Suspect ADHD with ODD

Arielle

New Member
I am new to this forum. I have an almost 8-year old daughter that I suspect is ADHD with ODD. She was evaluated when she was 3 yrs. old, however, at that time the evaluations were inconclusive. In addition, the evaluation by a neurologist and developmental pediatrician at that time were also inconclusive. I suspected for the longest time there was something wrong and that she had a listening problem and that it wasn't because of a hearing problem. daughter is still in pullups at night since she bedwets. In the last few months, she has regressed and has often done no. 2 in her pants which has prompted me to once again see a developmentsl pediatrician this past November. We are now seeing a child psychologist since November, as well. daughter is defiant and fresh. She refuses to comply with rules and has no respect for my authority as a parent. The more you tell her not to do some type of behavior, the more she does same on spite. She talks back and kicks, screams and hits and always wants to have the last word. She hits her 2 year old brother for no reason. She can be like Dr. Jekyl and Mr. Hyde. She does have a good heart and is really sweet especially if things are going her way. She can be destructive. She has damaged my mom's car. An hour's worth of homework can last for 4 hours at times because she refuses to do same. She is bright. Up until now, she was an A student. Her grades have started to slip since Christmas. She makes careless mistakes on tests as of late. She gives me a hard time about studying too. My husband is in denial about something being wrong and is opposed to medication. He suggests we get a tutor to free up time for myself That will not fix the defiant behavior. I am at a loss of where to go from here. Any advice welcome,
 

Nancy

Well-Known Member
I suspected something was not right with my difficult child when she was not even two years old. However, it took several more years to be able to identify some of the issues we were dealing with, and even then they continued to change over the years.

It's important to have her evaluated again to see what is going on. Others will be along to tell you their experiences and suggest diferent evaluations. We went to our local children's hospital. I will caution you though that even that does not necessarily identify what is causing this behavior. It could be personality or it could be more.

Nancy
 

BusynMember

Well-Known Member
I recommend a neuropsychologist evaluation. in my opinion it sounds like more than ADHD/ODD. NeuroPsychs do very intensive testing, and cover all areas. My son was tested for twelve hours in two hours increments. I found both the testing and the answers far superior to any sort of testing we had before. The late pottying is worrisome and I don't believe it is part of defiance. in my opinion something more is going on and it should be explored. In my long experience (I have bipolar and Learning Disability (LD) problems and son is on the autism spectrum) the best diagnosticians tend to be NeuroPsychs and second tend to be Psychiatrists (with the MD). Both me and my son have had terrible luck with plain psychologists, therapists, social workers etc. Did she have any atypical development? Did she walk or talk late? Does she know how to socialize with her peers? Do mood disorders or substance abuse run in your family? You may want to do a signature, like me. That would help us. I would NOT rush to medicate until you are 85% sure what's wrong (you can never be more than 85% sure). The wrong medications can make a child even worse. It all depends on what is really going on. Good luck :)
 

slsh

member since 1999
Hi Arielle and welcome! So glad you found us.

The thing that speaks loudest to me is that you have suspected for a while that there is something going on with your daughter. Over the years, the one thing I've learned to trust is my mommy gut. I think we know our kids best and have that innate ability to know when something is up. Follow your heart on that one, in my humble opinion.

Did the developmental pediatrician or psychologist have any ideas? Do you still think there's a hearing issue? My first thought on reading that was to wonder if there's an auditory processing problem - I'm embarrassed to admit I don't know off the top of my head who evaluates that, but I'm thinking maybe a speech therapist or occupational therapist?

Does she have behavior difficulties in school? Have to echo Midwest Mom's questions too.

What are the consequences when she defies, talks back, or hits?

I would strongly recommend "The Explosive Child". I'm not a self-help book kind of person, with the exception of this one. Aside from giving us a peek into the thought processes of our challenging kiddos, the book also helps to identify priorities. For example, and this is just based on life with my difficult child so take what you can use and skip the rest, in my opinion the hitting and violence would be top priority. Zero tolerance for violence (destruction is violence in our home), always. Swift, consistent, and concrete nonviolent consquences. Time out. Loss of privilege. Loss of allowance. Letter of apology. I'd worry less about fresh mouth and even less about her always having to have the last word. The idea is that if you try to address *all* the behaviors as if they're equally important, you're going to flame out really fast and your quality of life is going to be just awful. Pick out the priorities for your family and start small.

