I'm a newbie; opinions on books?

[Diabolique]

Hello everyone --

I have been lurking here for a while and have finally decided to register and make contact with others who seem to going through things similar to what I'm going through with my son. To say that I'm battle-weary would be the understatement of the century. To say that I'm worn out, anxiety-ridden, exhausted beyond description, and about 30 seconds from a nervous breakdown 24/7 might be closer to the truth...and I don't think that's even descriptive enough. I'm a wreck.

I have a 3.5 year-old son who is the air I breathe. I am in the process of finding a professional to evaluate him for what his regular pediatrician suspects is ADHD and ODD. Tomorrow, I will be making more phone calls to doctors on the list the pediatrician gave me in the hopes that I can find someone who will accept the insurance I carry so that I won't be bankrupted in the process of getting the help my son (and his father and I) so desperately need. I have known for a long time, probably at least 2 years, that something just didn't seem right with my son. I am a high school teacher and deal with defiance on a daily basis at work. My son, even at 2 years old, put even the most defiant of my students to shame; at 3.5 years old, my son is now putting me through hell on a daily basis. I'm just about ready to come unglued.

I have been ravenously reading everything I can get my hands on, and I feel 6876549746% certain that he has, at the very least, ODD. I know we need a professional diagnosis to be sure, but it would blow my mind were he not to be found to have ODD: every single one of the criteria is a frightenly perfect fit for my son. In the meantime, before going to the doctor, I have been reading books I've seen recommended on different sites. I have ordered Greene's "The Explosive Child" and it should be to me within a few days. In the past week, I have read two other books in my attempt to begin to understand what could be going on in my son's head. I have read "Your Defiant Child" (Dr. Russell A. Barkley) and "The Defiant Child: A Parent's Guide to Oppositional Defiant Disorder" (Dr. Douglas A. Riley). Both books had me reading with tears running down my face because it was like reading a book written about my Noah. Maybe I was crying because both books offer hope for help and improvement, or maybe it was due to relief of knowing that it's really NOT all my fault and there are other perfectly good people out there who have kids like mine.

I can see that the book by Ross Greene is very popular among members on this forum. Has anyone read either of the other books I mentioned? They take two very different approaches to dealing with a defiant child, and I was curious to know what opinions or experiences others have had with these two approaches.

I am sorry for the incredibly long first post. Thanks for reading it if you managed to stick it out! I look forward to interacting with people here; it's good to know that I'm really not alone in this battle.

 

[Diabolique]

I'm sorry to reply to my own post, I just have one other question. I checked the FAQs and couldn't find a response to this: what does the difficult child mean? Pardon my ignorance, most of the time I know the lingo or am able to figure it out. This one has me stumped.

 

[BusynMember]

Be careful. ODD rarely stands alone as a diagnosis--all the kids here have ODD traits, but that isn't the cause of the ODD.

I think most of us have also read "The Explosive Child."

How was your child's early deveopment? Social skills? Eye contact? Anything on either side in the family tree--mood disorders, any form of autism/Aspergers, substance abuse?

ODD appears in all childhood disorders. I recommend, even at a very early age, a neuropsychologist evaluation--they are the longest, most intensive and in my opinion the best. They know about both psychiatry and neurology, whereas therapists just know a little about psychology theories. With many disorders behavioral therapy just does not work and, as always, the earlier you catch a problem, the better the prognosis. Do NOT bank on straight ODD!

Welcome to the board.

 

[Diabolique]

Thanks for your reply and kind welcome. I am definitely not banking on just a straight diagnosis of ODD. The reading I have done indicates that ODD rarely stands alone and is often (even usually) part of a behavioral disorder "package." My son's pediatrician strongly suspects ADHD, and I have the same suspicion. My son exhibits *many* of the symptoms of ADHD, and *all* of the behaviors associated with ODD.

My son was born just a couple of days beyond my due date via emergency c-section. He was a little peanut at 5 lbs 10 ounces and 18 inches long. He was never able to latch on and was then swtiched to soy when colic kicked in when he was 2 weeks old; it lasted until he was about 8 months old. I thought I wouldn't survive it. He had some sleep problems early on, but those have all worked themselves out. He's quite bright and has exceptional verbal skills; he speaks like a very short adult and has extensive vocabulary and the ability to tell interesting and creative stories. I've not noticed any issues with eye contact -- he can maintain it when he wants, turn it into a death glare when he's being defiant, or avoid it when he wants to pretend my requests don't exist. Recently, I've noticed an awful lot of death glares when he's angry and then refusal to make eye contact when he wants to dismiss me. He gets along pretty well with the kids at his kid's morning out program, though he is prone to being VERY bossy with other kids and putting his hands on kids (not hitting, but handling) when he shouldn't. In a group of kids, even when kids are much older than he is, he tries to run the show and he becomes wildly angry and throws fits when other kids don't follow his directions. In addition to thinking he is MY equal, he seems to think that there is nobody over whom he cannot exercise his will.

On my side of the family, there are some issues with depression (me, father, uncle, grandfather -- the last 2 committed suicide) and eating disorders (me, my aunt). On my son's father's side, I don't know of any mood disorders, but there are other health problems. I suspect my son's father to have some sort of Learning Disability (LD), but I don't know exactly what it is. Son's father is prone to occasionally drinking too much when he's upset, but I wouldn't say he's an alcoholic.

I will be getting him in ASAP for diagnosis. I have been given a list of doctors to call -- I will have to find out who can do a neuropsychologist evalutation. He is set to go to pre-school this year and I'm having nightmares about how that will go. As a teacher, I know first-hand the effect that ONE defiant child can have on a classroom, and I don't want to subject a teacher to what I am subjected to on a daily basis. And, I don't want my child to be short-changed in his learning due to behavioral problems.

 

[Sara PA]

Being defiant is a normal characteristic for 2 year olds. It a part of the maturing process as they learn to separate their identity from their parents -- particularly mothers. And, lacking the reasoning power, verbal abilities and social skills of high school students, I would expect a typically defiant two year old to put a high schooler to shame. That's why temper tantrums are considered childish, even babyish.

 

[Andy]

difficult child = Gift From God

I see no one has answered that question for you yet. The others have been covered by those who have more knowledge than I do.

I think sometimes when a child has exceptional vocabulary skills, it is hard to see him or her at their age. I know that was an issue with my easy child - at age 3 she had a vocabulary of a 5 year old. Being the size of a 5 year old also didn't help because when she acted her age, I would get diapproving looks from people who assumed she was older and should behave differently. I was constantly reminding myself that she was still younger than she looked and sounded. And because she knew a lot of words, didn't mean she understood any more than a 3 year old.

I did look into this a little bit this past Spring. I came to the conclusion to be as positive as possible around my son who at the time was displaying some ODD behavior. I did whatever I could to prevent him from feeling that he was being judged or viewed as unable to do something. For example, it is common for parents to say, "Please put your glass further on the table so you do not accidently knock it over." ODD children may reply, "I will not knock it over" or "Like this?" as they show what will happen if they do knock it over. They take it that you are sure they will mess up or that you do not trust them. Instead say, "Everyone's glass is put past their plate." They don't feel singled out.

I think sometimes defiant behavior comes to play when a child really doesn't know how to accomplish a task or feels he/she is unable to. (Sarah is right, 2 years old are common for this behavior as their way of learning who they are - if it continues into school age, there may be something else going on.) They don't have the tools to explain why they can't/won't so they just refuse. Then we try to reason and they are not really old enough to know how to reason so we get frustrated.
For example, "Time to go to bed" "No, there is a monster in my room"" So parents take child to room to show there are no monsters but child can not be consoled. Lots of arguments, child lays down, parent turns off light and child starts to scream, "Monster". Parent returns to find a shadow cast on the wall that the child thinks is a monster. Child doesn't understand about shadows, he/she just knows there is a monster in the room. What parents saw as defiant was really child unable to face the task of going to bed because of the monster. (so when checking for monsters, turn off the light )

Be positive in the rules and try to figure out why the child is disobeying. Sometimes it can be outright disobedience but many times there will be a good reason.

Non-personal statments whenever possible; "The light needs to be turned off" - instead of "you need to turn off that light."
"Today's clothes are on the bed" instead of "Your clothes are on your bed" Decrease any chance of a challenge. "We need to leave in 5 minutes, can you be ready? Do you need anything?" If you had a guest staying, you wouldn't yell, "Get your stuff on, we are leaving in 5 minutes." You would say, "We need to leave in 5 minutes." or "Can you be ready in 5 minutes?" or "How long do you need to be ready?"

I hope that makes sense. By being positive, your child may realize some day that it is really is no big deal to have the glass in front of the plate or to turn off the light when you leave the room. We just do these things, nothing to fight about. And, we work together to meet schedules (getting out the door in time).

Behaviors may be normal for a certain age, however, if the behavior is more intense than normal, then you should start figuring out if there is something going on.

I hope you find answers for your family.

 

[BusynMember]

Just a note (thanks for the explanation). First of all, I've raised five kids (youngest is twelve now). The only one who was overly defiant was my autistic spectrum kid. Most kids who are two may have a short meltdown, but it doesn't last for a long time or turn violent nor do most kids really act up, even at two. It's their first quest for freedom, but it doesn't usually extend to being THAT difficult--if it feels over-the-top, it probably is. Since I had kids to compare my autistic son with, I *knew* he was not a "normal" type of defiant. I knew something else was going on too. ADHD/Autism Spectrum Disorders (ASD) have similar traits, however it's kind of like ADHD carried to the extreme.
An extremely precocious vocabulary is kind of a red flag for Aspergers. They talk like "Little Professors." Anyway, glad you're going for the neuropsychologist exam.

 

[SRL]

Welcome Diablique, I'm glad that you found us.

Whenever we hear a parent describe their child as talking like a miniature adult in conjuntion with behavioral issues, our radar screens start blipping like crazy with Asperger's Syndrome. It is no guarantee that's the cause but it's very important that it be considered as part of an overall assessment with a specialist who is experienced in diagnosing/ruling out Autistic Spectrum Disorders. It's also very important that parents do their homework because it's frequently missed in early ages--sometimes just because it's not recognized and sometimes because it's atypical in that one of the major earmark traits isn't standing out. Sometimes that might be eye contact, sometimes the child is more social than is expected, etc.

ODD/ADHD is a fairly common starter diagnosis reported by parents here who later find out that something more is going on.

In a child who is age 3.5, you'll want to take a close look at play behaviors. Usually around this age there will be obsessions, and often about topics that typical 3 year olds wouldn't be interested in: rocks, geography, the alphabet or words, bathroom fixtures, numbers, etc. Often a parent will see toys or other household objects being lined up in straight lines or formations or a lot of sorting by color. Collecting rocks, string, sticks is something else to watch for.

Echolalia is pretty common--the adult sounding speech often is memorizing chunks of speech from books or TV and then repeating that back in various settings instead of inventing their own speech. Repeating back questions instead of answering them is another thing to watch for.

Many kids with AS or AS tendencies will have sensory sensitivities, and many of them were difficult infants because of it. Here's an introductory article. See the book The Out of Sync Child by Carol Kranowitz if anything here is ringing a bell.
http://www.tsbvi.edu/seehear/fall97/sensory.htm

Sorry, I haven't read the books you've mentioned. The Explosive Child has worked so well that I stopped there but I'll be interested to hear your report of how the strategies compare.

 

[klmno]

I just happened to glance through this post and wanted to point out that depression is a mood disorder. You said your family has experienced suicide and eating disorders. I would say that there are mood disorders there. Not that it can't be or might not be something completely different with your little one, but I wouldn't rule anything out yet.

 

[Diabolique]

Thanks again for all the replies...and for the explanation of what difficult child means! It's funny, while I was helping my son brush his teeth last night, all of a sudden '''Gift from God" came to me as a possible meaning for difficult child. Happy to see I was right!

People say that a mother's instinct is so strong that she often knows when something is not right with her child even when others don't see it that way. I have had so many people, some of whom don't know my child at all, tell me "it's probably just a phase" and "he'll outgrow it." When people say these things to me, it hurts me because I feel like it minimizes the gravity of the problems I am having with him. I'm sure other people on here have experienced the same thing at times. Truly, I feel that if my son's behavior were in the "normal range," the human race would have ceased to exist because people would look at other people's children and think: No way, I'm never having kids. I know in my gut, in every fiber of my being, that something is just not right.

Adrianne -- Thank you for the suggestions on how to rephrase the requests I make of my son. I have already tried to reduce the "negativity level" by not using "no", "not" and "don't" so frequently, and I'm trying very hard to resist the temptation to raise my voice unless he's doing something that puts him in danger. I will try to depersonalize my requests to make them more neutral to see if that helps. As it stands right now, Noah rarely does anything the first time I ask him, no matter how I phrase it. He usually waits until I'm upset and angry and doling out a time-out and THEN he will try to comply. By then, I'm already past the end of my rope because I've asked about 10 times.

SRL-- I had never thought of AS as a possibility. I don't know that much about AS, so I'll have to do some reading up on this; thanks for the link. When my son was younger, he did do a lot of organizing and lining things up. I would come in the room and find all of his dinosaurs lined up perfectly in a row that extended all the way across the room. He would do the same thing with his cars. He doesn't do it as frequently as he used to maybe a year ago, but he does still do this occasionally. He will line up all his lizards (or cars, or dinos) all the way around the outside edge of his round play table; all will be facing the same direction outward. Or, sometimes he'll line things up in a pyramid type of formation, or using the lines on the tile floor as a guide. I haven't noticed him collecting sticks, strings, or rocks. However, he cannot get enough little "critters": play lizards, bugs, dinosaurs, and snakes. That seems normal to me? When I say that he speaks like a "short adult", I mean mostly that his vocabulary is outrageous for a child his age. He uses words that most kids his age don't seem to use and he uses them in the appropriate context. I have always attributed this to him being exposed to mostly adults. When I am at work, it is my mother who cares for him and we've always believed in not using "baby talk" with him, even when he was very young. We never used words like "ba ba" for "bottle" or did that thing where you add "-ie" to the end of a word (kissie, huggie, juicie, etc.); I honestly can't stand hearing that so I made sure not to model it. I have noticed, though, that my son has quite a memory for things he's heard other people say and I have heard whole chunks of other people's words (mine, my mom's, etc.) come out of his mouth. There have also been occasions where I've read him a book once, and the next night he'll "read" it to me -- he will turn through the pages and boggle my mind by reciting the book word-for-word. For the most part, though, most of what I hear him say are his own words rather than memorized speech; at least I think so. It has always just seemed to be that he has a extraordinary ability to pick up new words and use them correctly. Who knows, though...maybe this is really a sign of something else.

What I know at this point is that the level of defiance is out of hand. Trying to describe it would take hours and hours. I feel like we're doing battle 24/7. I am amazed at how mouthy and hurtful my son can be. Just Saturday morning, I was watching him play on the slip-n-slide and smiling because he was having so much fun. You know how we do that, we smile to see our children smile. All of a sudden, he stopped dead in his tracks, glared at me with narrowed eyes, and put on his tough guy stance with balled up fists. He looked me in the eye and said, "Don't be happy, Mommy. You are not allowed to be happy." I was devastated. He has said plenty of awful things to me before, but there was just something about this comment that tore me up and I instantly dissolved into tears. I still get tears in my eyes when I think about him saying that to me. Happiness is a basic human desire, it is something we all want. All I want in the world right now is to be happy again and to see my son happy; apparently, I am not allowed to even have a momentary smile on my face at the sight of seeing my son have fun. And, what did my son do when he saw me crack and start crying? He laughed at me. He thought it was funny to break me like that. It was so completely out of the blue, we weren't arguing when he said it, I wasn't making any requests of him, I was just watching him and smiling.

 

[Diabolique]

I just happened to glance through this post and wanted to point out that depression is a mood disorder. You said your family has experienced suicide and eating disorders. I would say that there are mood disorders there. Not that it can't be or might not be something completely different with your little one, but I wouldn't rule anything out yet.

