animals (killed a rabbit with a rock)
    bed wetting
    hitting people (esspesially - but not limited to - me and his 15yr old sister)
    hitting objects (walls, doors, tables and anything else within reach)
    throwing things in anger
    and I am sure I am leaving many things out here

    He is very manipulative and feels no empathy.
    He is EXTREMELY intelligent (in the superior range on cognitive testing)
    He knows right from wrong and chooses to do the wrong thing anyway.

    Within the last three weeks we've been given the diagnosis of Conduct Disorder.
    We are working on extreme behavior intervention.
    He currently has no privileges, no tv, computer, video games, friends over, sports, trips and outings.
    These privileges must all be earned by not exhibiting the behaviors we want to change.
    He has been able to earn some things (a movie, a 1/2 hour visit from a friend, a trip to the beach) here and there.

    I am so tired of always having to say no to him...I feel like as a mother it's my job to make him happy and yet with the behavior intervention I'm not allowed to.

    Everything I read online is so discouraging and depressing that I am starting to think that there is not hope for my son and he's going to grow up to be a psychopath (which according to our phycologist is a possiblity)

    Is there somebody who can give me some hope?
  3. SRL

    SRL Active Member

    Hi Jensfishing. Welcome to our forum.

    Could I ask what kind of specialist did the diagnosis and what length of time that diagnostician spent with your child before making this diagnosis? I'm not suggesting it's not correct. I just want to make sure that it was typical of a thorough evaluation.

    Also as you mention he tests in the cognitive superior range I am wondering what he was like when he was very young. Did he have typical interests of a young child? Obsessions? Anxiety?

    Has he grown up in a stable family situation?

    As for giving you hope, never give up hope. Some kids do better, some not as well, but that goes with any diagnosis we see here. What we can tell you is that getting a correct diagnosis and finding appropriate treatments at the earliest possible age increase the chances of positive outcomes. Frankly, with what you're describing to us in terms of the behaviors, diagnosis, and psychologists comments, I'm very surprised that an intensive behavioral modification plan was recommended at home instead of sending him into residential treatment.
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hi there.
    I think it's hard to answer because most of us are from the US and they wouldn't give that kind of diagnosis here. CD is for kids who are almost adults. ODD is sort of a throwaway diagnosis here as well...means "He's defiant." Well, guess what? We know that! WHY? Could be autism spectrum or some mental illness...if you lived here I'd tell you to go to a neuropsychologist. What kind of professional diagnosed him? Are you sure the professional got it right? Often they don't. How old is he or she?
  5. SRL

    SRL Active Member

    MidwestMom, the most recent DSM revision extended the ages of CD diagnosis, so diagnostically speaking, it's not longer just a late teen and older diagnosis.

    I agree with the need to make certain of the diagnosis.
  6. jensfishin

    jensfishin Guest

    My son, Austin, has lived in a loving stable home always. He hit all the milestones you'Learning Disability (LD) expect from a "normal" halthy child. The only thing he did a little slower than average was talk and we soon realized that was because we never really made him (we always met his needs before he had to verbalize them). He was always fearless (he once climbed so high in a tree I couldn't reach him while I was standing on a chair, he was 18 months old). He never had any health concerns as a baby, preschooler or even now besides some pneumonia occassionally. He occassionally suffers from night terrors but I can't even remember the last incident of this. He has broken both his arms and one leg, had stitches twice and chipped eight of his baby teeth.

    His dad and I have a great relationship and have always strived to give our children a well rounded life with many opportunities to see and try new things (we camp all the time and have taking the kids skiing, snowshoeing, cliff-diving). We spent a year living on a first nations reserve followed by three years in northern Canada. When we moved back to a less isolated setting we had more access to mental health care.

