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?

'Of course some children have certain conditions but it alarms me how often children are 'labelled' perhaps incorrectly'

It alarms you how often something perhaps happens?

Your sentences don't make any sense. It is just sensationalism fo the sake of it.

What you allude to doesn't make any sense either. Incorrect dx are rare due to the rigorousness of the assessments. Believe it or not, parental input is nearly always investigate FIRST and as such is a fecking horrible part of the process as no parent can be in doubt that they are under scrutiny. Only WHEN that is ruled out does the more indepth assessment of the CHILD occur.

Davsmum: Let me spell it out here.

When a multidisciplinary team made up of a developmental paediatrician, clinical psychologist, speech and language therapist and perhaps occupational therapist examine all of the evidence gathered from parents, school or nursery, batteries of tests and assessments and their own obversations, thet do not give a child a LABEL. They give a DIAGNOSIS.

WRT your sister-in-law, my DS's GP has perhaps seen him for a total of 20 minutes over the last year when I was getting referral appointments for him. During that time you would not have had time to observe any issues at all. Anyone who actually knows about ASD understands that there is a complex set of problems and needs and not all behaviours preset all the time. The developmental paediatrician, however, observed DS for around 4 hours at the last appointment alone.

No child is diganosed with any developmental disorder based on the statements of the parents alone.

No child is diagnosed with any developmental disorder when it is a parenting problem.

You do not know what you are talking about, regardless of what your sisters cousin's aunt has told you.

Starlight - Gone too far with this ??? You sound like a headteacher !
You seem to be under the impression that I am suggesting no children have anything wrong with them.
I am well aware parental interview is just ONE aspect of it.

I am suggesting that there are many parents who may assume their child has a condition because they do not know how to handle some behavioural problems. I have met parents like these - They don't do it for fun - they are often desperate !
You seem unwilling to consider any other view and appear to be getting annoyed because my view does not suit you. I may not be explaining myself very well, so I apologise if, to you, my sentences do not make sense.

'I am suggesting that there are many parents who may assume their child has a condition'

This is what I mean. Parents 'may' 'assume'.

It is dangerous to put out this propaganda. Either say they do or say they don't and back up your claim with the very least anetdote but better still proper statistics.

You are nit picking there.
SOME parents DO assume. Is that more acceptable to you ? It is not propaganda - It is a view based on personal experience. Are you suggesting we may not have views or beliefs unless we ahev 'statistics' to back them up ?? In what way is it 'dangerous' to say what I have said ?
Personally - I think it is dangerous to put children on medication they may not need. I say 'may' because opinions by professionals on this differ ! There are doctors who are absolutely convinced of the necessity for medicating children with various conditions - and others who are totally against it.

One can provide statistics to suit whatever they believe. Statistics differ depending on who takes them !

Well I don't think ANY parents 'assume'.

I think struggling parents who are investigating the causes of concerning behaviour will consider if there is something going on with their child as one of the options.

And the semantics are important in our current culture of disability-bashing and the media-driven idea that people use their either real or made up disabilities to shirk their responsibilities to society, in order to ripen the country or more cuts and funding to essential services.

YOu do not have to provide statistics. I didn't say you did. I said you need to back up your claim.

You cannot simply make outrageous statements such as 'There are doctors who are absolutely convinced of the necessity for medicating children with various conditions' and be expected to be taken seriously unless you explain the basis for your claim.

Errr sorry to butt in but I think a lot of children on the spectrum are worse at home.

Some children realise that to 'fit in' they have to try and be the same - so all day they are trying and its vvv difficult to try and behave a way when its not your 'norm' then bang your at home in familiar surroundings,accepted unconditionally and that tightly wound spring uncoils and flips.

My friends whose son is autistic says that for every reasonable hour out of the house she has 3 hours of unpredictable at home.

A lot of children on the spectrum have well behaved siblings who wouldnt/couldnt behave like that if they were asked to so its not poor parenting.

The majority of parents at my friends parenting class were mature educated parents who were open minded enough to attend these classes just incase they could learn any strategies to help their dc survive in what really isnt an autustic friendly society.

It's always the parent's fault isn't it? In my ds's case we would never have asked for him to be assessed as we find he fine if slightly highly strung at home. He does what is asked of him, though he may need a reminder or two and although he can get angry and upset more easily than some other children, we manage that and he seems to thrive at home the vast majority of the time. All of our family think he is fine if a bit quirky, none of them have ever said they don't want ot look after him or that he is any more difficult than other children in the family.

It is at school where is behaviour is almost unmanageable - He has a dedicated 1:1 TA for 20 hour a week, which is almost unheard of and we have just received his statement o SEN, one of only around 3% of children nationwide!. In this case I assume it is the our fault because we let him do as he wants at home and haven't prepared him adequately for school

Parents really cannot win. if the child misbehaves at home but not school, the parents are to blame and are in denial as to how they parent.

If the child misbehaves at school but not at school, it is because the parents are also in denial and don't have high enough expecations and/or lying.

Having got all thst off my chest however, I would actually agree that what the OP describes seems normal to me. Her ds may well be worried about school or a number of other things.

I personally would try a combination of clear expectations and als asking her ds about any specific incident (later when he is calm), not why he did something but try and find out her ds's view of it.

The best way to do that is to ask questions about what happenedm but not too much about feelings or motications which just tends to confuse most children.

Something Like "I noticed yesterday that you were really angry when...,tell me what happened" Then ask questions to try and re-create what happened from your ds's point of view. Factual questions Questions like "what happened then, who was there, what did they say etc. "

When I have done this with my ds I have opten ben quite surprised at what his view of things were and what the problem was. Sometimes it was nothing at all like my view of the events.

Starlight,
I have read articles and seen documentaries where doctors have discussed these issues. I have met doctors myself with differing views on this. Would you say that ALL doctors agree with medicating children with various conditions ?
Even without any hard evidence to support either view - it would be daft to state all doctors thought one way or the other !
You say you do not think ANY parents assume. Really ? Not any parents at all would make assumptions ? You do not think THAT is an outrageous statement ?
Are you saying personal experience and observations count for nothing ? We should discount what we witness and believe what we are 'told' ?

Parents come in all shapes & sizes and personalities. Do you think ALL of them are logical ? ALL of them can detach and view their situation objectively ?

I am not working off documentaries that will be biased to whichever direction the programme maker wants. I am also not working off "he said, she said", like you are.

I don't believe what I am told, I work on empirical evidence of the process that I know exists and have personally been through and that other parents who I have spoken to have been through.

All of the doctors I have met would agree with providing medication for a child where that child's well-being or symptoms would be enhanced or alleviated by said medication. No doctor would agree with medicating a child that didn't need it. Two children with ASD may not benefit from being medicated with the same drug - e.g. My child benefits from taking melatonin to help with his sleep. My friend's child who has the same type of ASD doesn't benefit, so doesn't take it.

Parents may suspect that there is something wrong with their child and may have their fears or concerns rejected, despite being the ones who know their child best or spend the most time with their child. If there is nothing wrong, then it is made apparent during the diagnostic process.

I am not saying that personal experience and observations count for nothing and neither is starlight. It just happens while you've watched a documentary and talked to a doctor in general terms, we've both got personal first hand experience of what we're talking about.

It is possible to get two doctors who will disagree whether the same child needs medication. Doctors DO disagree with each other.
Some articles & documentaries cover BOTH sides of an issue - not all are biased !
You are talking about parents who HAVE a child with a disorder/condition - I am not ! I am talking about parents who will explore that route before they have taken anything else on board. i.e what they are doing doesn't work so there is a problem with the child.
I have not watched A documentary and spoken to A doctor. I am not working off 'he said' 'she said' !
I have worked with children. I have spoken to parents with similiar problems but who have different ideas.
Just as you can claim to 'know' from your 'experience' then so can others !
ASD is not the only 'condition/disorder' children have.

'i.e what they are doing doesn't work so there is a problem with the child.'

This is a more fitting description of my ds's teachers' attitudes than any parents I know.

Who are these parents who will explore the route of a possible developmental problem before they will look at their own parenting?

Who are these doctors arguing over whether a child should be medicated, when its already been explained that a diagnosis is a multidisciplinary affair where no medication is ever offered until a diagnosis has been reached?

You have demonstrated that you don't have any first hand experience of what the diagnostic process entails or the steps that may lead a parent to going down that route. You could watch a thousand documentaries and still not have that understanding.

"I have worked with children" or I" have spoken to parents with similar problems" doesn't equal you having an understanding of a wide range of developmental disorders and how they present themselves.

To quote Mumsnet at its finest "The Plural of Anecdote is Not Data".

I believe it can be an attitude of anyone who deals with children. I too have seen that attitude in teachers - but often, they, like parents can dealing with many things or children at one time.

We obviously disagree on things, However, I hope you do not think I was doubting that your child has ASD. I was in no way suggesting any of these conditions do not exist

Babyheave - You are totally misunderstanding what I have been saying.
There are parents who go down that route and get a diagnosis - and there are parents who go down that route to find their child does not have a (medical) developmental disorder.

What I am curious about - are those parents who do not fully explore their own attitudes and get very defensive about their parenting.

Davsmum, perhaps you need to go back and read what you have written.

[facepalm]

I have - but there is no need. I understand what I mean and I think something is being missed in translation.
I am obviously not explaining this very well so we must agree to disagree.

OP please do not self diagnose your child. ( 4 years is too young for this diagnosis anyway). Many of the characteristics listed in the DSM are common human traits. Which is why most psychology students walk around for the 1st term of Uni thinking they have many of the syndromes they are studying about.

Not to be rude but I personally believe that ODD really is not a syndrome at all. To me it simply means bad behaviour and lack of boundaries. He is 4 and he will push the boundaries and test the limits (like most intelligent 4 year olds).
Set your rules (ex:no hitting) and mean it! Don't waiver. Don't make empty threats and carry through on what you say you will do ( this applies to rewards and sanctions). Be firm but loving.

If you sort out his behaviour now you could avoid lots of problems in the future. A health visitor could advise you on parenting course in your area if you feel this will help. It's also nice to talk to other who have similar problems.
Good Luck

Leningrad,
Yes, course I do. I really am not talking about parents whose children DO have conditions/disorders and I also appreciate that is heart wrenching for parents who are struggling with ANY child who has behaviours that are a concern for whatever reason.

If I could have explained myself better - I really would have.

Pang the problem with ODD is that the child often has other aspects from the autistic spectrum linked with it -dyspraxia,aspergers,adhd etc etc and so whereas the general rule of parenting is be consistent dont waiver,with a child with any of the above its very very difficult.

Its difficult to have autism its difficult to be different autistic people cant stop being autistic they can learn to adapt their behaviour to be 'accepted' but ultimately they battle a constant fight,imagine living in a world where you didnt ever quite understand the rules where everything needs thinking through.

Imagine being the parent of the child that finds things difficult,imagine knowing that your child isnt the same as his peers isnt the same as you were as a child,having to deal with behaviour that people will look at you and question your parenting- its not a choice.

The problem, Davsmum is that all of the children who DO have diagnosed developmental disorders will, at some point, have been undiagnosed and will have had parents worried or pulling their hair out at what on earth is going on and trying to fix it and getting no where, while having to deal with the day to day judgements of people who don't believe there's a real problem, but its just down to crappy parenting.

The ideas people have about how children are subject to misdiagnosis or over-diagnosis don't fit the reality of the rigorous diagnostic process that they will have gone through.

Not to be rude but I personally believe that ODD really is not a syndrome at all.

Thank you for that insightful post, Pang. Tell me are you a Paediatric Clinical Psychologist or a Developmental Paediatrician? I am sure we'd all like to hear what clinical research lead you to such a breakthrough.

Like people have said, before you go down the diagnosis route or try and label something which might just be misbehaviour, have you shown how cross with him and upset you are that he tries to hit you?
If he knows how upset you are and that you really won't accept his behaviour, it may well help things. It is indeed one of the stages when kids push the boundaries so you really have to be clear what behaviour you're not prepared to accept. Some may well call it bribery, but the promise of outings or denial of treats...have you tried all that? Bit of bribery and corruption always seems to work for me as a last resort..
Excuses if you have already tried this.

To answer the OP, I wouldn't be considering ODD at this stage. The reasons for this are that the problems have only been evident in the last few months - and 4 seems to be (from all I read on here and amongst my and my friends experience) a VERY difficult age. My ds had extremely angry outbursts and did also hit me at times when he was 3 and 4. I am told that age 4 boys experience a testosterone surge which can really affect behaviour.
In my opinion 99.9% of children age four are oppositional and defiant!
Alot can be gained from re thinking both your expectations and your approach to see if things can be managed that way.
Many children age 4 want to, and can be, spoken to in a much more adult way - they want to be included, not ordered. Which can be hard to do and annoying and time consuming but ime HUGE amounts can be gained in terms of your relationship by choosing this time to examine how you speak to him and interact with him and make sure that every interaction is not about you telling him to do something etc.
Yes good boundaries are needed around hitting etc; my DS was given time alone in his room for this.
Don't expect it to work right away, it's so tempting to think "nothing is working!" if the behaviour doesn't stop but don't be put off; a consistent consequence WILL pay off in the end as long as it is reasonable and proportionate. Don't let a four year old put you in a lather about your consequences - you be consistent and press on imo.