Morwen made an excellent comment on my original ODD post which leads me to revise the post and also add new links:
Hello Doug, I feel as though the information you presented above lacks critical engagement with diagnosis or disorder. There are many important critiques of ODD, particularly in it’s overuse as a label for children of color. There is serious concern that ODD diagnoses also hide other struggles, such as trauma and neurodevelopmental conditions, making the focus behaviour rather than situation or neurology.
Your line about feeling as though you should just say “May god bless you” and move on also plays into the narrative that these children (again disproportionately children of color) aren’t savable, and that they are inherently and irrevocably destined for violence or anti-social behaviour. Considering that less than 30% of diagnosed ODD children progress to having a conduct disorder, and only a minority of diagnosed CD children progress to APD, your glum, hopeless tone of your post is distressing to me.
Note: CD conduct disorder; APD antisocial personality disorder
“About forty percent of kids with ADHD have or will develop ODD, Oppositional Defiant Disorder. “
I think 40% is too high.
What is ODD?
“A disorder in a child marked by defiant and disobedient behavior to authority figures. The cause of oppositional defiant disorder is unknown but likely involves a combination of genetic and environmental factors. Symptoms generally begin before a child is eight years old. They include irritable mood, argumentative and defiant behavior, aggression, and vindictiveness that last more than six months and cause significant problems at home or school. Treatment involves individual and family therapy.”
When I see a post that starts, ” My son is diagnosed with ADHD and ODD, and —“, my heart sinks. The parents are having a hard time, as is the child, and I don’t have good advice to give and so I feel inadequate and helpless and unhelpful and pessimistic. I’m trying to get more information.
There is a support group, and the parents do need support. The parents need knowledgeable professional help, and to be consistent with a good behavior management program , and to stick with it for a while even when it doesn’t seem to be working. (This is different from most situations, where if what you’re doing isn’t working, try something else.)
There are successes, but these kids tend to develop serious problems – school drop out, drugs, incarcerations. The parents need to learn to protect themselves, and to avoid enabling. The worst outcomes I’ve seen were where parents kept bailing the kid out of the trouble they were in.
The main point from Morwen is that if the diagnosis of ODD is being considered, there needs to be a careful look at what else might be going on – truama, dyslexia, depression, etc. Also that we cannot just give up one these kids and write them off.
Stimulants for ODD
“For co-occurring ODD and ADHD, clinicians often prescribe stimulants to treat ADHD first. Typically, the ADHD stimulant medications greatly reduce ODD symptom severity and frequency. One study also found that patients with ADHD who consistently took medication significantly lowered their risk of developing ODD or CD in later life compared to patients with lower drug adherence3. In practice, clinicians often use liquid formulations to avoid having the patient potentially dispose of tablets.”
Personal Notes O the Day:
- Did I have ODD too? Only a touch. I was too afraid of consequences, but I tended to automatically disobey any rule or direct order if I could, even when I realized it was in my best interest. But, I was a “bad kid.” A bully, lots of fights, and convicted of a serious offense I hadn’t done.
- Sometimes parents are, or were, fined if their kid was too much truant. But what if they were just not able to force the kid to go to school?
Quote O the Day:
“If you tell me I can’t do something, I’ll do it twice, video tape it, and post it on all the social media.”
ODDer? That was me.
Question O the Day:
Did you have ODD?
#ADHD, #adultADHD, @dougmkpdp, @addstrategies, @adhdstrategies