    Aus saw a school psychologist when he was in grade one and first having difficulties socially (making and keeping friends mostly). When he began acting out sexually in grade three he was seen by the school consellor on a regular basis (this was **** in my opinion). When the problems continued and began to escalate we sought a clinical psychologist outside of the school. Aus saw her regularly for about 18 months before he was diagnosed. She (the psychologist) also consulted a child phychiatrist to confirm her diagnosis. She has reccomended the behavior modification.
  7. jensfishin

    jensfishin Guest

    He was diagnosed by a clinical psychologist (she consulted a child psyciatrist specializing in CD) after seeing my son for nearly 18 months. I've read a lot on this disorder and as far a the charateristics of the disorder are concerned Austin seems to be exhibiting all of them as well as most for ODD
  8. WearyWoman

    WearyWoman Guest

    Hi and welcome. You've found a great place to connect with others who understand in this forum. I'm so sorry to hear of your son's behavior issues. It is a hard thing to go through, and as you know, unless others have experienced these unique challenges, they are unlikely to comprehend the disruption in your life. But here, you'll find information and more importantly, caring support. You're not alone.

    I recently read an article about new research that seems to indicate some biological brain differences in children who have tendencies toward a conduct disorder diagnosis. You describe a stable environment for your son, and yet, he is demonstrating these challenging behaviors. I'm not sure what is available to you in Canada, but a neuropsychologist evaluation could lend additional insight. The conduct disorder label simply describes the behaviors you already know exist. It doesn't help with the cause or possible overlapping conditions (like ADHD, depression, autism spectrum disorder, bipolar disorder, anxiety, and other psychiatric conditions). While there may not be a medication for conduct disorder specifically, if your son has other neurological/psychological conditions, medications may play an important role in reducing the behaviors indirectly.

    And, regarding your feelings of hopelessness, please don't despair. There's no such thing as hopeless - only the illusion that there are no alternative outcomes. An article specifically addresses this, stating, "But new research in behavioral therapies has proven that CD kids can have happy, contributing adulthoods free of their anti-social past. Early intervention and aggressive therapies are the key."

    Here's a link, if you'd like to read it:

    I'm sending you lots of hugs and hoping you are hanging in there alright,

  9. SRL

    SRL Active Member

    Take this with a grain of salt because we're obviously just parents here and not doctors, but for a child who has had a stable home life with reasonable (not perfect) parenting, I'd be considering a diagnosis of CD and ODD to be the doctor's way of saying "This child has behavioral problems but I don't have a clue why." And then I'd be doing everything in my power to find out why. Research, ask questions, compare your son's behaviors and developmental history and family mental health history with what other parents report, and see different specialists who might see it from a different perspective. And don't stop until you have a clinical reason that fits.

    Has he seen a neurologist to rule out seizures? Undiagnosed seizure activity can a number of behavioral issues, as can undiagnosed sleep problems.

    Did the psychologist have you and his teachers go through any Autism screening checklists, especially with consideration to his early developmental history? Kids with very high functioning Autism are frequently missed and can have a whole host of problems that mimic other disorders. Late speaking, lack of empathy and superior cognitive ability would be very consistent.

    Has he had an occupational therapy evaluation to determine if the fearless behaviors could be related to sensory seeking due to sensory integration problems?
  10. jensfishin

    jensfishin Guest

    I'm still pretty new at this and I will certainly be talking a bit more with the psycologist when we have our next appointment. I am not sure about a neuropsyc but will ask at our appointment on thurs. I do know that even she agrees that this is a good idea we will first need to find a gp for our son (not an easy task) and then get an appointment to see the gp (we could be waiting two months for that) then if we do get a referal to a speciallist we will likely be waiting two plus years for that appointment. And in the mean time we will be exhausting ourselves with this behavior modification...did I mention the constant visual supervision...yep we can see him at all times.
  11. Marguerite

    Marguerite Active Member

    Welcome to the site.

    I really loathe the term "Oppositional Defiant Disorder". It seems to imply that the child is deliberately choosing, for his own malevolent reasons, to be as obnoxious and difficult as possible. In my own experience with this term it has been thrown out to us generally by people ready to throw their hands up in despair and walk away, a sort of "I don't have to try to help this child because by definition, nothing can be done."

    Wherever you look, you can find a disorder that fits your child. If you don't look too far you risk stopping by the first one that seems a reasonable fit, not knowing that there may be 20 disorders, all of which could be your child.

    I really think that those of us on this site should submit for professional publication, our own described disability - "difficult child Syndrome". Kids with this are generally socially inappropriate; tend to be disobedient and impulsive; prone to raging especially when baulked; may do well academically but at some stage begin to do very badly at school; resent authority and fight it. There may or may not be sensory issues as well, to the point of dysfunction.

    This condition would be distinguished from "Spoilt Brat Syndrome" which tends to be induced in a child rather than inherited - the Spoilt Brat is one who has been indulged, never given consistency in discipline or even environment; has been raised indifferently but with enough money thrown at the situation to slide through, so they grow up to be aimless, to feel a need to seek attention in whatever way including antisocial means, to shock people and grab headlines, all because there is a deep-seated sense of insecurity and lack of real connection to parent figures. I don't think I need to go too far to suggest some possible high profile names.

    It's a case of "seek and ye shall find". And for some specialists, if you can't find a label for it, invent one. Not just in this sort of disorder, either - I've seen it in other areas of medicine too. I remember one disorder name that had two different disorders fighting for the same label. One was a type of thyroid deficiency, the other was a copper toxicity in the liver. I've known doctors who were campaigning to have "their" pet disease accepted as a valid label (and of course named after them). One research team I had dealings with, "modestly" told a news crew that they expected to get a Nobel prize for their work, which later turned out to be the medical equivalent of a mathematical identity (an equation that boils down to the bleedin' obvious, such as 5 = 5).

    So even if you are satisfied that the label is correct in your son's case - always be prepared for the label to still not be the best fit. Also do not accept at face value any pessimism, any description that says, "this is hopeless, untreatable, unfixable." Remember that 30 years ago, parents of autistic kids were told to put them in an institution and forget they had them. Same with other disorders such as cerebral palsy and Downs to name just a few.

    Ideas change, knowledge changes, we learn more and you know where a lot of that knowledge comes from? It comes from US, the families. WE are the ones who say, "No, it's not like tat. Look what happens when we try this," and the doctors slowly see that perhaps the picture is different after all. Of course the doctors then do more formal stuff which includes observing, collating all the information, then writing it up - that is how it gets accepted into the scientific community. But the coalface is the family. The child himself, who also deserves some credit for working to overcome the disability.

    ODD is a description. You put any kid in a situation which is blame-baased, where there is a constant competition for control int he child's environment, and especially where a child feels out of control, that the world round him is too un[predictable and confusing - and you risk ODD developing. If, in contrast, you change that environment away from blame, away from "Because I said so, that's why!" and more towards, "Let's work together to solve this problem," you can turn it round. Really. What is more, it is easier than continuing to fight a losing battle. Because once you find yourself engaged in a battle with your child, you have lost the war.

    There is a book we recommend here called "The Explosive Child" by Ross Greene. It's not a cure, but it helps a lot. Not in every case, but it's sure worth a look. I just wish we on this site got paid for recommending it!

  12. Marguerite

    Marguerite Active Member

    I posted on your other thread, but a question I want to ask - has this boy been sexually abused? It happens far too often and if it happened some time ago and this behaviour has been part of the response, then it would take a lot of therapy now to help sort it. But it could be sorted.

    The abuser needn't be an adult in his life, either - my eldest, easy child, was sexually abused at the age of 5, in the school playground, by a 7 year old boy who she had grown up with (they had been in the same child care centre as infants). I've heard of similar scenarios with other people I know - different schools, different kids, but again - nothing was done. In easy child's case, she didn't tell us for two years because this boy had her so terrified for her life and for mine (he had said if she told, he would send his father round to our house to run over me with the lawnmower). Another young friend of mine was sexually molested in her first week at school, by some boys in the oldest grade. Because she could not identify them (she was too new at the school) nothing was done.

    Your son sounds like he has big problems. In easy child's case, the counselling she had was worthless. It is vital to get GOOD help, and if you feel they're not getting it, you keep nagging for something better.

