ODD in young children

[biracialkids]

When I finally talked to mental health and said I suspected ODD the intake worker told me he was too young for that?? My son is 4 years old, and somehow I can't believe that ODD crops up when a child is older, wouldn't this be something that is always there?? Isn't that why they ask about what the child was like as an infant??

 

[smallworld]

It is best to think of ODD as a symptom, not a diagnosis unto itself. ODD is generally a set of behaviors that arise as a result of an underlying condition (like ADHD, mood disorder, autism spectrum disorder). When the underlying condition is diagnosed and treated, the ODD behaviors typically improve.

Doctors ask about what the child was like as an infant because early development gives clues about diagnosis.

 

[Ltlredhen]

You have asked the million dollar question for sure, lol.

From what I've read, people feel ODD is more of a symptom of some underlying problem. Figure out what is the "original" disorder and manage that and the ODD goes to the background.

I'm sure there will be others around to explain that much better than I could.

Donna

 

[biracialkids]

Yes I've read that ODD is typically the secondary thing, however I can't figure out what the original is, I'm not a doctor so I know I shouldn't bother but I can't help myself. I don't believe it is ADHD because he's not hyper, implusive and he does have a good attention span if it is something he likes.

I just don't see how they can say a child has to be a certain age before it is ODD.

 

[tiredmommy]

Some doctors are leery about giving a diagnosis in a young child as many behaviors could seemingly be considered developmentally appropriate. Smallworld is right that they look the child's total development to come up with a working diagnosis. What that means is that the treatment will be coded as such-and-such a diagnosis for insurance and also to seek early intervention services from the school district. Most parent's find that their children's diagnosis changes as their child grows and matures. One thing you can do to be well prepared for an evaluation is write up a parent report, this way all evaluators have your son's pertinent info at their finger tips.

 

[biracialkids]

Thank you for the link, very helpful information and I will start to put that together.

 

[smallworld]

Most good child psychiatrists won't give out the diagnosis of ODD at all. My difficult child 1 probably meets in full the criteria for ODD, but he has never been diagnosed with it. That's because his mood issues and ADHD drive his ODD behaviors. There is no way we could have figured out at age 4 why he was defiant. It took observation over time, a lot of neuropsychologist testing and an excellent psychiatrist to put it all together for us (and we're still working on finetuning the diagnosis).

As TM suggests, the best thing you can do is describe in great detail (without editorial commentary) the behaviors you see and under what circumstances they appear. In addition to the parent report, you might want to start a daily journal of your difficult child's behaviors.

 

[PJD123]

So far I'm convinced that my difficult child's ODD diagnoses, by a well respected Phys.D, is correct! He was diagnosed at 3.5 and the dr. said it's too early to see if he has anything else, but he definitely has ODD.

 

[tiredmommy]

You are both correct. ODD is a stand-alone diagnosis with it's own criteria and listed in the DSM. Most children with ODD who also have an underlying condition won't respond to therapy or behavior modification unless their underlying condition is effectively addressed.
An analogy would be obesity and heart disease. We'll say obesity is equivalent to the underlying condition while heart disease is equivalent to ODD.
Chances are that a person who has lost significant weight after being obese has lessened the negative impact on their heart and circulatory system. Their heart function will improve greatly by taking care of their underlying health problem. The sad fact is, however, that not all people have easily discernible risk factors but they still have heart disease. These would be the folks with ODD as a stand-alone diagnosis in this scenario. It's not real common, but it does happen.

 

[BusynMember]

There are some diagnosis. that tend to not stand alone most of the time though, and ODD is one, as is anxiety disorder. Usually something else will crop up eventually, often a mood disorder. Check your family background. Any mood disorders or substance abuse in the family tree? Any neurological problems? Defiance/ODD is common is almost every childhood disorder, but is rarely the diagnosis itself. It's true that if it's stand alone ODD, therapy alone should work. Otherwise, you'll need other interventions too, such as medication. Good luck :smile:

 

[biracialkids]

Well it is nice to know there is at least 1 other young child diagnosed as ODD, I just found it strange when the intake worker said he was too young for that.

I'm sure there is a mood disorder involved too, most likely bipolar. He snaps from happy to angry in less than 10 seconds sometimes.

 

[Jewel33]

well, my son is only four and I am sure he his ODD! I have an anxiety/deoression disorder and may have adhd myself and his father had adhd when he was a kid and still has some kind of mood disorder so diagnosis or not I strongly believe he had it. The kid is out of control! He can be sweet and kind, he's smart but I swear he has two personalities sometimes and his defiant behaviour is on a every day basis. At school, however, he's shy and quiet but at home he shows his true colors.

