Daughter Diagnosed with ADHD and ODD - Page 2

[karne]

Originally Posted by joensally

I'm fascinated by how often ADHD is co-morbid with other diagnoses. I strongly suspect that in many people "ADHD" is a label for behaviours that actually come from the primary diagnosis and would not exist independent of that primary diagnosis - so treating the primary addresses the ADHD behaviours. Although I agree with Karne that it's hard to call it ODD when the ADHD is not addressed first <dizzy>.

This is why I wonder how ODD can be dx. w/out looking at addressing the ADHD dx? I can't see finding ODD as the primary before this? Also, I wonder if sensory issues come into play here at all? It's very complex when kids are so young.

OP, it doesn't have to be meds vs. no meds. Meds can be combined with nutrition, therapy, etc.

[LauraLoo]

I think you have received excellent advice here. As another mama of a complicated child, it took a couple of years of sleuthing to find out what my ds' issues truly were. Take your time, do your own research, ask a lot of questions, follow your mama instincts and breathe. I can't stress this enough.

I'm not sure if homeschooling is an option for you, but in our case, it was the best thing that we did for our ds while we were still figuring things out. He's been HS'ing for 1 1/2 years, and is now contemplating going back to school. HS'ing doesn't have to be forever, but it can give you some grace while you are working through things with your daughter. Since she is gifted, she will be able to catch up academically if she happens to fall behind. She might even excel at home, as was our case with ds.

[columbusmomma]

My DS has ADHD. His "symptoms" were first noted around age 4 when he was in preschool. To me he was just DS, my first child and I didn't notice symptoms at first as to me he was always a certain way. It wasn't until he was in the school environment that he was described as high energy, lost focus easily, couldn't sit still, couldn't stay on task, etc. These same issues surfaced again and again every school year. We tried classroom modifications,behavioral modifications, diet changes, psychologist,and neurofeedback. This year when he started 2nd grade, Dh and I knew the only thing we hadn't tried was medication. His teachers had noted his self esteem was declining since he couldn't sit still like the other kids, complete his work, or keep his attention on specific tasks. He was also starting to stand out with his behaviors in the classroom. His pediatrician prescribed vyvanse, the lowest dose, and it has made a world of difference. It is extended release so he takes it before school and it doesn't wear off until around dinner time or so. I still don't "like" that he has to take medication and know when he's older he can make the decision to take it or not, if he will need it to function as an adult. He know can sit on the rug with his peers, complete his work,doesn't jump around the room, and has improved concentration. It is amazing that I don't get daily phone calls from the teacher about his behavior. He is the same child, no difference at all in personality, still has his spunk and energy, and hasn't lost any weight, and no problems sleeping at night. Homework doesn't take hours or fighting anymore. He doesn't have anything negative to say about taking his medication except the occasional I'm not hungry, which does wear off and I let him eat as much and often as he wants.

[Magella]

I can't speak to the ADHD, but I have a kiddo who received a diagnosis of ODD, along with diagnoses of anxiety disorder and Tourette's. She has an explosive temper, a history of aggression and other behavior problems, and tends to be quite irritable and oppositional. Really, the ODD diagnosis was a very accurate description of her behavioral challenges.

A lot of parents of kids who have received this diagnosis, myself included, think that a diagnosis of ODD is really just a description of symptoms-not an explanation of any kind for why the child is displaying those symptoms. It's like having a diagnosis of "fever of unknown origin." Describes the symptom, but doesn't explain the cause or lead to effective treatment. A lot of people have found it helpful to pursue a neuropsychiatric evaluation to better pinpoint what's going on.

We haven't done a neuropsych. eval. so far. But what we have found helpful is to work with a therapist to better identify what's going on with dd. What we came to understand is that the following factors contribute to the behavior that was diagnosed as ODD: anxiety disorder, inability to regulate emotion effectively, inability to articulate emotion, lack of problem-solving skills, rigid thinking, difficulty with flexibility. When we addressed those issues, the behavior that was diagnosed as ODD reduced in frequency. At this point I don't know that she'd fit the criteria for ODD, though she still struggles (and so do we) with some difficult behavior and irritability.

The Explosive Child is a very good book, and worth reading. I found it to be very helpful with my child. One very helpful tool in that book is a questionnaire to help you identify what factors are involved in your child's behavior problems. It's a very compassionate view of children with behavior problems, with a very effective strategy for helping children do better (that is not at all based on rewards or punishments-but on building skills). We also found that therapy was/is extremely helpful.

[steelydan]

Our son was thought to have ADHD...as it turns out he has
Sensory Processing Disorder. This disorder mimics ADHD
symptoms very closely.

[Polliwog]

Originally Posted by Evan&Anna's_Mom

Yeah, me too. And I've seen some as well. Which is why I so didn't want to do this. For us, a doctor that I trust and can talk to was key. The fact that she has a DD of her own of about the same age was nice. The fact that SHE suggested with start with homeopathic/nutritional/non-medical options really made me feel better too. I never felt railroaded into medication from her and that makes me feel better.

One thing I realized as I researched medication is how many options there are now. I think many of the horror stories we've seen or heard about were a while back, when there weren't so many options or so many different dosage choices. But now we can try something for my 45 lb. 7 YO that that would never work for an older/larger kid, whereas several years ago it was more "one size fits all" and my little girl would probably be zombied.

I'm not pushing meds, and I would still be more comfortable not doing this, but I would push being open to the option and/or giving it a trial before saying "absolutely not".

Stimulant medications aren't age and weight dependent. So, a small child could need a higher does and not be "zombied."

[NaturallyUnnatural]

The sustained-release stimulant meds have dosage-by-weight "guidelines" though. I think Evan&Anna's_Mom just meant that these days doctors tend to start small and slowly work their way up the dosage ladder, as opposed to starting big and backing down to eliminate side-effects.

If you have a doctor that isn't going to start your child on the lowest dose of a stimulant medication - I'd run screaming in the opposite direction.

[2xy]

My DS1 was dx'ed with ADHD and ODD when he was five. It wasn't any teachers who wanted an eval....it was us, his parents. The child was truly awful to live with.

Anyway....long story short....

ODD is often shorthand for "we don't know what's wrong." My own research has told me that ODD often transforms into some more easily identifiable diagnosis as the child grows and symptoms become more concrete.

My son went through counseling, as did our entire family. We tried behavior modification. We tried different parenting strategies. We tried the Feingold diet. We tried meds. Eventually they were saying he might be bi-polar. He was definitely suffering from depressive symptoms by the time he was 8yo. He said once that if he'd known his life was going to be so miserable, he would have jumped off a building when he was four. Nothing really helped.

Guess why? He had sleep apnea. Once his sleep disorder was treated, his depression was gone and he was a largely different personality. Imagine being sleep deprived for over a decade? No wonder he was cranky, irritable, explosive, depressed, and had trouble focusing. It took me THREE YEARS to get a doctor to listen to me, as I suspected sleep trouble (it runs in the family).

[LauraLoo]

Originally Posted by 2xy

My son went through counseling, as did our entire family. We tried behavior modification. We tried different parenting strategies. We tried the Feingold diet. We tried meds. Eventually they were saying he might be bi-polar. He was definitely suffering from depressive symptoms by the time he was 8yo. He said once that if he'd known his life was going to be so miserable, he would have jumped off a building when he was four. Nothing really helped.

Guess why? He had sleep apnea. Once his sleep disorder was treated, his depression was gone and he was a largely different personality. Imagine being sleep deprived for over a decade? No wonder he was cranky, irritable, explosive, depressed, and had trouble focusing. It took me THREE YEARS to get a doctor to listen to me, as I suspected sleep trouble (it runs in the family).

This is a perfect example of why it's important to go slowly with a dx and do your own sleuthing. No med. or therapy would have helped with sleep apnea.

In our case, ds kept evading a dx -- not enough of this, not enough of that, and some fingers pointing down different paths. I knew something wasn't right and that my ds was suffering. No one was providing us a path to eliminate possible dx's because while we had some behavioral issues, ds kept performing at or above grade level. For ds, it turned out to be severe vision processing issues and a soy allergy. The vision issues made his world pretty wacky to navigate so he was anxious and fatigued, and would do odd things to compensate. His soy allergy made him feel yucky and irritable. We definitely could have had a very different dx that would have been wrong.

ADHD is a dx of last resort after all other possibilities are considered and ruled out:
http://aappolicy.aappublications.org...105/5/1158.pdf


2xy - I am glad that you were able to figure it out! My dh has sleep apnea and is now using a CPAP - what a world of difference!