    Welcome to the site.

  13. SRL

    SRL Active Member

    I know you're new to this, which is why we're telling you that a diagnosis of CD is a cop-out diagnosis for a ten-year-old with his background, especially without a comprehensive, multidisciplinary evaluation.

    Do your homework and you'll see that unless there was some traumatic event(s) in his past, or other factors that would seriously predispose him to these behaviors, a CD diagnosis just doesn't fit. And intensive behavioral modification carried out by mom as the only treatment isn't anywhere near what a comprehensive treatment plan should be. It's cheap, local, keeps the family dependent on one therapist, and is absolutely certain to exhaust the parents.

    Is there any way you could move along outside referrals? Would the current diagnosis move him up on waiting lists? Can you do an extended stay elsewhere? Is the system such that they would give a child such a very serious diagnosis but not have any further diagnostic options or treatment routes beyond addressing behaviors available?

    I'd suggest you start doing some intensive research. Marguerite was right that any number of neurological conditions could cause these types of behaviors, so it's important to do your own homework.

    I'd highly recommend starting with the first book, and I've added some sites representative of the problem areas often seen by families who land here.

    What Your Explosive Child Is Trying to Tell You: Discovering the Pathway from Symptoms to Solutions by Dr. Douglas Riley

    Asperger's Syndrome

    Bipolar Disorder

    Childhood Sexual Abuse
    Last edited: Jul 18, 2010
  14. Fran

    Fran Former desparate mom

    Jensfishin, welcome.
    This is all very overwhelming at this stage, for you. Despair is common when we first start to unravel the intricacies of our difficult children. Remember that the behavior you see at 10 may not be the what you see at 15, 20 and 25. The belief that early intervention is the best hope for having a more positive outcome is what we hold on to.
    I can see your concerns with his behavior and creating a household of severe restriction. It's a tough life for us to act as policemen to our children. It doesn't feel right. My only suggestion is to replace the action you are denying for difficult child with a positive activity. No tv, but read a book to him. No friends but a nice walk with mom and dad. it doesn't have to be torture but it takes a lot of energy to be negative all the time. Turn it around into a positive activity. If he is raging, wait until he gets over his opposition and do an activity when he is calm.

    I agree with the above.
    I have found that no one will advocate for your child more than you. I found that specialists tend to always find their specialty in your child. It's up to us to take all the facts and make an educated choice of what your child needs. Most of us had several different opinions of what was going on with our difficult children. Time changes their behavior and current medical research as SRL has said.
    Your little guy has some big red flags flying with his behaviors thus far but that is not a guarantee that he will follow that path. Work hard now to get the right vision of what is going on with your son and the right treatment plan.

    Is there any history of "unique" behavior in the family tree?
    Alcohol/drug addiction? Any addiction?
    mental health issues?
    Unable to stay employed?
    school issues?
    suicide/dysfunctional behavior?
    You must turn over all those ugly stones of the family tree to help fill in the background of what is going on with difficult child.

    Welcome to our world. It's a sad day when you find us but this is about not being a passive victim to a label. We are here to offer direction, suggestion, and support. Occasionally, we share a good laugh and big success. We all used different methods, came from different family situations and sought various treatment methods. Judgment is not what we do.(hopefully) We try to sound alarms and try to calm the storm when you are in the center and are at the end of your rope. Most of us have been there.
  15. smallworld

    smallworld Moderator

    I just want to point out that "hypersexual" behavior is often a red flag for mania associated with bipolar disorder and has absolutely nothing to do with being sexually abused. You can read about it at
  16. SRL

    SRL Active Member

    Smallworld, are you referring to this article?

    If so, it doesn't say that hypersexuality has nothing to do with being sexually abused. It says that in a study of 93 individuals diagnosed with BiPolar (BP), 43% of them were also hypersexual. I'm not disputing that it's a red flag for BiPolar (BP) in children, but I'm not aware of research that supports that hypersexual behavior can't also be associated with sexual abuse.

    But is this so? When Dr. Barbara Geller and her colleagues at Washington University in St. Louis looked at a group of 93 children and adolescents diagnosed with bipolar disorder as a part of an ongoing NIMH-supported phenomenology study, they found that 43% of this group who were manic were also hypersexual. In order to rule out any overstimulation or sexual abuse in the environment, each child and family was examined first with the Psychosocial Schedule for School-age Children Revised (PSS-R).

    Dr. Geller explained:

    This is a comprehensive semi-structured interview that was given by the research nurses separately to mothers about their children and to children about themselves. It has a section with items on sexual abuse. In addition, pediatric and other medical records were obtained and examined for any possible clues to abuse (e.g., multiple visits for accidents, unusual urinary problems etc.). Teachers and after school caretakers also supplied information.
    Dr. Geller and her colleagues found that less than 1% of these hypersexual bipolar children had evidence of overstimulation or sexual abuse in the home environment. The conclusion of one of the journal articles published about this on-going study of children and adolescents with bipolar disorder was that “the 43.0% rate of hypersexuality in the prepubertal and early adolescent subjects strongly supports hypersexuality as a symptom of mania.”

    Is there's other info on the site that would clarify? We've definitely had reports of kids here who were hypersexual whose parents didn't report a BiPolar (BP) diagnosis, but who had been abused, had other diagnosis's such as Autism, etc.
    Last edited: Jul 19, 2010
  17. klmno

    klmno Active Member

    I think she meant that in cases where the child is bipolar and hypersexual, it doesn't mean they have been sexually abused. I can't speak for her but I don't think she meant it didn't mean a red flag for abuse, just that it wasn't necessarily abuse.
  18. Marguerite

    Marguerite Active Member

    My observation and question about the possibility of abuse, was based on our experience of easy child being abused. She also was acting in a sexually provocative way at that time, told us the boys told her to take down her panties while she was jumping on the trampoline. It was two years later we found out about the abuse.

    Yes, you can get hypersexual behaviour in bipolar, but you can also get it where a child has been molested.

  19. totoro

    totoro Mom? What's a GFG?

    All that I can tell you is to take it one day at a time. My Daughter has been dealt a pretty raw deal as far as diagnosis's.
    She has SX's of almost everything. She truly has BiPolar (BP) she has classic symptoms. But one can look at some of her SX's and say, "Oh it must be Schizophrenia or this or that"... Even with Autism a child can have a very real imaginary "friend or friends".
    But when you seriously look at the list of SX's for BiPolar (BP) it covers most of her issues.
    When she is medicated and semi-stable she then shows signs of Autism. But it took a long time for her to get stable and tease out all of the non-manic/depression etc. SX vs what are other true separate diagnosis.
    But saying all of this, none of it really matters in one sense because the SX's still need to be treated. But on the other hand having the diagnosis's can get you better help.
    My daughter could NOT get any social skills group help until she was diagnosis'd with High-Functioning Autism (HFA) and now she is actually offered help.
    Having a correct diagnosis also helps you with the right medication choices also. K is hyper-sexual, but she was never abused and I know this for a fact. One of the wonders of her BiPolar (BP) is that she is brutally honest.
    Keep trudging forward and things will get better, maybe not right away, but for you it will settle down and you will be able to accept this and see a future no matter what it may entail.
  20. jensfishin

    jensfishin Guest

    This just keeps getting in addition to everything else I have to be worried about an incorrect diagnosis.

    difficult child went for a sleep over last night...the first one in so long I can't even remember. We talked to the family so we know they are being very careful and keeping a very close eye on him...I really hope he had a great time.

    Totoro - I wish I knew what it was like to have a child who is brutally honest, difficult child lies about everything, absolutely everything.

    husband and I had a chance to talk last night and are going to start pushing for more tests and a second opinion. I hope this won't take too long but for now we are going to continue with the behavior modification.

    As far as abuse goes we have racked our brains and can't think of a way this may have happened. We spend so much time together and when he,s not with us we know who he's with and very well.