 

[Allan-Matlem]

Hi,
Even if your child got a ODD diagnosis it does not tell you much. The diagnosis says what the kid does - deliberately - and not why . It could be temperament , not a skills deficit , it is behavior so behavior management , modification programs are recommended and for the aggression maybe a medication like respiradil. Many professionals don't like the ODD diagnosis and look for the underlying factors. A lot depends how you view behavior - children do well if they can or children do well if they want to. If you see problems in behavior as a learning disability and the kid lacks cognitive skills you will adopt a skills building - working with approach. If the problem is neurolgically- biology based we might need medications together with one of the other approaches .
in my humble opinion evaluating a kid using Greene's pathways- executive function deficits, language processing skill deficits, social skills, emotional regulation skills deficits and cognitive flexibility gives one a better understanding than a diagnosis.

Allan

 

[Nancy]

My difficult child had ODD also, and she had it since she was able to walk and talk. I would rather have my child diagnosed with ODD than with some of the other diagnosis too soon. I could tell you the story of my daughter but it is long. Last year we were convinced she would be living on the street and in and out of jail when she grew up. She is now 15 1/2 and is doing wonderfully. People tried to tell us that she must have something else that was causing the ODD, but it truly was ODD. She defined the word defiance.

Was something underlying that? Probably her predisposition to being stubborn and having little impulse control and her adoption issues and her birthfamily history. But it was the ODD that had to be treated and resolved. ODD can be outgrown. It takes a great deal of consistency and patience. Our daughter is proof of that. Do perhaps some children also have ADD or ADHD or some other disorders that will manifest themselves later on, of course. But there are others who for whatever reason are born with the temperment that does not allow them to exhibit any self control or self comfort and so they act out and defy.

Don't be discouraged. Keep looking for a tehrapist thatmakes sense to you, that will listen to what you say and is willing to find the right approach for you child. Don't fall into the trap of trying to figure out which came first the chicken or the egg. Find coping skills to manage the ODD and as he gets older other things may come into focus.

Good luck, Ihave lived through 15 years of ODD behavior so I'll be happy to share my experiences with you.

Nancy

 

[mightymouse]

Why don't doctors go ahead and give the ODD diagnosis in young children with the recommendation that they continue to be evaluated as they grow older since it is so hard to recognize other disorders at this age? I am having my 3 1/2 yo son evaluated now and know that ODD is part of the problem. If he is given any other diagnosis, I know I won't really take it to heart until he is older. The main reasons I want him diagnosed is #1 so that I can learn how to better parent him and help him with his issues, and #2 he will be eligible to start pre-K at PS next year and if I decide to send him, I want them to know that there is something else going on rather than he is just a brat with and ineffective mom and so they will know better ways to handle him.

 

[momof3boys]

Hi just my 2 cents . . . My son was diagnosed with ODD and ADHD when he was 3 1/2. I learned a lot of good parenting techniques to deal with defiant behavior from books like, "Your Defiant Child" by Russell Barkley. It helped us tremendously. We tried to avoid medication, but by 4 years old, we were willing to give it a try. He now takes Adderall every day, and with that combined with learning how to parent him better he's doing really really well. Don't get me wrong, we still have really bad days, but for the most part, he's doing great. I too was skeptical that a little 3 1/2 year old could be diagnosed correctly, and for a long time I didn't believe the diagnosis. But, guess what? They were right! He does have ADHD, and now that I know how to treat it, he has a much better life than he would have if I had stayed in denial. I have a very close friend who has a little boy with Asperger's Syndrome, and he was also diagnosed at a very young age (3). With the diagnosis, his parents were able to help him with medication and with different parenting techniques, and he's now in a special kindergarten class in the public school that's only for kids on the autism spectrum, and he's doing awesome. If they hadn't gotten an early diagnosis, I really don't think he'd be doing so well. Anyway, the point of all of this is that I do think that its possible to get the right diagnosis at a young age. You just have to find the right person/people to do the diagnosis. It's tough. It can be very difficult for the family if you get the wrong diagnosis, and treat your child with the wrong medication or techniques thinking that he has something he doesn't. But if you do find a great diagnostitian, and get it right, I personally believe that it can make all the difference in the world. Anyhow, good luck. And you're off to the right start just finding this website.