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?

oblomov, I'm sorry if any of my posts got under your nose; I never addressed any post to you before this one, so I'm at a loss to see why you have taken what I posted to the OP so personally. I notice a lot of people have voiced the same opinion as me, so to single me out seems pretty random.

I'm sorry if you thought I was being tardy in "answering your post" - 'would you respond to my post'. I'm not on MN a lot - I work as well as parent, you know, pesky real life.
I'm a trained counsellor if you still are wondering? How many children I have is none of your beeswax, and I fail to see how it is relevant.

I'm genuinely sorry for your family situation, and wish you all the best.

Dorje, you are the only one who suggested that getting a dx is an easy way out.

You know what, it isn't. If only you had any understanding quite what came after diagnosis you would know that.

The easy way out is often to bury your head in the sand. Sometimes I wish it was what I had done.

OP, I'm a health professional, I've worked and taught on child mental health issues for the last 10 years. I also have an extremely feisty, wilful, challenging little madam of a 4 nearly 5 year old dd!

the fact his behaviour isn't pervasive suggests it's not ODD and it's actually quite positive in a weird sort of way that he's only lashing out and you and his mum, it's indicative of a secure attachment. he knows he can with you as you'll always love him and be there for him unconditionally. It sounds like he's anxious, my dd certainly is about starting school and she's become v shouty and emotional.

She's nearly 5 but we've just come through a year of extreme stress and upheaval with her, she's been bossy, defiant, stroppy, contrary you name it. At times despite (or maybe because of!) my professional knowledge i've been pulling my hair out and seeking refuge in wine! 4 is a tough age, my ds is only 2 and tbh the "terrible" 2s seem like a dream compared to the screaming and tantrums we've had age 4. She's just beginning to come out of it now, I've had to be very very strict.

Re parenting courses, the experience is different for different families. Some of the parents I talk to have found them very helpful, others not so much. Webster-Stratton groups are run because they have an evidence base in in large studies in America were found to be a lot more effective for behavioural problems than treatment as usual or individual work with families.

Your local CAMHS service may run them, or your local schools and sure start centres, unfortunately in a lot of areas of the country funding for parenting interventions has been cut....at a time when it's needed most . Recent riots anyone?

It's unlikely what you describe would warrant a CAMHS referral, it's not pervasive and is robably developmentally appropriate. If there's been a complete change in temperament that would be more of a concern but it's important to take temperament variable into account. From the moment she was born the midwives raised their eyebrows and told me I had " a one" with dd her screams were so loud! she was never going to be miss laid back and compliant.

Best of luck x

Starlight - the OP's DS sounds like a very normal little boy to me. I suggested that the OP may be looking for a Dx on the basis of his posts and I used a "?" when asking if it was an guilt relieving quest. In no way what i said was definitive, or transferable to you or any other poster. I'm not being paid by the OP for a professional opinion, and of course I can't make a diagnosis on an internet board: no-one can.

As I say, a lot of posters who are professionals have described the Op's DS's behaviour as normal (as I did) and not 'worthy' of a Dx, as he is behaving well in most all situations besides at home where he is channelling his frustration and anger at his parents.

That's not abnormal behaviour. I asked why the OP who is a psychologist is looking for a Dx, as he himself admitted he was looking for one, (hence my ?guilt relieving comment) and I suggested some things he might like to try with his lovely little boy, which I note is more than you did.

Good luck OP. Have a look at that book I recommended. IME 4 is devilish and maybe surprisingly? hard, considering the trials of babyhood and the tribulations of the terrible twos etc... but this too will pass.

Dorje, Minxofmancunia and others - thank you all so much for taking the time to help out on this thread - I agree that it does sound like, having read all your helpful posts, my 4 year old son is just being a 4 year old. Phew, that's good. It is his last day at nursery today and when I asked him how he felt about it he said "it's a very sad day" - bless him. So I'm sure the stress of leaving nursery and thinking ahead to his first day at school is most likely affecting his behaviour.

Thanks again to you all ! And for helping out a Dad, even though this is "Mumsnet" !

As it happens just been emailing my son's (7 year old) teacher about this.
He goes to a school with great provision for SEN (although he is totally mainstream). All teachers are applied behaviour therapist. Justvsaying this to explain i trust his judgement.

First if the defiance is only at home and he is otherwise socially apt ( respects authority, rules, routine, outside and at school) + has friends you can pretty much rule it out.
ODD is usually all encompassing.
Second, at 4 he can not seriusly hold a grudge for more than 5 minutes, so the anger is more likely to be attention seeking ( bedtime anxiety, separation anxiety etc....)
If you really think you need to do something, the advice I've had, is a course of applied behavioral analysis for parents! There you go, just what you wanted to hear I guess!

Laptop Where on earth are you that you have a ms school filled with behavioural therapists?

Hong kong. The children's institute

You know behavioural therapists aren't generally allowed in UK MS schools right? They are considered out of date and cruel.

Behavioural therapists cruel ??

I notice more and more on Mumsnet that parents prefer to assume their child has a 'condition' when they cannot understand the child's behaviour. Often the descriptions of the behaviour show a normal child who is frustrated or confused or angry.

There seems to be an awful lot of analysing and over thinking about things that are not that complicated.

'I notice more and more on Mumsnet that parents prefer to assume their child has a 'condition' when they cannot understand the child's behaviour'

Can you explain a bit more about this? I'm not so sure I have seen it.
I do share your confusion as to why behavioural therapists are so contraversial in the UK though.

I think you will see it on many of the behavioural threads.

Lively kids, unruly kids,..could be ADHD amongst othe rconditions mentioned.
Constant questions, 'what is wrong with my DS/DD'

A lot of the problems are just down to inexperience as parents - or overwhelmed parents. No one takes behaviour and child psychology lessons at schools because its not available.
We all start out as parents with good intentions - and then get a huge shock that our children are intelligent and have a mind of their own.

Davsmum,

I have seen parents seek out a variety of explanations for their children's behaviour, but I have not seen one single ocassion where they have indicated that they would PREFER that their child had a 'condition'.

I did not say thay any parents state/say they 'prefer' their child to have a condition.
I said I notice that they prefer - I should have said 'It seems they prefer'
It comes across that way.

So you have decided to interpret parents comments, who have not specifically stated that they would 'prefer' their child to have a 'condition' as prefering that their child has a 'condition'.

Why would you do that?

If I can be honest, MY interpretation of your words is that YOU'D prefer that that is what they would prefer.

Yes. From what I have read I would have to assume that some parents on here would rather find an answer for the problems that they are having with their child as being with their child i.e. not anything to do with what they are/are not doing. I assume this because when it is suggested ( based on their descriptions of what goes on) that they are being inconsistent or allowing /enabling the child's behaviour/problem - they take great offence and appear to be able to be logical or objective about it.

I would prefer they did not. I would prefer that they took responsibility themselves.

When it is suggested by someone, or by you?

Well as someone whose child has recently been diagnosed with ASD, I can categorically state that I would much have preferred to hear that the problems with his behaviour were down to bad parenting as then I wouldn't be dealing with a child with special needs, he wouldn't face a life of struggling to fit in, form relationships and manage in the everyday world and I would have been able to do something about it.

Some of his behaviour may also appear in a child who has not been properly disciplined or who is just being 'naughty' and I was certainly criticized, but now, it transpires that it is down to him not being able to process information, hyposensitivity to touch and hypersensitivity to sound that made him behave the way he was. We are now taking a different tack on how to deal with it.

However I have been in the position where I've gone "There's something not right here" but so many were quick to judge and call it poor parenting. His school, his paediatrician, SALT and the edpsych disagree.

There have been some pretty insulting things said on this thread.

I have met a lot of parents with children who have been diagnosed with a range of conditions, from AS, HFA, ADHD, ADD, OCD and ODD. Not one of them is happy with the diagnosis and all of them wish they had NT children or that it was down to them.

To get a diagnosis isn't as simple as going to the GP and saying "Ooh he never stops he must have ADHD" and the GP nodding sagely, writing a scrip for ritalin and kicking then out of the door.

Most diagnoses take months and are done by a multi-disciplinary team of specialists. You do not get a diagnosis unless your child had a condition and in my experience when you do get one you don't go "Hooray, its not my shit parenting" you are way more likely to cry. Lots.

