Dr. Riley checking in

[Dr. Douglas Riley]

It has been a long time since I have visited the board. Those of you who remember me will probably assoicate me with my book, The Defiant Child. I am writing let everyone know that this past August my latest book, What Your Explosive Child Is Trying To Tell You, was published by Houghton Mifflin. I am happy to announce that it has been awarded a gold medal by the Mom's Choice awards for 2009 in the parenting category.

The reason I wrote the book is this: There is literally an explosion of explosive behavior in children in the three to ten years old age range. However, there has been nothing written about the actual underlying causes of explosive behavior, and many parents are rightfully confused on the differences between explosive behavior and ODD.

In order to help explosive children, you first have to understand that there are multiple, hidden causes of explosive behavior, each of which has to have its own specific treatment. There is no generic, one size fits all treatment that will result in any lasting change.

For example, many of the young children I see at my office explode because they are unusually sensitive to unexpected changes in their schedule, unexpected transitions, or changes in what they thought was going to happen. We all have a mental roadmap, and for some children it is carved in stone. When what they thought was going to happen does not happen, there is a massive eruption of anger and outrage.

I see a significant number of children who explode due to undiagnosed food sensitivities. In particular for little children, the sensitivities are often to milk, wheat, corn, high fructose corn syrup, or food colorings. One mother I know refers to juice boxes as "liquid crazy." If your child has a sandpaper rash on his or her wrist, or excema, try taking them off of milk for a week to see if it helps. It will in a surprising number of cases.

There are still other reasons: Some children have sensory integration issues that leave them cranky if their clothes don't feel right, or they get set off by certain food textures or smells. For some of the children in the 10, 11, and 12 range, explosive behavior is a sign of depression. Perfectionistic children will explode when they can't get things just right. The anxious child who explodes because she can't get in your bed with you at night invariable is fearful of being harmed, or of you being harmed, at night. Some children explode at school because of the frustration of undiagnosed learning disabilities. Other kids explode at school during the day because of undiagnosed sleep difficulties and airway problems.

As you can see, each of the issues I noted above can be treated. But, the treatment for each is quite specific.

I hope that the new book will prove useful to the parents on this forum. By now, most public libraries will have it. It is also available through the typical commercial store and web outlets. There is also a link to a lengthy podcast interview with me on explosive children on my website, drdouglasriley.com.

This site has come miles and miles since it was originally founded by momma bear. I will check back in on occasion and will attempt to answer questions about explosive children.

Best regards, Doug Riley

 

[susiestar]

Thank you for letting us know about your book. It certainly sounds as if it has very useful information. I look forward to reading it and reading other posts on this forum.

 

[bran155]

Thanks for the book and for stopping by!

 

[TerryJ2]

Gosh, what a surprise!
I'll have to buy the book and get it autographed.
Congratulations.

Can you write a book on A Cure for Explosive Moms? Oh--wait--It's already been written: Healing Vacations in Hawaii.

 

[Allan-Matlem]

Hi,

many of us here are familiar with Dr Ross Greene's Explosive Child, the Collaborative Problem solving approach , treating the child's behaviorial difficulties in a way similar to learning difficulties , helping them through parenting acquire the various cognitive skills that they are lacking and being more responsive to their needs.

Dr Riley - Briefly , what in a few words is your approach ?

Thanks

Allan

 

[Janna]

So, treatment for each issue is specific, but what do you do when you have a child that explodes over all of the above and then some?

It's great if you have a child with anxiety and can treat that with behavioral modification techniques. But what do you do when it's above and beyond that?

*sorry, I'm the difficult one of the board - just questioning

 

[Dr. Douglas Riley]

Let me see if I can try to respond to most of these questions.

For Janna: First, anxiety, while complex, is not the only cause of explosive behavior. Anxiety cannot be treated using the same methods that you would use for depression, which in turn cannot be used for treating definat behaivor, and so on. As you are no doubt aware, some children have multiple "disorders." They can have ADHD, can be oppositional, and can be depressed. There is no one universal cure for all of this. The research on this is very clear that each set of symptoms must be addressed using methods specific to it. It is also true that some explosive behavior has a biological basis, such as bipolar disorder, and medications may be useful in these situations.

