ODD/ADHD consultation - desperate! End of the road! Aargh!

[popcorn1000]

Where to start? Our kind, bright, affectionate, funny DS is 10 and since a toddler there's always been signs of significant additional needs. I'm a teacher and knew it was probably ADHD (and LOTS of) ODD but just dealt with issues as they arose. He's now in the process of ADHD referral but I know that the ODD is the real issue. I mentioned it at his ADHD referral today and the only thing she mentioned as treatment for ODD is behaviour management. OMG. I smiled and nodded politely but was secretly screaming inside, 'Oh no, we're *.' I've trained in this stuff and I KNOW the professional approach is that ODD is virtually all down to bad parenting etc. I'm the first to hold my hands up to not being a perfect parent, but I can, hand on heart, say that he has had the most nurturing, supportive, positive, structured upbringing that I could possibly provide. Friends who work as secondary school teachers say they can't believe how well he does when they get to know him and his challenges and that he'd be one of those kids making nightmare headlines without it. I've read virtually every behaviour management book published (UK and USA) and on a daily basis use positive behaviour management with him. I finally get to speak to a professional and they have nothing...NOTHING.. to offer, except more behaviour management. I know how these poor kids get on at secondary school - they don't. Sadly, I've always had a good idea of where he's heading developmentally, at the moment it's excluded from secondary for lashing out at a teacher. I'd home school him but then it'll just be me getting thumped instead. I know I'm not the only one out there but don't know anyone else. These poor kids, he's desperate to do the right thing but feels he never can, in a hundred years we'll look back and have all the answers, but now, nobody knows how to help them. I don't know what to do next, I'm currently in the process of arranging my own soft restraint technique training ...

Have you looked at Pathalogical Demand Avoidance? Similar symptoms to ODD but caused by a type of Autistic Spectrum Disorder and needs very different treatment. Essentially bad behaviour is caused by unberable increases in anxiety and usual behaviour management methods just don't work!

Have you begun to treat the ADHD? Has he started medication? ODD seems to go hand in glove with ADHD in many cases, and a successful outcome from medicating can often go a long way to helping the ODD.

The lashing out, anger etc can all be symptoms of the ADHD. If he is still having major problems with behaviour then it is definitely worth looking at what, if any meds he is on to help the ADHD.

Hi educatingarti and thanks for the post. Interesting to hear something else than ODD! Teachers have said they don't think he's spectrum etc and I need to get up to speed with PDA as I'm not sure he fits. However, if it helps, examples include spent several years (Y...E...A...R...S) refusing to get dressed every morning (e...v...e..r...y m...o...r...n...i...n...g). Star charts, making a game of it, positive reinforcement, letting him out in his pj's, 'showing him' it was snowing so he needed to keep warm. Nothing. No response. Would always fight and argue about it, with a cycle that would culminate at least once a month in him screaming in distress until he soiled himself. But no would ever guess it as he's high functioning - then if they ever saw it they were always horrified and I would subsequently feel the need to protect him. Similar brushing teeth, using a toilet (won't mention as opposed to where). They've mostly passed now, but new ones crop up. E.g. for several months would 'pretend' to fall over repeatedly in the shops in an attempt to knock something off a shelf because he knows the social expectation is 'not to knock things off shelves'. Sigh. I CAN'T be the only one out there.

ODD is not down to bad parenting! Rather children with ODD require very careful parenting.

Dopes he have sensory processing issues? Is the 'not getting dressed' because he doesn't like the feel of some clothing?

Thanks Pom. No meds yet, after years of putting it off now pushing for it. Yes, ODD often does go with ADHD, but I'm concerned as I've heard that ADHD meds aggravate irritability. Aggravate it! If it does we're in trouble, he gets cross every day, from zips to a road sign in our street being changed! LOL!

I would definitely give the meds a try. They don't necessarily make the irritability worse at all, but it does involve trial and error in getting the dosage right.

Much of the advice I've read has been to treat the symptoms of ADHD first with medication, before tackling the ODD stuff, as you may even find that many of the worst behaviours can improve greatly with medication.

You're not on your own - and things can greatly improve for you and your DS. When do you see your consultant again? If things have got to the point where you are looking at ways to defend yourself against his aggression, then I would say you urgently need to consider the medication route.

You have nothing to lose really. Most common types used are stimulants, which don't have an accumulative effect, and you can stop them at any time.

Tyto, he is very sensitive but I don't think comes into sensory processing category. E.g. have to cut labels out of lots of clothes as his skin actually turns red with irritation, rather than it 'annoys' him

Pom - I was pushing the consultant today for a return meeting. I'm hoping to see someone again within 4 weeks and have meds prescribed at that stage. Fingers crossed.

PS By the way, thank you everyone, just coming on here, ranting and having some positive responses has already made me feel better (bit calmer slightly less ranty).

Sorry you're struggling. It must be really stressful. I wonder why you didn't try the meds earlier - I know you say irritability can be a side effect, but surely it's not for every child, is it? Were there other reasons behind your not wanting medication for him?