Again, welcome!
 

Arielle

New Member
Thanks so much for the welcome and reply. I apologize I took so long to respond. I have been having computer problems and had to use my I=phone for email and Internet -- very cumbersome and eyestraining to say the least! Well my computer is now up and running!

To answer some of the questions put to me, I had the evaluation of a nuerology psychiatric although it was inclusive at that time. We had an MRI done of daughter when she was 3 and everything looked normal. They wanted to do a sleep EEG and we refused and stopped going to the doctor. First off, they medicated my daughter with chloral hydrate when they did the MRI. Our daughter had a terrible reaction and went into convulsions. The ditzsy receptionist never had the MRI approved with our insurance plan and we could not do the MRI that day. Our daughter went through all that for nothing!!! When she actually did get her MRI approved at a different date, she had the same reaction to the chloral hydrate and it took forever for her to fall asleep since she was fighting it and contorting her body in every direction. Anyway, the MRI did not show anything wrong. We refused to have the sleep EEG done because we did not want daughter medicated with the chloral hydrate again. Her nursery school set up evaluations with the school district. She had a social psychologist assess her as well as a physical therapist and occupational therapist. The only thing they came up with was that she was developmentally delayed with gross motor skills in that she toe-walked at times and shuffeled once in a while in her gait. The only suggestion was to get a physical therapist to work on her gait and walking. She outgrew her problem. They also had daughter checked out with a hearing specialst for auditory processing purposes. Well, she hears fine. She did have her share of ear infections the first 5 years of her life, but that has ended.

Still, in my heart of hearts I knew something was wrong. husband is in denial and says that all kids get into mischief and misbehave. Well, I think at almost 8 years old, she should not be drawing purple hearts on her wall with sharpie permanent markers or using elmers glue to smear on the new television in her room. She should not be spraying shaving cream on the tiles in the bathroom or brushing lines of nailpolish on the bathroom counter. She should not draw X's on my mothers' car outside paint job nor bite into the window's inside moulding surrounding the window and make bubbles. She should not hit me or poke me with a pencil when I ask her to do her homework. She should not use foul language while addressing me or anyone for that matter. She should not be hitting her brother or anyone. She should not make scratches to the inside roof of the car so you can see lines. She should not go out of the house any time she wishes to visit her friend two houses down when I explicity ask her not to. She should not hit her school bag purposely against our brand new Lexus SUV -- which have left smudges on the paint -- when exiting or entering it. I could think of a lot more things that these situations, but my mind currently draws a blank. My husband's response is that I want perfect children and that we can paint our walls and pay my mother for the damage done to her car. My mother has yet to see any money or I any new paint jobs.

I am the disciplinarian in the household. husband only scolds daughter when her behavior affects him. We both need to be singing the same song and on the same page, but that is not the case and I don't see that changing any time soon. I am stuck with 2 children in the house all day and husband is working all the time. I am worried that DS will learn daughter's behavior. The pscyhologist thinks daughter has ADHD with ODD (I personally felt she met the criteria too) and suggested that I have her evaluated by a child psychiatrist. husband wants to have a tutor in our house to do homework with daughter so that she is not constantly arguing with me. That may free up my time with daughter but I do not think that will change her overall behavior. husband just doesn't get it.

Taking away privileges such as Directv does not seem to bother her. Time Outs do not work. I am at my wits end. She constantly argues when things do not go her way. The only time she is good is if she is sick or things happen to be going her way. Then she acts just fine. She is able to control her actions at school, otherwise, I am sure they would be beating down my door if there was a problem. I only once got a complaint in kindergarten that she was drawing on the desk with crayons and they made her clean it off.

