Could this be ODD/PDA?

[Mumofthreeandme]

My DS (aged 7) has been referred for assessments for ASD and ADHD and we had the forms through to complete today.

He’s always been a bit of a question mark as he has no delays, but he has had trouble following some rules and sitting still enough at school to warrant us seeking a diagnosis, in the hope that any support he needs will be in place in secondary school.

The ODD boxes on the form got me thinking. He displays some of the behaviours like arguing with adults (ie DP and I and he will answer back to teachers sometimes too, in response to requests or to being told off), and he is a big wind up merchant, mostly with his younger siblings but he does push DP and I, and I think he has done in the past with teachers.

He’s not aggressive though, and he doesn’t have an awful temper, although I would describe him as touchy and irritable if things don’t go his way. He also freely says sorry, when he’s been rude or defiant and he gets a “look” or stern word. Defiance is a key theme that’s been there since nursery though, refusing to comply with some rules if he didn’t want to. He’s improved overall as he’s grown, but clearly still enough of an issue.

I’m wondering how extreme behaviour needs to be to be classed as ODD? I have looked at threads on here and it seems quite extreme, lives turned upside down etc. We are able to carry on a normal life and DS participates in clubs happily enough (although not always the most proactive/good at listening).

When I say wind up merchant I mean do things that he knows will annoy us, whether he’s attention seeking or trying to be malicious is hard to know. Silly things but annoying nonetheless, and causes us to tell him off. He’s definitely impulsive, but he does get upset if we are REALLY cross with him.

I'm not going to pretend to be an expert but we actually have an ODD diagnosis for our DD, with an * that it's not actually ODD, but PDA is not recognised here (we're in Germany).

PDA is an inability to cope with every day demands, be that demands from authority figures or themselves (this is important). Struggling with basic things like being able to brush teeth/hair, going to the toilet, doing schoolwork, or even things they normally enjoy themselves. The fallout from it is anything from 'excuses' that don't seem to make sense, to complete shutdowns where they are not even communicating, or aggression. ODD children don't tend to refuse to do things they want to do.

PDA is a subcategory of autism, so there will likely be other autistic traits too, although maybe not enough for an ASD diagnosis based on an ADOS test. The PDA society has lots of information about identifying PDA and things to look out for. ODD is a considered a deliberate act to not comply with demands whereas PDA is an inability to do so. People with ODD are also less keen on embarrassing themselves in front of peers and want to fit in, PDA on the other hand can be more unpredictable and can have episodes in front of peers.

Without a diagnosis, one way you can try to tell is ODD children respond well to positive behaviour plans whereas PDA children do not. With PDA often the answer is literally to let them do 'it' in their own time, no pressure, low demand levels.

Our DD would literally only let me brush her hair once a week, and she has long bum length hair. I felt like I had given up and I just stopped nagging her and resigned myself to it. Out of nowhere she started brushing her hair by herself on her own terms. Brushing her teeth was also a living hell, I tried everything, and the real world consequences of having an infected broken tooth with a huge abbess did nothing to encourage her, nor did the operation she needed. All I could do was tell her I can't force her, she knows it needs doing, if she needs/wants something to help (new toothbrush, toothpaste, apps etc) I will of course help her but it's down to her. She will only brush her teeth in the bath, or sometimes some elaborate drawn out process in the sink I'm not allowed to see but she is doing much better at it now. This 'method' though can take a long time and is the most difficult thing I have ever had to do.

I hope there is something useful in there.