Guanfacine Proscribed for 3.5 year old with ODD

Discussion in 'General Parenting' started by Taveuni, Apr 8, 2012.

  1. Taveuni

    Taveuni New Member

    My 3.5 year old son was prescribed Guanfacine for Oppositional Defiance Disorder which was just diagnosed. My son has been incredibly difficult since he was 15 months old. We have had issues with biting, throwing, hair pulling, refusal to get dressed, constant screaming and temper tantrums. Currently, he constantly says "no" to anything he is asked to do (even preferred activities), he is defiant, and he runs wild (he will turn a room upside down in 5 minutes). He can be charming and sweet, but he has a constant motor that never stops. My husband (who is a stay at home dad) is completely exhausted. Our son has injured our 1 year old daughter (he is incredibly jealous and attention seeking). I am interested in exploring medication (in addition to therapy and community activities) but my husband is opposed. Has anyone out there tried Guanfacine for a young child (under 5) and, if so, did you see any improvement? Any problems with side effects? It is difficult to imagine medicating my child, but it is also difficult to get through the day with his constant negativity and impulsive behavior.
  2. InsaneCdn

    InsaneCdn Well-Known Member

    First, welcome... glad you found us, sorry you had to...

    ODD diagnosis at age 3.5?
    I'm thinking you need a second opinion.

    Lots of us have had the ODD label tossed at our kids. Usually? it's more a recognition that there are problems... but ODD is rarely the cause. It's usually the result of other problems not being caught and dealt with.

    Has he ever had an Occupational Therapist (OT) evaluation for sensory issues and motor skills problems? Either one of these can be huge, and they can have both... in which case, there are therapies, interventions and accommodations that help. If a child has these and they are not dealt with, they can literally drive the kid crazy... which would then explain the ODD behavior... if that makes sense?

    He's a bit young to get a comprehensive Speech Language Pathologist (SLP) evaluation for Auditory Processing Disorders (APD) - but you might want to start watching for it. Does he "hear" you and respond and interact? Consistently? or not in some situations... such as when there is background noise? How are his language skills? Problems with hearing, language processing or auditory processing, have a HUGE impact on the mental well-being of a child...

    Others will be along with additional ideas...
  3. buddy

    buddy New Member

    I have a child who was very similar. Here is our story.... He was in foster care (pre my adopting him) starting at 7 mo. He had a very good foster mom. She had to carry him everywhere after age 1 because he banged his head, bit, screamed, hit, etc...would have silly charming moments, said some words in between.... but they treated him behaviorally and he went to Special Education. He started having seizures which often started with those screams. The head banging ended up being intense pain. He had a large brain mass that had grown, was full of blood and was leaking and causing strokes. He also has autism. whether or not that was caused by the brain injury who knows, he does have a predisposition in his bio family as he has at least one confirmed bio brother with autism. It is very likely that there are other things going on with your son and ODD only describes behavior. It does not help define what is going on that is causing the symptoms of opposition and defiance.

    Now, that said, from the time he was 2 he was on Clonidine (similar/same class of medication) and it is used for very very young kids in tiny doses ...when they are this aggressive. Often for kids with autism. It is a blood pressure medication that had the effect of calming and helping with aggression and attention (for some kids). He is on it again as a teen and it works beautifully for him. It doesn't for everyone, as you will find....medications are so variable. He was on it from before I adopted him at 2.9 years until he was nearly 5. Then we just managed with a stimulant and an anti seizure medication.

    If I were you, and of course this is totally up to how comfortable you feel, I think ODD is a very incomplete picture of what could be triggering this. Because of my son's story I would say if you notice anything that seems odd physically to see a neurologist. (good to clear that area anyway). Then I would seek three complete evaluations. 1. A speech/language pathology evaluation looking at his understanding and use of language and how he uses language for engaging others (he is young, you need someone who understands how very young children play and communicate and most early therapy centers do a good job at this). Of course you need to make sure hearing is ok. At his age you can only get hints as to whether or not he is processing language (like does he need longer time to understand what you say and does he have a harder time when it is noisy around you etc....)
    2. An occupational therapy evaluation: check motor and sensory integration function. 3. get a neuropsychological evaluation (neuropsychologist). These are specialized psychologists who look at the wide range of behaviors and symptoms people have and help connect that to how our brains work. They can help give a more specific diagnosis. They take longer to get into than the others so it is good to get the others done first and bring those results so they can put the pieces together.

    In the mean time....What is his birth history like?? any difficulties during pregnancy, the birth, illnesses after?? How does he play?? mostly chase types of play (climbing, running, maybe some imitating, etc...) does he do back and forth imaginative play or does he just share the same area/piles of toys and play next to/sort of with other kids?? How does he do when you go from one activity or one place to another? Especially from a preferred to a non preferred activity? How is his eating, is he picky? Does he get more upset in noisy places? Does he have intense fears? Does he look at people when he is communicating with them? Does he like to be touched, if so is it only on HIS terms? Does he rock, shake his hands, do anything like that? (my son loved to sit on a couch or big chair that was fluffy behind and rock to bounce off of it, he likes that deep smashing pressure.

    How is his sleep? How is his speech/language, did he talk early? Does he like books? Is he already learning to recognize letters, numbers, words, etc???

    Just some questions that allow us to say if our kids were similar to yours and if our stories match at all it can give you some ideas of where to check for help. You will get lots of input and it is all out of care and understanding for how hard this is. And how wonderful our kids are and well worth the effort to help them.

    A couple of books that may help What your Explosive Child is Trying to Tell you has specific early childhood ideas (by Douglas Riley) and The Explosive Child by Ross Greene has lots of ideas and there are sections on this board that help adapt it for early childhood.

    Welcome to the group! I am glad you found us and hope you can find some comfort and support here. Let us know what you decide and how it works out for you!
  4. Taveuni

    Taveuni New Member

    Here is some more info on my son. He had a language delay and received a year of toddler development services beginning at 24 months. It included monthly Occupational Therapist (OT) and we were told he had some sensory processing issues for which a sensory rich diet was suggested. He required lots of physical input and loved to push heavy objects and crash into things. The program was successful at developing his language and his language is now excellent. He can play nice with other children but has one child in particular that he has hit and pushed down on occasion. He has a little girl friend that he loves and he will let her take his toys and not blink. He is extremely mean to his baby sister. Today he spit at me and her as we were sitting on a bench watching him. He also pulled her hand in the car. He is constantly in motion, sometimes even making a buzzing sound with his lips like a bee. He gets overwhelmed in Busy or chaotic situations. He can be calm at times and will have good and bad days. I feel his behavior is getting worse. He is impossible to discipline. We have tried spanking but I think he enjoys the negative energy as it does not change his behavior. We tried time outs which he would only do strapped in his car seat. I think he may get an ADHD diagnosis later in life. He has a difficult time staying engaged in play and tends to bounce from one activity to the next. He will pull his entire preschool class around in a wagon. The child has superhuman strength. He is not good about making eye contact but can be very engaging on his terms. He has excellent hearing. Everything must be on his terms. Transitions are very difficult so we try to give him warnings (5 min). We took him to Disneyland for his 3rd birthday and he could not wait in lines and completely melted down. He is generally fearless and will run away from us in public settings. He is potty trained but refuses to poop in the toilet instead announcing "I need a pull up.". Any advice you can give is appreciated. Please note the diagnosis of ODD was made by a child neurologist. We are also seeing a child therapist that focuses on behavioral issues. He confirmed the Diagnosis but was skeptical about medication for treatment. Regards.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Actually, he sounds a lot Autism Spectrum Disorders (ASD) to me. My son acted a lot like yours did. I don't think you are dealing with ODD at all and agree that it is sort of a catch-all when a professioinal doesn't know what is going on. Bet the neurologist didn't do any intensive testing on him. Neurologists are good for epilepsy and sleep studies, but really are not very good at diagnosing childhood behavioral issues. I'd see a neuropsychologist. BIG difference.

    JMO, but our kids tend not to respond to behavioral therapists and their theories. Our differently wired kids seem to rebel against regular "typical" reward charts and the like...I would get another opinion on what is wrong first. Also, therapists can often point the finger at YOU as the problem, and in my opinion it's not you at all. He does have problems that make him different, unrelated to his family life. ODD is really a very unhelpful and incomplete diagnosis.

    Here is an online test that you can take to see if he leans in that direction. I am told, by posters on an Autism Spectrum Disorders (ASD) chat site, that if you answer the questions honestly, the test is quite accurate. Here it is: