Does my DS aged 4 have opposition-defiant disorder?

[PrinceCorum]

My 4 year old is a bright, lively little boy. He loves learning, and is very social with his little brother and his friends. But over the last 6 months he has got quite disruptive and aggressive at home. He often hits me (I?m his Dad) and his Mum when he gets cross about something, and it can be something really trivial such as he doesn?t like the way I put one of his toys back in his wardrobe ! I?ve read the DSM-IV definition of ?Oppositional-Defiant Disorder? and I?m wondering if he has this, as he does have about 4 of the listed symptoms, which I understand is enough to be disgnosed with it. But is 4 years old too early to diagnose ODD? He is fine for the two days he spends at nursery and the nursery do not find him disruptive. He?s often also OK while we?re out ? it?s at home he has meltdowns that can turn violent towards Mum or Dad (occasionally towards his little brother too). We have tried time out and reward charts but so far they haven?t stopped this behaviour. Could it be that he is anxious about starting school in a couple of weeks? Any thoughts on the ODD issue?

I think a lot of the behavior the Op describes is typical of a 4 year old.

The thing with 4 year olds is that they dont recognise rules actions and consequences and they copy what they see.

You need to be consistent you need to continually remind him that that behavior isnt acceptable a 4 year old child that hits his parents out of frustration may become a 15 year old teenager who deals with frustration the same way.

If he did have ODD/OCD or any of the spectrum difficulties a diagnosis isnt a full stop,a diagnosis is simply affirmative proof that from here on in every day will be a constant reminder of helping him control his behaviour and its not an easy job,ask any of the Mums on here who day to day face this,they will tell you a stroppy 4 year old is the easiest thing to adapt behavior of.

You need to seek some support from your Hv and you need to make a strong behaviour strategy that will be constant,but to be fair he does sound like a lot of 4 year olds testing the boundaries.

Also my friend is a fantastic Mother - who having sought advice for the behaviour problems of her 2 teens (one with Sn) was advised and supported to attend a parenting class - not because her parenting was lacking but just because she would find areas of other parenting methods helpful - so if a parenting course is advised its not a 'training' course its a 'top up' class .

Dorje
would you respond to my post, where I quoted you please.
What ages are your children ? Do they have a diagnosis for SN's ?
Do you do a related job , i.e. pyschologist ?
I only ask because you are posting very sensitive issues and seem to know alot about it.
Your post, the 3 sentences, I quote below: HAVE got RIGHT UNDER MY NOSE. And really insulted me.
As if getting a diagnosis was taking the easy route out. YEAH right. Just shows how you haven't got A CLUE.

"before sending him off for a ?guilt relieving diagnosis".
" Remember that diagnosis will stay in his files: "
"be dutiful to your DS and ensure you are doing everything you can to help your DS channel his energies and frustrations before you go to the doctor, and not just taking an easy way out."

To be fair, it is incredibly hard to write an OP which gives the pertinent facts, because often, what marks SN from NT behaviour, is the subtleties of behaviour, not the gross facts.

For example, when my DD was first going through the 'identification phase', the person advising us said 'immature'. However, it was only when I said 'yes..but is all of this 'normal but immature'? It was the little things, like having to do a roly-poly on a patch of grass every day on the way home from pre-school. Kissing bins as we passed them, and saying 'bye bye bin'. Hysteria every time her favourite video ended. Hysteria every time we passed our own home. The list goes on.

OP, you may have other details that bother you. The details from your OP didn't ring any alarm bells for me. But if there are other things that make you suspect that your DS' behaviour is beyond typical, the best thing to do is to visit your GP. Be aware though, that detail will be important, because '4 year old gets angry and lashes out' is a very typical story.

Hello again. He does sound oppositional at the moment. My son was/can still be like this at times. He also only took it out on mostly me (Mum). Oh the privileges of mothering!!!

However, I think it is very normal- what is tricky is not getting stuck in patterns of behaviour and this is probably more tricky for parents than children!!! I would say set boundaries, respond consistently and don't let resentment build up. If it's still worrying you in 6 months then seek professional help. Have you read any of the Dr Christopher Green books? I've got the older ones one now (5-12s) as my son is nearly 5 and he's very straightforward on different personality/temperament types in children- worth a read, really down to earth.

yy nickschick - parenting courses are v useful - they don't teach you how to parent - they provide an environment where people can get together and discuss specific issues they find challenging as a parent, hear other people's situations, and brainstorm new ways of dealing with the problem/ finding new avenues of support. i attended an sn parenting course once upon a time, learnt v little about sn (lol) but did pick up a great deal of support and a few new ideas as to how to deal with my then perfectly nt 4yo ds.

I lernt ZERO from parenting courses. Nothing. Not a sausage.

did you not learn anything from meeting the other people on the course? not anything that worked for them? were you able to offer any ideas to anyone else?

the actual 'syllabus' can be a bit like sucking eggs, but it's talking around the issues that can be helpful. or maybe mine were just better...

or, you get out what you put in...

NO. They were ever so nice. And I still meet for an occassioanl coffee with one lady. But they were all at the very beginning. Of like normal parenting. Having a stroppy 2 year old and not knowing how to deal with it. But all 3 coaches, said they had nothing to offer me.

I offered lots and lots of advice. And they kept asking me and asking me. And I kept saying, no no, I really musn't, I feel like I'm dominating, and 6 or so women, were saying, no please carry on, this is really helpful.
So I felt 'pride' at being able to help others. But re helping myself, No I'm afraid not at all.

it's tricky if it is an unequal match, particularly with parents at different stages - or worse, if everyone are newbies except you! you do feel a bit long in the tooth then... but it was probably really helpful for the others

you should have asked to be paid to come to the next one!

and at least if you've ticked the box and the coaches say they have nothing to offer, then you can go to paed and say 'done that'. it does all help along the road to dx and support if ncessary...

I now have dx. Just doesn't seem to have helped much in the daily challenges !!

ah, but like we always say, tis the same kid he was yesterday whether he has a dx or not

I learnt nothing from any parenting courses either. At least nothing from any free ones.

My DS has ASD and by the time I had got through the system to even access a parenting course I had tried and tested all the suggested and more.

OP, I am not bothered particularly by your OP either. It doesn't tell me anything that would overtly concern me, but the fact that you HAVE posted is the key thing.

For that I would suggest you look into ODD and the various ASDs and take a checklist with you to the GP of all the things that your ds does that raises flags. They aim is to get a referral to a Developmental Paeditrician, if nothing else but to put your mind at rest. You need to do this earlier rather than later, because as your child develops lots of additional explanations will need to be explored for why his behaviour is the way it is i.e is he bullied at school, who are his friends etc etc. At the moment there are few people involved with him so a dx or not will be a more straightforward process.

As for behaving differently in school and home. Well, with the Child Initiated Learning Agenda in the Early Years, very little demands are placed on children now in those settings. They can often get away with things due to the number of children i.e. not tidying away, not coming inside immediately etc etc. They can also become quite anxious and feel unsafe from not completely understanding the social rules and therefore just about 'get by' to take it all out on their parents who they know will love them unconditionally.

Hi OP,
you have had some good advice here from other posters but I just wanted to add a couple of points as a clinical psychologist.
4 is very young to get a diagnosis of ODD and before such a diagnosis is made other diagnoses would be ruled out first, everything from ASD to high IQ. I am of course not in a postion to make a diagnosis over the Internet but I would add that his behaviour sounds quite normal for a 4 year old. Also before making a diagnosis, we would look assessing behaviour in a number of settings and situations. ODD usually remains present in the majority (Ie. At home or school, whether engaged in task focused or free play, towards a variety of authority figures). Normal 4 year olds may display difficult behaviour in some of these settings but not all. We would then look at what it is about the setting whether the difficult behaviour is ocuring compared to settings where it isn't. So, is he stimulated too much or too little? Who is caring/putting boundaries in place? What tasks is he engaged in (too easy/challenging?) Is he getting enough attention for good behaviour as well as difficult behaviour? Is parenting consistent and age appropriate? I would be cautious about labelling your sons behaviour based on reading DSM criteria on the Internet, you would be amazed at how many diagnoses we could all attribute to ourselves if we did that!! if you are worried about your son, talk to your HV and also nursery teachers about how they are managing his behaviour and try to implement the same as far as possible. If in time his behaviour doesn't improve, then seek further help. It's not about blaming the parents at all, but sometimes a small shift in how you manage a difficult behaviour can make the world of difference to reducing an esculation in normal behaviour.
HTH

Sorry about the typos... Typing on iPhone whilst my own toddler is displaying 'normal'/difficult behaviour!

Thanks Orangeone - I'm a psychologist as well as it happens, but not a clinical or child developmental one. I guess having some knowledge of DSM myself just makes me a bit more likely to want to diagnose my child and I know that's not the best approach. Thank you for your helpful post.

May I ask - is there any other disorder apart from ODD that is associated with a lot of angry behaviour? I had kind of ruled out ADD as my child's social and language skills are not impaired in any way. Oh dear, there I go again trying to get a diagnosis...

Mmme you've said it yourself- why so keen to find a diagnosis. In this instance (at his age and with what you describe) you'd be unlikely to get a diagnosis (tbh in my service you wouldn't even warrent a referal- that's how 'normal' your boys behaviour is).
Lets look at anpther way....ok so, if you're a psych here is a way of looking at it, look at the big five personality traits and other temperament characterisitcs that are less plastic and think if any of them apply to your ds eg it may be that he has poor impluse control and is a bit emotionaly reactive (mind you tbh you could say that about a lot of 4 year olds). It may be that these things are part of who he is and are just coming out in a four year old way.... It's all about helping him in the things he is less good at.
Put another way ...He's angry... try and work out why and what will help him manage his anger is a less disruptive/more socialy acceptable way.....What so you do when he hits/kicks throws stuff? What do you do when he doesn't do those things- keep an honest log of your responses to his behaviour for a few days.... I say this not to criticise you as a parent but becasue it is very very common for unhelpful and coercive cycles to get set up with children who are "difficult" or harder to manage and unfortunaltley it requires the parent/adult to up their game and respond differently.

Yes, most of the ASDs are.

Frustration and not being understood or not being able to control your world can be relieved when shown how to manage this and increase understanding, but until that happens you can get very angry children indeed.

And, surely you know by now that the only profession that beats 'teachers' as making the worst parents is.......'psychologists'.....

"Oh dear, there I go again trying to get a diagnosis..."

Is it that important to you OP that you get a Dx? It won't change your DS in anyway afterwards - just help you in your mind. Why?

Why don't you try and change your behaviour toward your DS and see if he models you?
Use an angry mat where he can dance up and down in rage - and only there.
Use a punch bag / special pillow where he can vent his frustrations by punching, and only there.
Use paint and clay so he can be creative with his emotions.
Use your imagination with him! 4 year olds are fun and again I say, he sounds like a normal 4 year old to me - especially as you say he is social and behaves well in school.

Get an angry mat for yourself if he's pushing your buttons. It can be very fun to be hopping mad together! Put on the music and mosh.