The mood disorders -- depression and eating disorders -- are on my side on the family. I might not have been clear in my original post, but I think I said that I'm unaware of any mood disorders on my son's father's side. Sadly, I'm aware that they exist on my side of the family

I'm definitely not ruling anything out. I will do whatever I have to in order to help my son and our family. This has really taken a toll on all of us.

 

[SRL]

The lining up that you are describing is very typical for kids with Autistic Spectrum Disorders. Sometimes seen in other kids but not usually to such a degree in neurotypical children. Your description of his language would fit as well. Kids who are exposed to mostly adults do not necessarily speak like adults, even if they skip the baby talk, etc.

Again, we're not diagnosticians but based on what you are describing I would research that thoroughly keeping in mind that all children will not exhibit all traits and that some traits may not emerge until later.

I know his defiance is what brought you here but the reason that we urge parents to have the child thoroughly assessed and to do their research is that understanding the reasons behind the behaviors is critical in dealing with it. A mother who is devestated by the fact that her son says hurtful things can get stuck in the hurt and anger whereas a mother who recognizes that her son says hurtful things because he isn't naturally grasping appropriate social interactions is empowered to seek out help. I can't say it would totally eleviate the pain but it will put a whole new perspective on it should you find some underlying neurological condition.

Parents on this forum generally find developmental and behavioral pediatricians and pediatric neuropsychologists to do the most thorough job. If Autism Spectrum Disorders (ASD)'s are suspect then an Autism Clinic (usually at a university or Children's Hospital) is a really good route to go. I'd like to see him assessed by an overall specialist plus Occupational Therapy plus speech/language. Get as much in terms of assessment as you can do up front.

http://www.oreilly.com/medical/autism/news/getting_diag.html

 

[Diabolique]

Parents on this forum generally find developmental and behavioral pediatricians and pediatric neuropsychologists to do the most thorough job. If Autism Spectrum Disorders (ASD)'s are suspect then an Autism Clinic (usually at a university or Children's Hospital) is a really good route to go. I'd like to see him assessed by an overall specialist plus Occupational Therapy plus speech/language. Get as much in terms of assessment as you can do up front.

Thank you so much for the suggestions. My doctor has given me 4 different names of people to call. Two of them appear to be "counselors" (they have MALMHC and LMHC "titles"). One of them is a PhD Licensed Psychologist, and the last one is a MD Psychiatrist. I am not even sure where to begin; I trust my pediatrician and know he must trust these people to give out their names. But, I don't know who does what in terms of testing and evaluation. Oh, and then there's the checking to see who will accept our insurance.

You're right, I am so hurt by the things my son has said to me. When I ask him why he says these things or why he does the things he does, his answer is always the same: "I don't know." At first, I thought he was being cheeky. I have recently come to realize, though, that he REALLY doesn't know why he says and does certain things. The knowledge that Noah really doesn't know has given me the strength to step back and start doing something. He doesn't know why he does things that make everyone (including himself) unhappy, and he needs help. Moving away from my prior thinking that he really intentionally means to hurt me or annoy me to the point of insanity has been the thing that has (barely) kept me glued together.

 

[SRL]

Call the pediatrician back and tell him that you want to make sure that Autism is included in the evaluation and see if these are still the specialists he would suggest. Also tell him that you would like to have a more thorough evaluation done to include speech and Occupational Therapist (OT) and see what they can come up with.

Also be aware that if the type of specialist your child needs to see isn't within your system, the pediatrician can write a letter to the insurance and often get them to cover an out of system.

 

[klmno]

My suggestion would be to call the psychologist and ask if they do neuropsychological testing (some do but others only counsel). If they do, see if you can get that set up. I would also make an appointment with the psychiatrist (psychiatrist). If the psychologist does not do nueropsych testing, you could ask the psychiatrist to recommend one that does when you call to make that appointment. Chances are, the psychiatrist won't prescribe medications until after the testing results are in, which is actually a good sign, but he/she could be getting familiar with you and your child's situation during a couple of appts in the meantime.

These are just my thoughts...

PS- I just read SRL's response- I agree with that, too, but in some cases, the psychiatrist might be able to recommend better specialist than the pediatrician (at least, it is that way here).