We have been up until now gone over my Mom's every afternoon so that I could do homework with daughter and my Mom could watch DS. Well, my Mom has had it with daughter's behavior and asked us not to come back until she learns to behave. daughter is jumping and running through the house when asked not to. She does not sit still to do homework when asked to and makes a bunch of excuses to get away from the kitchen table where we do work. She will get something to eat, drink, go see what is on TV and go for bathroom breaks. Before you know it, 4 hours have transpired and homework is not completed. I am at the end of my rope with my nerves and have been taking Ativan at times when she gets to be too much to calm down. I hate doing that because I do not like the way it makes me feel. There are days that daughter acts fine and I think to myself, why can't she be like that all the time? When she is bad and getting on my nerves, she tells me that she enjoys getting on my nerves. husband wants nothing to do with homework. English is not his first language and he uses it like a battering ram for an excuse.

I am truly at a loss of what to do. Should I get a tutor just for the heck of it to show husband that that is not the answer to these problems? I know it is going to be expensive. I rather get a real teacher than a student. If daughter does not listen to me, what make my husband think she will listen to some high school student?

Thanks for any responses.
 

daralex

Clinging onto my sanity
Just a few quick notes - Auditory Processing Disorder cannot be effectively daignosed until kids are roughly 8 years old (now would be a good time to re-test) Their hearing is usually perfect - it's not about the hearing, it's about the brain's ability to process wht they hear. I have to say however that the symptoms you describe sound much more like ODD than Auditory Processing Disorders (APD) - not a diagnosis - just an observation.
I hear you on the getting on the same page with husband - we've been working on that one for a while - it can leave you with an "alone" feeling. I'm also at home with my difficult child all day while he is out working - again the "alone" feeling. I would strongly suggest another round of testing. Something is obvioulsy going on and the more you know the more power you have to effectively deal with it.
Glad you found us, I'm sure you will get some great advice as all the board members are wise and dealing with the same stuff we are. Sending ((hugs)) and just letting you know you're not alone!!
-Dara
 

Arielle

New Member
Thanks Dara. I will mention that to the doctor at her next appointment. I do know that loud noises bother her to some extent. When she was little, she used to cry uncontrollably at the sound of nearby ambulances, fire engines and police cars. Now, at school and camp dances, she does not like to stay near where the band is playing because she claims the music is too loud. I agree it is loud, but not enough for me to leave the room like she does.

I think her problem has more to do with behavior than hearing though. When explicitly told not to do something, she does the opposite of what you tell her just to get your goat.
 

Snowie

New Member
My 11 yo is currently being tested for ADHD. My 9 yo has Auditory Processing Disorder and he was diagnosed when he was 5-6. He has a slight hearing loss in one ear, not enough to affect his learning. He was diagnosed through the speech therapist, a psychologist and hearing tests combined. Auditory Processing Disorders (APD) for him is a learning disorder, not a conduct disorder. Other than the Auditory Processing Disorders (APD), he's a easy child.

Having said that, as part of the ADHD testing for difficult child 1, he will have a hearing test and testing for Auditory Processing Disorders (APD) too - but that is because his brother has it, not because they suspected it might be a problem. When I was making the appointment for difficult child 1 Auditory Processing Disorders (APD) test, I asked the dr whether I should be able to recognise it considering I already had one with it. She replied that it presented in so many different ways that she couldn't even pick it until all the testing had been completed.

difficult child 1 is also a toe walker and has been since he got up off the floor. I did have him at a podiatrist who told me that his calf muscles were shortened (in hindsight, probably from the toe walking) and he was given exercise to lengthen them. Being who he is, he did NO exercises to help himself and ended up with orthotics, which he also rarely wore and so the problem is still a problem. I never realised it was anything more than this until I started reading this board and seeing the toe walking thingy over and over. I'll certainly be mentioning it at our next paed appointment.

Snowie
 

nvts

Active Member
Hi! Let me see if I've got the picture:

When she was little:

she freaked at loud noises that would scare most kids but she FREAKED OUT
she toe walked
adhd like behaviors
ODD behaviors

Now I have some questions:

did she seem upset by tags in clothes
gravitate toward certain types of materials that didn't feel "yucky" or "itchy"
seem to know everything about a particular subject (with my kids it was trains, yugioh cards, certain legos
really freak out when her routine was disturbed/changed
really freak out when she had to transition from one thing to the next

It just seems that there might be different avenues to take here.

Take a look at Ross Greene's "The Explosive Child". It really gives some insight as to how she's thinking/feeling/experiencing things.

Sorry for all the questions!

Beth
 

BusynMember

Well-Known Member
Has she ever been evaluated for high functioning autism? That would require a neuropsychologist. She has some red flags for that. The sensitivity to sound (and maybe other things) is common as is toewalking. My Autism Spectrum Disorders (ASD) son toewalked. Other common traits are difficulty with transitions, poor eye contact with strangers, late speech (in kids with Pervasive Developmental Disorder (PDD)-not otherwise specified), poor to no social skills (he/she can be friendly, but it's inappropriate and tends to scare off other kids). Lack of an attention span, Learning Disability (LD)'s, processing problems etc. can be a part of Autism Spectrum Disorders (ASD). These kids are "atypical" in the wiring in their brain, yet often improve a lot with the right help and do very well. It's not a psychiataric problem. If she hasn't had this looked at carefully, I'd want her tested. My son's first diagnosis. was ADHD/ODD, but that was wrong. But it's a common first label for an Autism Spectrum Disorders (ASD) child. They often appear oppositional on purpose because of their extreme fear of and inability to make smooth transitions and their hyper fear of anything new, even changes in their room. This is very broadbased, but, if anything sounds familiar, I'd check it out. It's sort of like ADHD EXTREME. I sometimes think ADHD is just a minor part of the spectrum and so do some professionals...
 

Arielle

New Member
Now I have some questions:

did she seem upset by tags in clothes Never mentioned tags bothering her.
gravitate toward certain types of materials that didn't feel "yucky" or "itchy" Likes elasticized waists in pants as opposed to jeans and button or zippered pants. I believe that is because that has to do more with comfort than anything. She is stocky and at almost 8 years old, wears a size 14. She hates things that are tight. The pants are always too long and have to be shortened.
seem to know everything about a particular subject (with my kids it was trains, yugioh cards, certain legos No. Not really.
really freak out when her routine was disturbed/changed She really freaked out the other day, when we told her that she is getting a tutor. She had a crying tantrum for about a half hour. She is bright and mostly an A and B student. My husband and daughter's psychologist believe that a tutor will free up time for me for my 2 year old DS. It will also make things less stressful for me because she gives me a hard time with respect to homework. An hour's worth of homework can drag out to 4 hours or more. She simply does not want to do it or do it when she is good and ready. My husband is in denial and thinks her defiance is simply in relation to homework and nothing else.
really freak out when she had to transition from one thing to the next She tries to undermine my authority at every opportunity. Yesterday, we had a date with my Mom to go shopping to two stores. When my Mom arrived to pick us up with her car, daughter refused to go. She went out in the backyard where my husband's workers were working (construction work) and called husband up to pick her up. She did not want to go shopping. I, of course, did not want to go out and yell at her in front of husband's workers and have them see her be defiant to me. So, we waited 15 minutes until husband came home from work to pick her up and then my Mom, DS and I went shopping. I did not have a problem with daughter driving around from job site to job site with husband and have him pick her up. I had a problem with him caving in to her request and not being firm and telling daughter that she ought to go shopping as planned with Mommy and Grandma. It is my contention that daughter is a child and is not the one that ought to be making decisions of what she wants or does not want to do. It becomes a struggle with respect to transition when she does not want to do something. Otherwise, if we are doing different things that she likes to do, there is no problem transitioning from thing to thing.
 

Arielle

New Member
Has she ever been evaluated for high functioning autism? That would require a neuropsychologist. She has some red flags for that. The sensitivity to sound (and maybe other things) is common as is toewalking. My Autism Spectrum Disorders (ASD) son toewalked. Other common traits are difficulty with transitions, poor eye contact with strangers, late speech (in kids with Pervasive Developmental Disorder (PDD)-not otherwise specified), poor to no social skills (he/she can be friendly, but it's inappropriate and tends to scare off other kids). Lack of an attention span, Learning Disability (LD)'s, processing problems etc. can be a part of Autism Spectrum Disorders (ASD). These kids are "atypical" in the wiring in their brain, yet often improve a lot with the right help and do very well. It's not a psychiataric problem. If she hasn't had this looked at carefully, I'd want her tested. My son's first diagnosis. was ADHD/ODD, but that was wrong. But it's a common first label for an Autism Spectrum Disorders (ASD) child. They often appear oppositional on purpose because of their extreme fear of and inability to make smooth transitions and their hyper fear of anything new, even changes in their room. This is very broadbased, but, if anything sounds familiar, I'd check it out. It's sort of like ADHD EXTREME. I sometimes think ADHD is just a minor part of the spectrum and so do some professionals...

None of the professionals that I have seen (neurologist/child psychiatrist, developmental pediatrician or psychologist) have indicated that they thought she had Aspergers. daughter has great eye contact and communicates her feelings well with respect to getting her point across. She wants people to like her and at times she seems older beyond her years. She just doesn't like the word "no" and to be told do do something she does not want to do. She thinks she is an adult and not a child in these type of scenarios. When daughter is confronted about whatever bad thing she is doing, she denies it or immediately changes the topic to something else to shift focus off what she has done. I will discuss this with her psychologist at the next meeting. husband is not open to further testing of daughter right now. He barely wants to continue with the psychologist and thinks it is wasted money. I was against getting a tutor for daughter because the actual homework is in and of itself not the problem -- she can do it. She just does not want to do it and she enjoys giving me a hard time and seeing my nerves rattled. She, in fact, told me that she enjoys getting on my nerves and my Mother's nerves. I have agreed to a tutor against my better judgment. He has agreed to further testing once he sees how the tutor turns out and if daughter is still very defiant. I do not foresee any changes with respect to the tutor, but that remains to be seen.
 

Nancy

Well-Known Member
My difficult child could be her twin. Is there anything in the family history that could help? My husband felt much the same as yours, that we were wasting our money on therapy. In many ways looking back on it I do too, but I needed help at the time and it did provide a safety net for us.

Nancy
 

BusynMember

Well-Known Member
I'd take her to a neuropsychologist. I really think they do the best evaluations (they spend lots of time with the kids and do all sorts of testing). No other professionals bother to test, at least none that my son has gone to. The result of that has been misdiagnoses. I personally think that if she is pottying in her pants at her age it is more than ADHD/ODD. Sounds like she could have serious anxiety or/and sensory issues caused by a bigger disorder. At any rate I believe in "Better to be safe than sorry" and I'd contact a good neuropsychologist. They can be found in children's and university hospitals. Second best, in my opinion, are Child Psychiatrists (with the MD), however they often don't do any testing either and sort of pull diagnosis. out of the thin air. I prefer the testing. There is no 100%; guarantees because psychiatric and soft neurological problems have no blood tests, however NeuroPsychs in my opinion come the closest to getting things right. in my opinion, find out what's wrong first, then worry about therapy. Therapy doesn't work with certain disorders and in my opinion it's kind of doing things backwards. Many here have had positive experiences with NeuroPsychs. Good luck!
 

Arielle

New Member
I'd take her to a neuropsychologist. I really think they do the best evaluations (they spend lots of time with the kids and do all sorts of testing). No other professionals bother to test, at least none that my son has gone to. The result of that has been misdiagnoses. I personally think that if she is pottying in her pants at her age it is more than ADHD/ODD. Sounds like she could have serious anxiety or/and sensory issues caused by a bigger disorder. At any rate I believe in "Better to be safe than sorry" and I'd contact a good neuropsychologist. They can be found in children's and university hospitals. Second best, in my opinion, are Child Psychiatrists (with the MD), however they often don't do any testing either and sort of pull diagnosis. out of the thin air. I prefer the testing. There is no 100% guarantees because psychiatric and soft neurological problems have no blood tests, however NeuroPsychs in my opinion come the closest to getting things right. in my opinion, find out what's wrong first, then worry about therapy. Therapy doesn't work with certain disorders and in my opinion it's kind of doing things backwards. Many here have had positive experiences with NeuroPsychs. Good luck!
I would like to have her re-evaluated. I have to get my husband on board which is no easy task. No matter what I say, he thinks she is a normal kid with occassional outbursts. I have these meltdowns almost every day. Yesterday was a relatively good day for her and she was compliant and rather subdued. He took that as a good sign. I just wish he could see what I see.

In any event, if these tests by the neuropsychologist entail her having to be put under chloral hydrate to sedate her, my husband will not approve. She went into convulsions twice 3 years ago when they did an MRI on her. My husband refused to let them do a sleep EEG on her.

As to her pottying, it is a night time problem. During the day she is ok. Just for a while there from Sept - Nov. she did no. 2 in her pants. It could be that she was upset losing her grandfather and that was the way she dealt with it, I don't know.

Thanks for your reply and input.
 

Arielle

New Member
My difficult child could be her twin. Is there anything in the family history that could help? My husband felt much the same as yours, that we were wasting our money on therapy. In many ways looking back on it I do too, but I needed help at the time and it did provide a safety net for us.

Nancy

Nothing in my family history that would indicate a problem. I can go back as far as my great-great grandparents on both my parents' sides. I do not know much about my husband's family even though my family stems from the same town back in Europe. He is very tight-lipped about his background. He grew up with his father and grandparents as his parents had divorced. A lot of it has to do with shame from the lack of a family unit as he was growing up. I believe his father had a reading/writing disability from what I can discern. (He lived in Europe. All the birthday cards, Easter cards and Christmas cards he sent us were written by different people for him.) Every time he came to the U.S., he would have me write post cards to people back in Europe for him. He claimed he had a messy handwriting so that is why he he wanted me to write.

I wish I had my husband's understanding and support where our daughter is concerned. I wish he could see what I see. Maybe he sees it, but does not want to admit to it or is in denial. Meanwhile, my daughter is not really getting all the help she should be. I want to see a Child Psychiatrist again, but husband does not want to at this point.
 

nvts

Active Member
Hi! When we had our neuropsychs done last summer there wasn't any type of medication involved.

It was IQ, sensory integration, etc. You can get them done at most childrens or teaching hospitals. They take a long time (long waiting list) to get so what I'd recommend you do is get on a waiting list, keep a journal of the behaviors and you're completely within your rights to just cancel the appointment.

Either way, it's help you to TRY to get husband on board. If he has a battery of tests in front of him, he's sitting in a room with the testers explaining what it all means and how to potentially attack the problem, it could result in a wake-up call for him.

Worse comes to worse, you come out with a potential game plan to deal with her.

I suspect that you've been single handedly facing this problem for an extremely long time and you're just getting to where you are at your wits end. Don't feel bad about it. There are times (this morning is a prime example) where you may love 'em, but you sure don't like 'em!!!

Just my 2 cents!

Beth

PS: We're on a "mid-winter break" for the week and I'm pulling my hair out! I'll try to pop on once in a while, but I don't know for how long!!

me
 

Arielle

New Member
Hi! When we had our neuropsychs done last summer there wasn't any type of medication involved.

It was IQ, sensory integration, etc. You can get them done at most childrens or teaching hospitals. They take a long time (long waiting list) to get so what I'd recommend you do is get on a waiting list, keep a journal of the behaviors and you're completely within your rights to just cancel the appointment.

Either way, it's help you to TRY to get husband on board. If he has a battery of tests in front of him, he's sitting in a room with the testers explaining what it all means and how to potentially attack the problem, it could result in a wake-up call for him.

Worse comes to worse, you come out with a potential game plan to deal with her.

I suspect that you've been single handedly facing this problem for an extremely long time and you're just getting to where you are at your wits end. Don't feel bad about it. There are times (this morning is a prime example) where you may love 'em, but you sure don't like 'em!!!

Just my 2 cents!

Beth

PS: We're on a "mid-winter break" for the week and I'm pulling my hair out! I'll try to pop on once in a while, but I don't know for how long!!

me

Thanks Beth. I have single-handedly been facing this problem for a long time. daughter's behavior has become much more apparent to me since I have become a stay at home mom two years ago after giving birth to DS.

husband has an appointment with daughter's psychologist alone this weekend. I am hoping she can put some sense into him regarding daughter's behavior issues. I am not going to hold out too much hope though. He has really built up a brick wall concerning her behavior. He doesn't spend as much time with daughter as I do. When he does spend time with her, it is doing all the fun stuff. No major meltdowns concerning homework or cleaning her room or doing anything she does not want to do which I get on a daily basis.

Hopefully, for daughter's sake, he will come around and opt for her to be tested further.
 
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