I'd rather deal with the terrible twos anytime than the terrible teens. ACK! lol It just further complicates an already difficult situation in children with neurological disorders....
It can be really difficult to get an accurate diagnosis. Unfortunately, coexisting disorders are the norm rather than the exception for almost any disorder -- including ODD.
I believe the Chandler papers are still on the FAQ/Board Help forum. If I recall correctly, Dr. Chandler addresses the high probability of coexisting conditions.
I haven't done any substantial research on ODD in years, but there was a time that my son met the "symptoms list" criteria. There are just so many behaviors on the list that are also on other "symptoms" lists....
"Oppositional Defiant Disorder is defined as having 4 out of 8 diagnostic criteria on a regular basis, over a period of at least 6 months."
For example the criteria of ODD include(from the DSM-IV-TR)the following:
Often loses temper
Often argues with adults
Often actively defies or refuses to comply with adults requests or rules
Often deliberately annoys people
Often blames others for his or her mistakes or misbehaviors
Is often touchy or easily annoyed by others
Is often angry and resentful
Is often spiteful or vindictive
Going back to how difficult child "presented" when he was 5 - 8 yrs old, he met 7 of the 8 the criteria. I'll put some examples of the unidentified underlying problems contributing to the behaviors.
Often loses temper - yes, emotional problems, language delays, sensory issues, Auditory Processing Disorders (APD), social skills delays, general Pervasive Developmental Disorder (PDD)-not otherwise specified related
Often argues with adults - yes, ADHD (still does -- primarily reserved for parents ARG!!!)
Often actively defies or refuses to comply with adults requests or rules - yes, misunderstood directions, fine motor skill delays, anxiety, sensory overload resulted in frustrations and shuting down.
Often deliberately annoys people - yes, had zero social skills [ADHD], unable to read other's body language [Pervasive Developmental Disorder (PDD)]
Often blames others for his or her mistakes or misbehaviors - yes, ADHD (improved but still happens occasionally)
Is often touchy or easily annoyed by others - yes, sensory integration problems (improved, but still has some tactile defensiveness, texture issues [clothing, food, and smell, loud noises, etc.])
Is often angry and resentful - yes, never really saw resentfullness, but there were anger issues [emotional, anxiety and just trying to climb mountains everyday of his life. We had more than one meltdown. Sigh....]
Is often spiteful or vindictive - no -- there have been a few instances, but never anything that could be classified as "often."
In short, while difficult child met the criteria for ODD, that wasn't the problem.
Thought the following comments from Dr. Sutton might be beneficial: "...Ive always held to the notion that effective intervention must follow accurate assessment. Otherwise, a condition could be treated as one thing when it is actually something else. In such a case not only will interventions not be effective, appropriate diagnosis and treatment are overlooked. This could cause the real problem to fester and worsen.
There are a number of childhood conditions that present much the same symptoms and behaviors as ODD. These include depression, anxiety disorders, ADHD, stress disorders, bipolar conditions, emerging personality disorders, medical conditions and other concerns. An evaluation and diagnosis of ODD must consider all of these and determine that they are not the childs primary condition or disorder, or that two or more conditions coexist (comorbidity). An accurate evaluation of ODD must also determine the severity and impact of the childs symptoms and behaviors over time, exactly how the behaviors affect others, and the overall clinical significance of the disorder as it could affect the growth and development of the youngster. In short, an effective evaluation is a complete mapping of an uncharted region
the inner workings of a child."
Shoot, it even happens that a child has allergies and it presents with ODD behaviors -- just like seizures can. It takes a lot of time to sort it all out.
That's not to say that ODD doesn't exist. It's just that many kids meet the ODD criteria and too many times underlying problems are not timely identified or treated.
Welcome aboard. :smile: