New to the site, need help have a 5yr old with ADHD and Defiance disorder

Discussion in 'General Parenting' started by maverik767, Mar 30, 2011.

  1. maverik767

    maverik767 New Member

    Ok, so I am reaching out cause I am at my wits end and I am out of ideas on what to do. I am in a relationship with a wonderful woman and getting married in October. She has 2 kids that are living with us, 5 and 13. The 5 yr old has been diagnosed with ADHD and behavioral defiance disorder. He is currently on Intuniv. We have setup a reward/sticker chart for him and have tried everything from being nice and rewarding to yelling and nothing seems to work. We got a very disturbing phone call today that he struck another child in school in the stomach, this is after we have told him numerous times that if a child is "annoying" him he is to tell the teacher and NOT to hit or touch ANYONE. I am furious and so is his mom. We decided to take away all toys that had anything to do with violence with no chance of him getting them back as well as banning him from any movies or tv shows with any hint of violence and he is not allowed to play any games that show aggression at all. I am so fustrated and at my wits end. If anyone has any ideas on how not to flip out on a child who is repeatidly doesnt listen and defies everything that is said to him please let me know. We have limited his sugar intake and watch what he eats, and completely cut out fast food. I need help, I love him and dont want to scar him but I dont know what to do. Please help...thanks.
  2. nvts

    nvts Active Member

    Hey Maveric! Welcome to the crowd - awesome group with a VAST amount of experience.

    Quick questions (my 2 year old is practically in my lap!): Who gave him the diagnosis'? When did the issues start? Have you noticed anything as far as possible sensory issues (do certain smells, tastes, textures - I call it "itchy tag syndrome" -, foods set him off?)? Has he had a neuropsychologist done?

    Here's the thing. None of us on here are doctors, so we can't diagnose, but with his diagnosis, it usually speaks to a different "overlying" problem. All 3 of my older kids started out with ADHD and Oppositional Defiance Disorder - turned out to be Aspergers syndrome. It's not a sentence of horror - it's working on adaptations.

    Check out the book The Explosive Child - it'll give you a little insight on ways to deal with him and you'll better understand what may be going on in his head.

    Trust me, you're not alone in like this can drive you off your nut! I truly respect that you're concerned about how you'll influence his life - the one thing I can tell you is that you have to let him know (almost constantly) that you love him. Make sure that there are hugs, tossing a baseball around, playing games, etc. Encourage him to talk about his feelings rather than acting on them, and make sure that he feels accepted by you. It'll be key with him when he gets a little older.

    Keep posting, ask a lot of questions and know that there are a lot of ears and strong shoulders here!

    Again, welcome!

  3. Malika

    Malika Well-Known Member

    Welcome. I really do second what Beth said about giving your little boy lots of love and affection. I have seen a BIG improvement in my son's "defiant" behaviour since I stopped getting angry with him over his behaviour all the time and since I have started very consciously showing him that I love and appreciate him. People - including children and adults - get into negative cycles of communication that make things much worse.
    About the hitting... I know you have told him that he must never hit anyone but as you know ADHD involves poor impulse control. And all children of that age are still learning to express themselves with words rather than gestures. It was not good, of course, and the boundary needs to be made clear but I personally don't feel it was some terrible crime he has committed. I have seen perfectly "normal" kids of this age and even older hitting each other, either in anger or play. Good luck - I know how hard it is sometimes.
  4. HaoZi

    HaoZi Guest

    Has he gotten better or worse since starting the Intuniv? Not every medication is right for every kid, some can be worse on certain medications. Not saying this is the case, but it's something else to watch for.
  5. AnnieO

    AnnieO Shooting from the Hip

    I'm probably going to be unpopular here... But... Taking everything away isn't going to work with a 5-y/o. Especially not one who has problems with impulse control. I'll be honest - I'm mostly a easy child, myself (hee hee), but if I'm bored? I can get into large amounts of trouble. And I get frustrated. And it escalates from there. (Honestly, this board has kept my brain working enough that it's probably helped me keep my job.)

    Behavioral charts don't work too well on a lot of our kids. Yelling just makes things escalate faster. If the child can see "no chance of getting them back"... Then why be good? If there is no reason to be good... Yes, we tell ourselves that we should be good because that is its own reward, but when you're 5... Even a so-called "normal" child would have issues with that.

    Something that I found works - when I can actually do it - is a monotone, showing disinterest in whatever the drama is. Then again, my kids are a bit older. I got Onyxx good yesterday... "And how is that working for you?" ...No answer...

    Do you know why he hit the other child?

    Babies cry when they need something. That's what they can do to express themselves. Young children haven't quite got words down - and when you add in ADHD and poor impulse control - WATCH OUT. I get frustrated sometimes and feel like being violent. I can reason myself out of it - if I hit the wall, I will have to patch the hole, and my hand will hurt - but kids can't do that. (And FWIW? I can't always stop myself, either.)

    Is his bio father in the picture? Sometimes... That has a lot to do with it.

    Hugs - and welcome.
  6. maverik767

    maverik767 New Member

    Thank you all for your replys and insight...We only took away all the agressive and violent toys not all his toys, we are trying to keep all the agression away from him. first the doctor thought he might have aspergers but in the following months and a little over a year already almost 2 he doesnt think he has that. Hitting any child in wrong and the boundaries were set and he crossed the line. I have been in his life since he was 21/2-3yrs old and his so called father aka sperm donor hasnt been in his life since he was 18months old. His "father" also has mental issues so it explains alot but dealing with N (the 5yr old) is so fustrating and I dont want him kicked out of school or worse. I tell him all the time I love him and try and play with him. I will look into that book and read it cause right now Ill try just about anything besides just ignorning it. Hes been on Intuniv for about 2months and the doctor has just increased his dosage from 2mg to 3mg, we need to get the 3mg filled so he hasnt been on it yet. The worst part of all of this besides the physical attributes of what he is doing is that it is causing an extreme amount of stress between me and his mother and is taking away a lot of attention from his older brother who also deserves attention. I'm really torn and dont know what to do. If anyone is in NYC(queens) and knows of a place that does family counseling and takes empire BCBS please let me know cause we want to get him and all of us into counseling. thanks for all the help so far.
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    You say the father has mental health issues? If so, this could have been inherited. I think it's a good idea to get intervention ASAP. The earlier, the motto is "better to be safe than sorry." While some people wait and just hope things improve, that is dangerous in my opinion. While a small percentage may improve, most troubled kids become even more troubled as they get older...we are not equipped to help them on our own.

    Good luck and I hope you find a wonderful professional.
  8. nvts

    nvts Active Member

    Hey Maverik! Why not get a full-blown neuropsychologist done? There are plenty of good hospitals around you and in NYC (Manhattan) that could do a great diagnostic on him. While psychiatrists are trained on kids and their issues, a neuropsychologist will really dig in with the testing to see what the total diagnosis is. He might not be an aspie, but he could have Pervasive Developmental Disorder (PDD) or something else developmentally. If that's the case, some adhd medications could make things worse instead of better.

    I'd call Empire BC/BS and find out which facilities are in-network and see if you need a referral from your pediatrician. It'll give you a more "slimmed down" area that you can direct your efforts in.

  9. rlsnights

    rlsnights New Member

    Welcome and you sound like you are a really caring and committed guy. Congratulations.

    Family therapy will be really helpful in clarifying some things and improving the family's well-being. You and your wife to be will have to be on the same page with parenting styles if you want a strong marriage and that can take a lot of education and on-the-job training that is stressful.

    I strongly agree with the others who have suggested that this child needs further assessment to help you understand what is going on with him. Going through your health plan for a neuropsychologist assessment is a very good start.

    And, frankly, lots of 5 year old boys hit other kids. I would want a lot more info about what was going on before I decided how strongly I was going to react. Not that it is wrong to make it clear the behavior was not OK. But the details are important. For example, there's a big difference between getting up and walking across the room and randomly socking a kid half your size so hard you knock them down and being in line for lunch and getting shoved over and over until you finally turn around and hit the kid behind you.

