Typical or not?

[Alisonlg]

Sick of me yet? I know...you're all thinking where did this woman come from and when is she leaving us? LOL I'm sorry...I hope you can bare with me and I certainly appreciate your time and responses.

If you've caught my other posts, you know my 8 yr old difficult child has a diagnosis of ODD from 5 yrs ago that we're pretty confident still holds true today, but we're in the process of looking for possible co-morbidities. While filling out the paperwork for his new evaluation, I wasn't quite sure how to answer one of the personality/mood traits questions and I was looking for your opinion on how deeply I should pursue this, since at this point it seems it's not a concern of the person doing his evaluation.

"Rapid Mood Changes" Now, *obviously* he can very easily be set off into an ODD fit and rant for 4 hours straight (or more) at a time...the nature of the beast...my concern, and this has become a more recent one of mine is he can come out of a 4 hour ODD rant and jump right into having fun, laughing, playing, making jokes as if NOTHING has happened. But, even more so lately, it almost seems manic in that he gets really over the top and exceptionally loud and animated and just "too much." Would you say this is typical of strictly ODD, or more a sign of an underlying co-morbidity mood disorder...bi-polar...something?

I mean, if it sounds pretty basic, typical ODD, then I won't push it when the evaluation comes back as stictly an ODD diagnosis still...but if this sounds more like something else, I want to make sure I dig my heels in and push for them to look deeper.

Thanks for any thoughts here.

 

[kris]

hon, four hour long rages is indicative of more than straight up ODD...at least that is the general consensus here. it does seem that he is having mood swings. only the doctor who does the evaluation can identify if it's bipolar or something else is at play.

to best fill out this questionnaire i'd strongly recommend that you do a Parent Report first: http://www.conductdisorders.com/community/threads/parent-report-updated.225/. this will help your get the chronology in order as well as guide you through looking at familial link. usually most disorders have genetic links...tho not always.

i also recommend that you pay a visit to the homepage & look at the links to the disorders we talk about here.

kris

 

[BusynMember]

ODD rarely stands alone. If there are mood disorders or substance abuse on the family tree, I'd take him for a new evaluation and have him see a Psychiatrist (the guy with the MD). I don't know much about ODD except that it goes along with along every childhood disorder, but it doesn't sound like just ODD to me. Five years ago is a long time not to have a re-evaluation. The first diagnosis is rarely the last one. I wouldn't trust a plain psycologist to make a diagnosis. Take care.

 

[BusynMember]

I noticed your younger child has a speech delay. I think it would be prudent to also have your oldest (and maybe youngest), see a neuropsychologist to see if he's on the autism spectrum. The higher functioning kids with Aspergers and Pervasive Developmental Disorder (PDD)-not otherwise specified are often VERY smart, but they don't think like we do and parenting them is a big challenge. Unfortunately, many psychiatrists don't know how to identify Autism Spectrum Disorders (ASD) in kids (everyone is soooooooo specialized). Here's a link for Aspergers Syndrome. It often looks like bipolar/ODD. My son is on the Spectrum. His first diagnosis. were ADHD/ODD then bipolar. All were wrong. He's doing great now. Here's an online test which can be very accurate if you are honest in your answers. You may want to take it for younger son too.

http://www.childbrain.com/pddassess.html

 

[Alisonlg]

Thanks for the link, MidwestMom. neuropsychologist is on our list...if the initial SpecialEd testing through the school comes up dry, then the school may pay for the neuropsychologist testing. So, we're in the hurry up and wait mode on that one.

Did the childbrain online assessment- 8 yr old came up OK (suggests NO Pervasive Developmental Disorder (PDD)), but 3 yr old came up with a suggestion of mild Pervasive Developmental Disorder (PDD) because of the speech and Occupational Therapist (OT) stuff. If I take out mild behavior issues, he comes up OK as well (suggests NO Pervasive Developmental Disorder (PDD)). Luckily, 3 yr old is already in the school system (Integrated Preschool). Definately something to keep an eye on.

 

[Liahona]

Schools are education slanted. If there is a problem that mostly shows up at home (like my son) Special Education testing isn't going to catch it. The tests done by the psychiatrist and therapists on both my sons were much more well done then the schools. Plus, the schools don't diagnosis like the docs can. Being education slanted means that the sp. ed. teachers (I was one) aren't educated about what can cause ODD. They are trained with how to do behavior modification to try to teach a child who is exhibiting ODD behaviors. I wouldn't have been able to spot a kid in my class and say he is autisic or bi-polar until I had lived with my sons. Now looking back I can see some of the same issues in my past students and my sons. I guess I'm trying to say that even if the schools testing comes up with ODD you might want to get him to a doctor.

 

[Hound dog]

I got the evaluations for my difficult children on my own, neuro neuro-psychiatric and psychiatrist (MD). The school did some evaluations, well they said they did.... But seemed they were looking for more of a "is your child a teaching/classroom problem" than is their a disorder going on with this child.

My T was never a problem for the school so they wanted to believe he was perfectly normal. Take a look at his dxes in my signature. Although I did finally manage to get him an IEP, the SD and I battled until the day he graduated for services and to keep that IEP in place. They still wanted to believe he was normal.

My N wasn't a problem at school til about jr high. School asked me to get her an IEP. School was actively involved in getting her dxes and working with her disorders. (although again I used my own psychiatrists and such) N was defiant with teachers and violent with students who happened to encounter her during her mood swings. School couldn't have been more helpful. They were angry I wouldn't get her an IEP, and eventually went to homeschooling when she was 16. (homeschooling is her niche)

I'd let the school do their evaluations if they want. But I'd also do your own with your own professionals to make sure dxes are accurate and treatment is appropriate.

Unstable or off medications and N can switch moods in the blink of an eye without any warning. She can be violent and raging one minute and the next smiling or laughing and wondering why people are being stand-offish to her. This could happen once every few days, or constantly throughout the day. Rages could last hours. It only got worse as she got older.

 

[Alisonlg]

Ok. I'm glad I found you guys. You're going to be a helpful group to know. I have NO ONE that knows anything and like I said, we just started the re-evaluation process and the center we went with stuck us with a Social Worker, not a psychiatrist. Already, I feel like we've perhaps choosen the wrong place...but the other place wouldn't return my phone calls. It seems impossible to get help. And, we had to fight for three hours on the phone with the insurance company just to get coverage for this place because they would only pay for a regular psychiatric and we were more interested in getting him into a "group" where we'd have a selection of Dr's, Social Workers, Nurses, and resources available to us.

Rambling again. But, THANK YOU again for your input. It's helping.

 

[Alisonlg]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: kris</div><div class="ubbcode-body"> <span style='font-family: Georgia'> <span style='font-size: 14pt'> <span style="color: #333399"> hon, four hour long rages is indicitive of more than straight up ODD...at least that is the general consensus here. it does seem that he is having mood swings. only the doctor who does the evaluation can identify if it's bipolar or something else is at play.

i also recommend that you pay a visit to the homepage & look at the links to the disorders we talk about here.
</span> </span> </span> </div></div>

Thanks Kris. Checked out those links...Boy does ADD fit him to a "T" or what?!?! (talking to myself there) By golly, if they don't come back with ADD, I swear I'm gonna have to put up a stink! I just read that list and nodded my head and said "YES" to every single thing!

I feel like the most impatient person in the world right now...I just want to get this evaluation over and done with...I can't believe it's going to take another 4-5 weeks, and if it's just the Social Worker doing the evaluation, I have a feeling we'll be taking him elsewhere to do it all over again...or at the very least DEMANDING a few visits with the staff Psychiatrist. Ugh.

Anyone have a fast forward button?

 

[totoro]

We had an evaluation with 2 social workers... one was great and one not so... they didn't really help with the diagnosis part of it... but the good one was nice to talk with and helpful for directions. The good one got the diagnosis close to accurate and the not so ggod one had it wrong and didn't take any time with difficult child...

So we had kind of planned from the beginning to seek a further diagnosis and evaluation regardless... which is a pain.
But if you really want it to be accurate and to know what to do with the diagnosis it is really so great to seek a nuero-psychiatric evaluation and then a psychiatrist.

The other thing is my difficult child had long rages and that was one of the factors that ruled out just adhd... that is not typical of adhd, the rages are more short and easier to end. Long drawn out rages that can not be stopped very easy if at all, or violent in nature... which my difficult child was prone to long violent rages. This is more a sign of BiPolar (BP) than adhd.

good luck...and hang in there

 

[Marguerite]

Alison, don't worry about wearing out your welcome here. You're not even coming close!
What makes you such a valuable person on this site - you're someone who is doing a lot of hard work with your child already but you're also doing a lot of reading, digging, asking questions and thinking a lot. Right now your focus is on your child (understandably) but you also seem the kind of person who already has a good feel for handing some situations and will be there with tea and sympathy when the next Alison comes along.

Basically, Alison - you are us.

With evaluations, look at the symptom description and not the label. Mood swings don't necessarily mean bipolar, so only answer each question based on your understanding of your observations. Same with the Pervasive Developmental Disorder (PDD) thing - it's all worked out carefully and connected to age, whether the problem is resolved or never existed, and it looks at everything. There is a connectedness there which can help. The Pervasive Developmental Disorder (PDD) survey also has a really good answer guide to help you when you're not sure of definitions, etc. For example, years ago I did the test on easy child 2/difficult child 2 and scored just outside Pervasive Developmental Disorder (PDD) (ie normal - just). Then she and I sat down and did it together. I was surprised at some of her answers until she explained them to me and we checked the guide on how to interpret the questions. She still only scores "mild Pervasive Developmental Disorder (PDD)" but it's still very definite.
But what does it mean, for her? Not much, really. She has already adapted and the label will actually make absolutely no difference to her life in any way. But sometimes, it's just nice to know.

Marg

 

[TerryJ2]

Alison, welcome. You've got a great support group here and lots of good ideas, as you can see.
I hate it when you have to battle the ins. company!!!!! on top of everything else. Sigh.
I know the feeling of impatience. It's so hard.
Sounds like you're starting down the right track, though.
Let us know what happens.

 

[jamrobmic]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Alisonlg</div><div class="ubbcode-body">I have NO ONE that knows anything and like I said, we just started the re-evaluation process and the center we went with stuck us with a Social Worker, not a psychiatrist.</div></div>

Some places have you see a therapist first, and then the therapist refers you to the psychiatrist if he/she feels it's necessary. That's how the clinic where we took my son worked. Fortunately (or not, depending on how you look at it), in my son's case, the therapist referred him to the psychiatrist on our second visit. Even then, it was a six week wait before we could get an appointment.

 

[sillydog]

Early diagnosis of ADHD or ODD is often indicitive of a hindering mood disorder. But in your son's case, because he is so young, the more behavioral changes you can make in your parenting approach, the better long term changes you will experience. medications are only a small part of treating behavioral problems in children. Young children have a lot of room to change if their parent can also make changes in regard to their approach.
The more you engage in the negative behavior he is demonstrating, the longer he will carry on. And as you stop attending to it so much, but follow through with the consequences you set, he will rage even more, and eventually decrease in rage intensity. But parenting is a hard job, with a sick child or not. So for you, it will be harder befor it gets any easier. The hardest part is changing your own perceptions and approaches and sticking with it. :smile:

 

[oceans]

It sounds like more than ADD to me...more like a mood disorder. Kids are difficult to diagnose at this age, but kids with ADD typically do not have 4 hr rages and then switch to manic type behavior. I think others have mentioned the bipolar child book. http://www.bpchildresearch.org/ This is an interesting site and they have a quiz you can do.