 

[Diabolique]

I have spent all afternoon making phone calls and doing online research trying to find a place to take my son for an evaluation.

I called the psychiatrist and the psychologist that my son's pediatrician recommended and they are both outside of my insurance network. I should have assumed that would happen.

Then, I called a well-known and reputable center for child development recommended by a bunch of people at the school where I work. They also don't accept my insurance, of course. Their cost for the initial evaluation process, consisting of two fairly lengthy appointments is $840. Follow up appointments are $155 for 30 minutes. Wow. I know that's not unusual, but wow...I just don't have that kind of money.

Finally, found a group of behavioral pediatricians at a children's hospital that is associated with a university in Tampa. Check them out online and it looks like just the kind of place I need to take my son. I call them and WOO HOO they accept my insurance plan! They are currently scheduling apointments to do evaluations FOR OCTOBER. I am like a deflated balloon at this point.

Tomorrow, I need to call the insurance company to find out what percentage of visits to doctors outside the network they will cover, what the co-pay is, etc. This is totally unchartered territory for me. I know that I cannot wait until October to get the ball rolling, I even told the secretary that I didn't know if any of us would survive that long!

Once I have some idea of what it will cost me to go out of network, I may go back to the doctors that were recommended by the pediatrician, just to get something going and feel like we're moving forward. Right now, I feel like we're standing still and like there's no help in sight. We may still end up at the children's hospital in October, but I just feel like I have to get something going as soon as possible. I need help. I need some answers. I need to know that there is something that can be done.

 

[tiredmommy]

Ask to be put on the cancellation list and be ready to drop everything to get there if you get a call.

 

[Diabolique]

I am going to be making a bunch more calls tomorrow, including one to the pediatrician to have him fax the necessary stuff over to the children's hospital. Then, once they've received the information, I'll be able to schedule the appointment -- at which point, they'll probably be setting up appointments for November! I will ask to be put on the cancellation list, thank you for that idea.

Do you think it would still be a good idea to get set up with either the child psychiatrist or psychologist recommended by the pediatrician? I don't know if they are able to do the same type of evaluation as the children's hospital group, but maybe we could benefit in the meantime from something...anything...I don't know. I feel like I may come unglued if we really have to wait until October for help.

 

[SRL]

If it were me I would definitely wait on the psychiatrist. I'd ask around and find out the reputation of the clinical psychologist. Google Autism Society of America and look for a chapter in your area. Ask one of the local parents aobut the specialists in your area.

I know it sounds horrifyingly long but 3 months is typical, and even pretty good compared to the one year wait on the east coast. You will have plenty to do filling out and returning forms--I did about 40 pages of paperwork in advance and after I sent in the first round I had to send in a second. They will likely be asking a lot of detailed questions you'll have to look back to calendars, etc. to find answers for.

I know it's a lot of money but $840 is pretty cheap for this kind of assessment. Hopefully the insurance approved diagnosticians will work out for you.

I'd still put a call to the pediatrician and tell him you want your son to have speech/language and Occupational Therapist (OT) testing done. You can also ask when you schedule at the developmental peds and they can refer you. Sometimes the waiting list for that isn't as long and if you can get through that you can bring those results along. Tell the pediatrician that you're seeing some signs of echolalia and adult sounding speech and he shouldn't argue with you.

I've been in your shoes and know how frustrated you are. Trust me when I say it's worth the time to get a thorough evaluation up front so you can work out a plan for helping him that's right for his issues. In the mean time, read The Explosive Child and the thread about the book at the top of this board. Put everything that isn't critical to safety on the backburner. Do that and I think you may see things going a little easier for you.

 

[Andy]

Wow!! Does he ever have your emotional buttons labled and place within his reach. Time for you to practice detachment big time.

Next time he says something mean to you, pretend you are a psychologist trying to understand what he just said. Very nonchalantly ask, "Why would you say that?" Make it as a curious question, not a challenging accusation. Use a that is interesting attitude.

It also may be time to start calling him on this. When he told you that you are not allowed to be happy, you can confidently reply, "Oh yes I am. Everyone is." If it does get nasty, he can get time outs for this also.

I need to go now but will think some more on this.