Reply To: Deep frustrations with child psych-Are psychologists afraid to diagnose ODD?

Home Welcome to the ADDitude Forums For Parents Symptoms, Diagnosis & Beyond Deep frustrations with child psych-Are psychologists afraid to diagnose ODD? Reply To: Deep frustrations with child psych-Are psychologists afraid to diagnose ODD?

#126750
Dr. Eric
Participant

I agree with Penny, and I am a professional in the field.
There are three reasons why I avoid ODD as a diagnosis, other than it is not really part of my job description to provide clinical diagnoses most of the time. Even though these are not 100% perfect explanations, any one of them is good enough for me.

1. It is a diagnosis of last resort. We spend most of our time on a process of elimination for more meaningful diagnosis that will inform services and treatment.

2. It is more of a label/circular logic than a diagnosis. In ADHD, you can read about impaired dopamine function in the prefrontal cortex. In schizophrenia, you can read about hyper-dopamine activity in the substantia nigra and/or similar biological issues. In ODD you get the following: How do you know they have ODD? Because they have these behaviors that cannot be explained by another diagnosis. Why do they have these behaviors? Because they have ODD.

3. Utility. My job is to help teachers and parents improve behaviors. I only discuss labels when qualification for 504 or an IEP is at issue. In fact, many states and/or schools will treat ODD and Conduct Disorder as evidence of “social maladjustment” which is actually a disqualifier for special education services. I would not be surprised if these are also disqualifiers for insurance reimbursement, but this is me guessing outside of my job description.