My approach is so different from Dr. Greene's that it probably takes reading both books to get the flavor of our differences. Dr. Greene is a highly regarded academic psychologist. Within the academic world there is a huge push to develop what is known as "evidence based treatments," or EBT. The idea is that each disorder should be treated with methods that have been shown through research to work well with that disorder. The attempt is to standardize treatment, much as the medical field has standardized treatments for various disorders. Dr. Greene's approach is to view explosive behavior as a unitary disorder, with no specific underlying cause other than cognitive distortions, and to treat all explosive behavior using collaborative problem solving.

I am a practicing child psychologist (in the chair going on 32 years), and take the approach that while all explosions look the same on the surface, the underlying causes for each child's explosion can be quite varied. Due to this, there cannot be a one size fits all approach. For example, some of the children I work with are so intolerrant of unexpected chages in schedule, or unexpected routine, that they are literally phobic of changes and blow up repeatedly when things do not go as they expected. The fastest way to treat phobic responding is with exposure therapy, as well as teaching the child to do various types of self-talk whenever they are in the face of an unexpected transition. Exposure therapy is obviously not the treatment of choice for children whose explosive behavior is due to underlying depression. The treatment of choice for this is cognitive behavior therapy. However, cognitive behavior therapy will do nothing for children whose explosive behavior is closely tied to undiagnosed food reactions. And so on. Using my approach, you will see that there are multiple "types" of explosions. Again, each is best treated by using methods that are highly specific to it.

I will clearly encourage people not to somehow pit my book and Dr. Greene's book against each other. This has happened frequently with my earlier book about defiant children (if you read my newest book, you will see that there are vast differences between defiant children and explosive children, and that their symptoms cannnot be treated using the same methods). Both Dr. Greene and I, as well as other writers, are really in the business of trying to improve a child's life. My own viewpoint is that each of the writers out there has something to teach me, and that a broad viewpoint is much better in helping children than a narrow one.

Hope this helps, and I will continue to visit.

Doug Riley

 

[Josie]

I think I have just become a huge fan of yours! I will read your new book but since you are here, maybe you can answer a specific question of mine.

My 13 year old daughter has diagnosed food allergies to gluten and milk. When she maintains her diet, she is a lovely child with some manageable typical teen behaviour. Unfortunately, she cheats on her diet with the whole family then suffering from her defiant, mean, ways. I have really been trying to teach her the value of staying on her diet by coming down hard on her with loss of privileges for chore refusal. When she cheats on her diet, though, there really is no reasoning with her and she doesn't care about consequences. There is some depression that goes along with it also.

So far, I don't seem to be making much progress with getting her to stay strictly on her diet with my approach. If I didn't know that diet was the cause of this, I would consider medicine, but I am not convinced medications would help when she would be eating her allergens. I've considered homeschooling her and not letting her go anywhere unsupervised but that doesn't seem like a good answer either.

The whole family is on the same diet as her since we all have the same allergies, so it is not that we are eating this way in front of her. I used to go to a lot of trouble to make treats for her to take with her until I realized she wasn't eating them.

What do you suggest to parents in your practice who face this problem?

 

[Janna]

Thank you, Dr. Riley.

I am always open to new approaches, so I will definately check out the book!

Have a good day.

 

[Suz]

Dr. Riley, it's wonderful to see you here again. I'm one of the dinosaurs...I've been hanging around here about ten years now.

Years ago, during the darkest times with my son you posted to me. Rob could have been the poster boy for The Defiant Child at that time. Your encouragement meant a lot to me then as it will mean a lot to the parents here who are still in the trenches.

Thank you for remembering us.

Suz

 

[Nancy]

Dr. Riley,

So nice to see you again. I'm one of those dinosaurs who remembers your earlier visit also. I read your first book years ago and used many of your ideas. I almost wish my child was explosive, but she is definitely defiant and has been from very early on. With her it appears to be genetic and no matter what we've done we haven't been able to change the behaviors very much. Although she no longer strikes out physically she still defies authority and its rules. She will be 18 in a few months and I know we have had a positive impact on her, but there are many traits we just have not been able to change. We fear for her future and can only hope that some of what we have tried to teach her sticks in the years ahead.

From your experience do the children that are defiant in nature, the ones that inherit drug/alcohol/dysfunction traits, what is their chance at success in adulthood? When we adopted our daughter almost 18 years ago we thought a loving and secure home would make up for anything but have come to realize that nature trumps nurture in many of these children. Years ago we decided if we could get her to age 18 without being pregnant, hooked on drugs or alcohol, and graduated from high school it would be a success. We are three months from that goal now but it hasn't come easy and she walks on the edge constantly. Please tell me some of these children actually mature of out of their defiant ways.

Thank you,
Nancy

 

[Dr. Douglas Riley]

For Fairly Odd Parent: It has to be exceptionally difficult to be a teenager and not be able to eat wheat-based products and milk-based products. If she has Celiac's disorder, about the only thing she can do is to avoid anything with gluten in it. Has she been tested for Celiac's?

However, it is also entirely possible that she is getting food reactions to wheat and milk products (not the IGE mediated allergic responses, as in hives and a. shock, but the IGG mediated responses that work at a much lower level but have a negative impact upon mood and behavior). If it is not Celiac's but, instead, a food sensitivity, I will strongly encourage you to begin to look up everything you can find on what is known as "low dose allergin therapy," or LDA. The european version of it is known as "enzyme potentiated desensitization," or EPD. It involves a series of shots (about one every 3 months at first, then fewer later on), which are thought to reprogram the immune system to not react to the allergins that it is presently reacting to. It appears to be quite safe, given that the allergins used in the shots are at an extremely low concentration. There are not many people trained in it in the United States. If you are anywhere close to Durham, N.C., you might wish to contact Dr. Robert Taylor, at Triangle ENT. He was involved in the original research. Please be aware that the whole issue of IGG mediated allergins is a contentious issue within the allergy world. Without going into detail, I will tell you that I have seen the evidence in my own family that it can be exceptionally useful.

The reason I bring up the issue of LDA is that it gives you a possibility of not simply treating the symptoms, but getting at the underlying cause. Food elimination diets are tough on kids your daughter's age, and if slowly over time these foods can be reintroduced in her diet, she will have a better life.

To Nancy: Thanks for remembering me. Oppositional kids do indeed have a chance of getting much better as they age. I have always been optimistic about their ultimate outcome. The brain is not in its final stages of wiring until around 25 or so, so it may be that she will literally think differently once she is a bit older. She may have to go through some hard knocks. Lots of ODD kids have to lose a few jobs and go through several breakups with boyfriends and girlfriends before they begin to think about the impact of their behavior on others, and make efforts to modify how they behave. Try your best to stay moderate and not get pulled into arguments with her. ODD kids and teens are seeking admiration and respect like anyone else. They simply think that they can get it by using power-based tatics. Maintaining a friendly relationship with her is your best hope to being able to offer her guidance about how she should be living.

Best regards, Doug Riley

 

[Allan-Matlem]

Hi,

here is a podcast with Dr Riley


http://mefeedia.com/entry/what-your-explosive-child-is-trying-to-tell-you/12348862/

Allan

 

[Josie]

Thank you, Dr. Riley. I will look into that. We do have celiac disease in my family but she didn't have the GI symptoms and has never been tested. I am willing to travel, if necessary, if it is only every few months.

 

[nvts]

Hi! Dr. Riley, I have a general question (although I'd love to pick your brain regarding difficult child 1!).

Our son has been in therapy since he's been 6 years old (he's now 10). I feel like I'm the one constantly giving the different therapists insight as to what his triggers may be, but no one will give me a true analysis as to what's going on with him. Then you add the fact that all of them seem to treat him with the "you did this, and you can't because it's wrong" mentality, yet he's been doing the same behavioral things for years.

The act as though he's doing things simply to get a rise out of people, yet no one will tell me that getting that rise is his intent.

I've had mental health professionals refuse to acknowledge that sensory input could be partially to blame as well as truly traumatic events from his earlier school experiences.

My question (finally!! lol): What type of therapy should I have him in? I just feel like I've been spinning my wheels with this kiddo for years to no avail! Let me make it very clear that I'm not a "not my kid" kind of mom. Trust me: my eyes are open to a lot of his shenanigans, but I just don't feel like we're getting anywhere with therapy.

Thanks!

Beth
(sorry the message is so scrambled: totally sleep deprived right now!)
me

 

[Dr. Douglas Riley]

Beth:

Kind of hard to know where to start. I gathered from your post that your son has Asperger's, that sensory issues can set him off, and that there was something bad that happened in the past.

Sensory input can certainly set off all types of behaviors in kids with sensory integration issues. It can be sounds, smells, sensations, pressure, taste, and so on. You would be the best judge as to what the pattern would be. If this is the issue, it would be best to consult with a pediatric occupational therapist. If you have not read The Out of Sync Child, by Carol Kranowitz, you really should. Kids with sensory issues can easily get diagnosed with ODD because of the way they over-react.

Also, Asperger's kids often do not like changes in routine. In this regard they will need lots of warning about what is going to happen, when, who will be there, what is expected of them, and so on. This group of children needs lots of practice at interacting with groups, which is hard for them because they do not understand the unwritten social rules that most of us get without much difficulty. Social groups, church youth groups, clubs, scouting, and so, are useful. You will have to give him lots of feedback on how he is doing when in groups, or when interacting with individuals. If you see him making social mistakes, gently take him aside and tell him what he should be doing instead.

Whatever the bad stuff was that happened earlier, it is also possible that he has some post-traumatic stress. People with post-traumatic stress will mistake current situations as having the same potential to harm them that similar situations had in the past, even when harm is unlikely (I worked with sisters who were mauled by dogs, and they would go through the roof if they heard the sound of a dog barking in the distance). If this is the case, you need to work with a therapist who has training in post-traumatic stress disorder (PTSD).

Your son seems to be an example of the importance of making sure that each of his issues receives the proper treatment, as opposed to some broader type of psychotherapy. Don't give up!

Best regards, Doug Riley

 

[tiredmommy]

Me next? My 8 year old daughter has a history of explosive & defiant behavior, mostly in the home. She has moderate to severe allergies and was recently diagnosis'd with cough variant asthma. She also has minor gait issues, minor motor skill problems, sensory disregulation and visual tracking problems. She is a bright and articulate child that frustrates easily, slips into negative thinking often and often won't attempt difficult things. Her self esteem has slipped somewhat and I think she has a bad case of perfectionism.

Do you have any advice on how I can help her set more realistic standards so that she might appreciate her achievements? Do you know of any books out there not only for parents but also for the child?

TIA!

 

[timer lady]

I've read your book; still have it here in my personal library.

In our case, the severe Reactive Attachment Disorder (RAD) combined with the complex PTSD along with dissociative states in each of my twins, your book & your approach didn't fit. I had to go back & reparent many of the stages kt & wm missed in their bio home. I wish with kt & wm it had just been defiance ~ there were too many scars, too much to be learned before your suggestions could even be tried.

 

[Hound dog]

I'm also an "oldie" of the board and was so pleasantly surprised to see you here again.

Thanks so much for stopping by and letting us know about your newest book. I'll recommend it to my eldest daughter who has her hands full with 2 difficult children of her own.

((hugs))

 

[Dr. Douglas Riley]

Tiredmommy: Children with mild developmental lags, from my experience, are often explosive because they cannot get their bodies to do what they want to do, whether it is making letters perfectly, drawing the picture they see in their head, throwing a ball where they wanted it to go, or expressing themselves verbally in the manner they intended. Life is frustrating for them. Children like this will often fall into thinking negatively about themselves, and they can be particularly prone to depression. They see others doing what they want to do, compare themselves negatively to those others, and fall into thinking about themselves in a negative way: "I'm dumb!" "No one likes me!" "I can't do anything!"

I tell the kids I work with who think like this that at my house, I call that type of thinking "stinkin' thinkin' " because by the end of the day it is bound to make you feel horrible. I love to point out to these kids that they are always nice to me when they find out about the things that I don't do well, but they beat themselves up about the things that they don't do well. I show them how silly it is to use such double standards.

I do lots of role plays with them. For example, one girl I work with was blowing up because she couldn't write her letters perfectly. I had her pretend that she was the "big kid" part of my brain, and that I was the "blowing up" part of my brain. She had to watch me try to write words and as I threatened to blow up and tear up the paper when I couldn't make them perfect, she had to be the voice of reason. I find that by doing this with children, they often integrate a calmer, more self-accepting voice into their thinking, and begin to get rid of the punitive, self-punishing inner voice that leaves them so frustrated. In my new book I go over this procedure, and refer to it as the "brain game." I have numerous examples of such role plays in the book.

As you might be able to tell, I have a pasion for working with self-concept in young children, as what they believe about themselves right now will determine how they think about themselves in the years to come. Everyone should read the late H. Stephen Glenn's Raising A Competent Child In A Self-Indulgent World. It has such a clear-headed view of how to get kids to believe in themselves. I also like Reviving Ophelia, by Pipher and Ross, as it gets at how girls judge themselves.

As for books for kids who are explosive - you might want to sift through the offerings at addwarehouse.com. They have lots to chose from.
Sorry to go on about this. Hope it was helpful.

Doug Riley