    I would also suggest that, if he doesn't already have an IEP for Special Education services, that his mom request that he be assessed for special education services right away. It's nearly the end of the school year and it may be possible to get the school to do some assessment before year's end that will help to guide his school situation next fall or later this year if he's in a year-round school. I would insist that they do a thorough speech assessment. Kids who are on the Autism Spectrum Disorders (ASD) spectrum often have language processing problems that will respond to intervention or that can be addressed through accommodation.

    Gathering a biological family health tree that includes both physical and mental health info will be a useful tool for the neuropsychologist to review. Things to include are the obvious physical stuff but also any diagnosed or undiagnosed but suspected mental illness. If possible you want to go back 2 or 3 generations. Addictions like alcohol and drugs should be listed as these are often signs of untreated mental illness.

    In the meantime, reading The Explosive Child together with your sweetie will help you figure out some practical things to put in place now.

    If you suspect that the medications are making his behavior worse you need to discuss that with the doctor.

    Keeping a behavior journal is really good because it gives you and the professionals solid info to use when trying to make sense of the day to day stuff. Noting his activity level, whether he took medications, changes in medications, rages, unusual events like a sleep over or illness, any mood issues you notice that seem unusual to you, any odd speech patterns, how much he's sleeping - all good stuff. Can help you discover patterns you didn't even know where there.
  10. maverik767

    maverik767 New Member

    nvts-He was originally diagnosed with Pervasive Developmental Disorder (PDD) and ADHD but the doctor at LIJ feels he does not have Pervasive Developmental Disorder (PDD), but does have ADHD with ODD. What is the difference between a psychologist ( or whatever their names are who can also give medications) and having neuropsychologist testing? He was tested at the docs on certain things, behavior, adaptation, how he plays and other stuff like that already.
    rl-We have had an IEP assessment done and the school feels he needs occupational therapy and in school counseling. We are working hard with him on his reading and writing skills as they are lacking, but progressing. He does pretty good when its one on one but the minute your attention wavers or anything he starts acting up or not doing his work right. I actually just picked up the book The Explosive Child today and am going to start reading it as soon as I can. As for the hitting it wasnt a one time incident, he has been caught pushing other kids and being very rough with them as well as telling other kids very mean things. As of right now he has been doing a lot better but he still needs the constant reminders and ques to behave and listen.
  11. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Why do they feel he doesn't have Pervasive Developmental Disorder (PDD)? He sure has a lot of symptoms.

    A neuropsychologist will usually do 6-10 hours of testing on every area of functionality, both psychiatric, adaptive, social, intelligence and executive function. They are psychologists with extra training in the brain (this last part is important). ADHD/ODD is sort of a default diagnosis that is usually the first one given to a young child. However it is often wrong and changes. If there is any chance he may be on the autism spectrum (Pervasive Developmental Disorder (PDD)), he needs help in all areas of function as early as possible. My son is on the spectrum. We also got ADHD/ODD as the first diagnosis. But that was not it.

    Good luck, whatever you decide to do.
  12. nvts

    nvts Active Member

    Hey maverick! A neuropsychologist is a doctor that knows the neurology AND the psychiatry behind the person being tested. A lot of our kids end up with the ADHD/ODD diagnosis early on because their Pervasive Developmental Disorder (PDD) is SO high functioning that it falls into the cracks. A neuropsychologist will test all kinds of stuff as well as take into consideration the behaviors and character traits that show within the child.

    One of my biggest concerns for your little guy is that he's not going to get the appropriate interventions on the social skills that he's lacking. How to handle frustration, anger, etc. in a socially acceptable manner. As they get older, the more people (including us parents!) start to view it as willful, spiteful and really start to feel that they're just being manipulative.

    I'm also concerned that he may have some sensory issues that the trained eye might be able to ferret out and address before his behavior is shaped by the guarding created by them.

    Got you guys in my prayers...!