Going to the doctors, getting a referral and going throug the hell that is diagnosing conditions on the autistic spectrum is not an easy way out, a way to relieve guilt or a way to excuse bad parenting. Its a fucking shit thing to have to do, especially when you have to deal with ignoramuses who hoik up their judgypants and come out with rubbish.

Baby heave - finally words of wisdom!

Agree with babyheave totally with her last paragraph.

I am going through hell and back for my son. I have two other children that have NO issues he is the youngest. Same upbringing, same parenting. Nothing different at all. Yet the first bloody thing that is thrown at you is a grilling on your own behavour.

As for parents taking responsibility..........I think that is precisely WHY parents seek out advice due to concern and to judge their parenting stinks. Even more so to actually think that they would want a child diagnosed with SN. And as for guilt...............we carry it all the time dear, a true parent always looks within themselves for something they have done or could have prevented. And that doesnt go away just because of a diagnosis.

From my ( limited) experience, aba is not so much about pointing out our shortcomings, but rather acknowledging and identifying the stress factors/triggers in the child to help the child and parents deal with a certain behaviour or blockage.
It is a long road, i agree. It took years to learn to recognise stress patterns in my son. And its only with help that we could see that in retrospect there were many signs.
We are now much gentler on him and ourselves.

Wow, my OP has opened up one hell of a can of worms hasn't it.

I can only echoe babyheave here - there is no way I would be HAPPY if my child was diagnosed with ODD or any other condition - I would much prefer someone to tell me that I can improve things through changing my parenting - I wouldn't be offended and would just be glad that there is something I can do to change things.

I think that a lot of what is happening on this forum and others like it is similar to what is happening in the health field generally, and much is due to the explosion of information that is now in the public domain thanks to the internet. It's easy to wrongly self-diagnose and start to worry about various health and psych issues you and your kids might have, because so much info about all of these conditions is out there. GPs are getting fed up with patients self-diagnosing through web surfing and I think this is part of why there are more and more "does my child have condition x" posts on here. PART of the reason. Of course, it's also because most of us want to do the best for our kids, and we don't want to run the risk of ignoring something that we should have spotted and sought professional help with.

I doubt very much that many (maybe even any) parent posts on here looking for their child to be diagnosed with some condition just so that they can sit back and say "well at least it wasn't our parenting that caused this"

Of course parents are not 'glad' their child has a condition !
They don't 'want' them to have one. They want an answer to problems they are experiencing and tend to look more for a reason with the child rather than look to their own behaviour.

I have looked after many children - quite a few whose parents were having them referred here and there for various 'problems' which they were experiencing with the child - but was not apparent when in the care of anyone else !
When the parents were observed with their children it was obvious, although they claimed to be consistent and firm and setting boundaries - they certainly were not. They did when they remembered or when they had time. They always had an excuse for why they gave in 'this time'

None of this means its the parents 'fault' or that they are not concerned about their child! Its about self awareness and not being in denial about how we actually deal with things.

Its strange how many children are diagnosed with all sorts of conditions these days. My sister in law is a GP and she has said many times that parents who bring their children to her are almost obsessed they get a diagnosis and referrals for all types of behaviour problems and the number of them is increasing all the time. Even professionals have said that diagnosing these 'conditions' is extremely difficult and often they have to go on information provided by parents.
Of course some children have certain conditions but it alarms me how often children are 'labelled' perhaps incorrectly.

DAvsmum - yes I understand where you are coming from to some extent. And of course, we all know that labelling a child can then spiral into a whole self-fulfilling prophecy, creating expectations in the minds of parents, professionals and others about the child

'Even professionals have said that diagnosing these 'conditions' is extremely difficult and often they have to go on information provided by parents.
Of course some children have certain conditions but it alarms me how often children are 'labelled' perhaps incorrectly'

Davsmum, You've gone too far with this. Diagnosing these 'conditions' IS extremely difficult which is why parental interview is ONE ASPECT and why diagnosing can take YEARS. And what professionals are you talking about. I now know flippin loads and none of them would back your claim.

'Conditions' such as ASD are not consistent in all settings. Children can put up with what is akin to torchure in a setting that doesn't understand them and that they are frightened of, and then have an emotional breakdown after transfering to the one that does.