I need help: 6 year old son with Oppositional Defiant Disorder/Mood Disorder /ADHD

[janabritt]

My son is 6 years old and in kindergarten. He was diagnosed when he was 4 with mood disorder. The psychiatrist at the time said he is too young to be fully diagnosed with a mental disorder because his brain is still developing/growing. So my son was labeled a mood disorder patient. The psychiatrist said that means he has something in the spectrum of being bipolar or having schizophrenia. We tried several psychotrophic drugs such as Abilify & Depacote....and no changes were seen. We were really nervous about using such strong drugs on such a young child so we went to our pediatrician for help. Blood tests were run and everything came back normal--except for one thing: he had high levels of strep antibiody in his blood. The doctor decided he must be a strep carrier. She looked into PANDAS but the symptoms didn't match my son. We then turned to the elementary school that my son would be going to. They have a preschool program for children with disabilities and with the behavior problems he was having he was eligilbe for the program. To start the program, extensive testing was done on my son. He had a hearing test, vision test, they ruled our Aspergers & Autism, and even had his daycare teacher & myself fill our long questionnaires about his behavior. The results showed he was way out of range in several areas....he was very agressive, very depressed, and he had a lot of trouble socially. Academically he is extremely smart but he has so much trouble doing regular everyday stuff.

My son is can be very mean, very vendictive, very negative, and very hard to get along with. I am divorced so I know that adds to the mix even more. His father still sees him every other weekend (occasionally more than that) and lives in the same city. I am remarried and the relationship between my husband (his step father) and my son is typically not good. My son tells him he hates him, he's not his father, he is stupid, he is a nerd, etc. The anger is extreme and uncontrollable.

Oh my there is so much to say about this little boy. I have had him meeting with a counselor for about 2 months now. But because my son hates talking about his behavior he hates going to see her. I guess this is good and bad. Bad because I am so embarressed by the way he treats her and good that she can see how he really behaves and can help us figure out how to help my son. The counselor said she belives he has ODD and might even be bipolar. We are scheduled for a psychiatric evaluation on May 20th (that day cannot get here soon enough). We are hoping to take my son off of his current medication (Clonodine) and get him on something else that will better help his outubrsts. I could really use some insight as to what medications have worked for anyone else with a similar situation. There are so many out there and I know that what works for one child may not work for another. But I would like to read up on some before our appointment so I am familiar with them.

Let me list some other problems we are having with him:

AHDH-cannot sit still, speeds through homework & doesn't care about it at all, hyperactive all the time, bouncing all over the place

Agressive--hitting kids & teachers at school (sometimes provoked and sometimes not), hit kid at daycare with a golf club, threw rocks at teacher, occasionally bites

Argumentative--constantly arguing with ANYONE and EVERYONE--family, friends, principle, counselor

Snaps--goes from ok to beyond angry in 2 seconds--you can see the change in his face & eyes

Sensitivity--hates tags in his shirts rubbing on his neck

Major Surgery Feb 2010--he had a Urinary Tract Infection (UTI) (unusual for males) so went to urologist, did sonogram and VCUG, found kidney reflux grade V (worst kind), left kidney was severly damaged, so it was removed 3 months ago. Speedy/great recovery.

If anyone has any suggestions or ideas I would really, really appreciate them. Thanks!

 

[BeyondWeary]

I noticed the sensitivity issue - many behavioral problems are rooted in inadequate "wiring" in the brain and can actually be tied to over or under stimulation of touch, joint pressure (proprioceptive), balance (vestibular), etc. Do a search on educational kinesiology. The therapy involves working opposing sides of the body in different activities in order to form the proper "wiring" to and from the left and right sides of the brain. It also involves some eye movement therapy and fine motor therapy. The Out of Sync Child is a book that defines sensory integration disorder which educational kidesiology addresses. Note - my experience is that this particular therapy is cutting edge and not covered by health insurance. The diagnosis by regular occupational and physical child therapists is, but in our experience, their therapy wasn't worth a hoot.

 

[Marguerite]

Has anyone considered Pervasive Developmental Disorder (PDD) in any form? It can explain so much, including sensory issues.

I just posted at more length on someone else's post about a similar child - have a read of it. Read around this site.

We often recommend a book called "The Explosive Child" by Ross Greene. It's not a cure, but it can make it so much easier to deal with oppositional behaviour. Kids with an underlying disorder such as ADHD, bipolar, conduct disorder or Pervasive Developmental Disorder (PDD) are often what Dr Greene calls "intermittent-explosive" and this means they have a high level of frustration, a short fuse and explode into rage because the world simply will not do what they want it to.

Read my other post (I'm in a rush right now) and also try to get your hands on a copy of the book. Go to the Early Childhood forum and read the stickies there on Explosive Child.

Also to consider Pervasive Developmental Disorder (PDD) (and I didn't say this on the other thread) - go to www.childbrain.com and look for their informal online Pervasive Developmental Disorder (PDD) questionnaire. You can't officially use it to diagnose but you can print the results and take it to the doctor, to let them know just what you're dealing with.

Keep us posted on how you get on.

Marg

 

[BusynMember]

I'm with Marg. A school therapist can't rule out forms of autism...you need a private neuropsychologist for that. It sounds to me very much like he could be on the spectrum. Socially clueless kids with anger (frustration) and sensory issues (Sensory Integration Disorder (SID)) have big red flags for Autism Spectrum Disorders (ASD)/Pervasive Developmental Disorder (PDD). I wouldn't be so sure he has bipolar...they insisted that my son had it and he was on a slew of medications. They didn't help. He is actually on the autism spectrum, the very thing they told me he COULDN'T be...and now he is sixteen and doing great OFF medications and with school interventions. And, yes, he had Sensory Integration Disorder (SID) and still has terrible social issues (shyness to the max), but he is learning how to function better and his frustration levels are lower and he rarely acts out. I would see the Psychiatrist, but also a neuropsychologist. A psychiatrist could easily miss it if he's on the spectrum because he is looking for mental illness, not neurological differences in the brain. NeuroPsychs test kids in all areas of function and in my opinion do a better diagnostic job. School, by the way and in my opinion, are the absolute worse in diagnosing. I wouldn't trust a thing they said. A therapist is not educated enough to diagnose by the way.

I would explore this possibility, but you won't get any answers without going to a neuropsychologist and your son, like mine, may be misdiagnosed and end up for years on medications with bad side effects that he doesn't need. My motto is: Leave no stone unturned.

Good luck, no matter what you decide to do. And welcome to the board

 

[nandz]

Janna--I feel your pain. My son is 5 yrs old and just diagnosed with ADHD/ODD and he is on Adderall. I know exactly what you are going through as it seems like our sons are very similar. I don't have much advice to offer because I, myself, am trying to learn new ways every day to deal with my dear child. Good luck and we are here for you!

 

[TerryJ2]

Hi Janna, welcome.

I am so glad you were able to rule out Pandas and a cpl other things. Pandas came to mind when I first read your post.

Also, try an elimination diet. Cut out everything except potatoes, rice and chicken, and do not fry or bread the chicken. Try to keep your son within arm's length as you do the elimination diet because if he's at a birthday party or overnight or school function, you have to go back to square one.

I agree with-the others--definitely check into the sensitivity issues. They could be causing the outbursts to the point where he can't focus on anything at all.
If the clonidine doesn't work, don't use it. It works for our son but it doesn't work for everyone.

Does your son take off his clothes the min he gets home? Most everyone hates tags, but we yes we, can verbalize our feelings and get a scissors and cut out the problem.
Does he hate/love baths or showers? Hate/love certain clothing textures? Hate/love certain foods? What about when he's really hungry and goes to stuff his face, and then all of a sudden, has a meltdown? It could be because he's starving and impulsive, and then once the food is in his mouth, he can't deal with-the texture, Know what I mean?? Sometimes when you backtrack and piece it all together, the over-reactions actually make sense.

Kids don't know enough to verbalize exactly what's bothering them, and one little thing turns into a huge issue. Add that to trying to learn the simplest thing--at the same time--and you've got a problem.

Yes, he could be bipolar. But you may not know for yrs. It's great that you can do testing, but I'll warn you, from what I've experienced, don't expect all of your problems to be solved with-the spectrum testing, or any testing. It will raise as many questions as it answers. The intellectual quest can be challenging and even fun, but the real life issues go on and on. And on ...

This is a long-term, lifetime adventure you're on. You can get it under control, really, you can, but just try to take it one day at a time and not expect too much from any one "specialist."

Nice to meet you!