November 19, 2019 at 4:38 pm #134895
Long time reader, first time poster.
We first started noticing problems with our son’s behavior around 2-3. He was refusing to nap at daycare and would scream in full on tantrum mode for hours. Soon the behaviors continued at home. Flash forward many tears and screams later he was diagnosed with ADHD and ODD.
We’ve gone down the usual routes of medication to treat the ADHD (Ritalin and now Focalin, single and extended release, various dosages). So far we’ve seen some success but the ODD behaviors have never lessened. We’re also taking Intuiniv with the ADHD medicines in hopes of helping with the ODD. Only 2mg (1mg in the morning and 1mg at night, 2mg at one time knocked him off his feet). It’s hard to be objective and say things are better with the Intuniv mixed in since we’re still having so many issues but I’m sure it’s better than it was.
We’ve also tried various therapies with mixed results. We personally feel therapy is the only thing that is going to help with the ODD. We saw a LCSW to help us as parents control ourselves so we could focus on helping him. It was the best thing we ever did. When it came to our son we tried applied behavioralists, but apparently we were recommended the wrong company. A small fortune later of in school observations gave us no new information and a basic color chart/behavior tracker…
We were blessed to get a scholarship at his current school for OT. However, again I think we may not have the best option. All of her advice and work with him hasn’t really targeted the ODD behavior or is something we’ve tried with no success. We’re currently looking at trying speech therapy to help with his social skills but the cost is daunting.
We don’t know where else to turn or what to do. Our biggest obstacles are concrete thinking and inflexibility. He flies into tantrum mode at the drop of a hat and is near impossible to bring him back down. All the skills and methods work great on paper but in the heat of the moment he refuses to try them. He knows that screaming and crying only brings punishment and not rewards but he just can’t control himself.
I could go on and on but we’re just at a loss. We don’t know where else to turn. I was hoping someone has found success with some therapies or medications we can look into. Just something to give us hope that it can get better…
November 20, 2019 at 9:23 am #134930
I see a lot of kids labeled with ODD or other mood disorder who actually have autism spectrum disorder. While concrete thinking and inflexibility are classic signs of “high-functioning” autism, it takes more than that to meet the criteria to have ASD. Something to consider exploring. (My son got the additional ASD diagnosis at age 12, six years after his ADHD diagnosis. Many therapists through the years suggested mood disorder and I knew it didn’t fit. When social struggles became much worse instead of getting better, and when stuck thinking was impossible to get through, I realized ASD could be the missing piece, and it was.)
I always teach parents that behavior is communication, just as Ross Greene’s work shows. There’s always a reason why the behavior is happening. When you address those reasons successfully, then the behavior improves. If you haven’t read Greene’s books yet, I strongly recommend them: “Raising Human Beings” and “The Explosive Child.”
The other piece that is likely contributing to the behavior is emotional dysregulation. Ask the OT if they can work on emotional awareness, communication and regulation. Our OT did this through the Zones of Regulation program.
And, remember, your son is having a hard time, not giving you a hard time. That’s very clear when punishments don’t improve behavior.
ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism
November 20, 2019 at 11:20 am #134967
Thank you Penny. This whole process started with an autism evaluation at age 4. The psychologist didn’t see any signs of autism but picked up on the ODD and ADHD. Our son’s teacher recommended getting him reevaluated to see if there were any changes as she also mentioned that he could have high functioning ASD. Perhaps we’ll look into another screening.
November 20, 2019 at 11:03 am #134960
My 11 year old was also diagnosed with ADHD and ODD. We saw improvement when we got to the right dosage of Intuniv. We still have moments that are difficult, and we have implement therapy for my son, as well as Plan B from The Explosive Child (see above). These have helped, but it is never a perfect fix. I think if you keep with it, you could see improvements. Good luck! It’s a tough road!
November 20, 2019 at 12:11 pm #134975
1. Diet control helped a lot, especially removing sweets and food with artificial additives.
2. Increase sleep if possible.
3. Do not use force. Use logic. Make connections.
4. Use one liners. And repeat them.
Suppose if a child always plays with water wasting ieverytime s/he goes to washroom, you can say – we conserve water and repeat that instead of a full lecture espisode starting with ‘how many times do I have to tell you…’
4. Show emotional restraint. If the child has a model for anger, ODD child will be quick to pick up on it.
5. Do not stop ‘showing’ love. It sure is there but its important that your child sees it and feels it.
All the best!
February 5, 2020 at 11:22 am #141058
I am new to this website and in search for answers similar to yours. We knew that my son who is almost 10 now had the telltale signs of ODD. He too was diagnosed but ASD was ruled out but not categorically. His behavior worsened with each year but it was never bad enough that it spilled outside of our home. He was always social and behaved when outside barring a few instances.
Fast forward to his ADHD diagnoses and falling behind on his educational milestones, we started him on stimulants. We tried a couple of different medications and dosages but the fall from when the dosage wears off was HORRIBLE. His behavior got noticeably worse and it was obvious that the stimulants were the cause. We stopped the medication to first get his behavior slightly in control. The first couple of weeks were better but then it took a turn for the worse. Every evening was a nightmare with him breaking down. We followed the rule book of not breaking down ourselves and not get upset at all – instead comfort him and show that we love him. It did not help.
After visiting the psychiatrist, we started him on Intuniv. It has definitely helped some but he needs therapy to go along with it. He starts CBT this weekend so we are hoping it helps more. I would like for him to start stimulants at one point because Intuniv does not help much with his attention disorder.
I wrote all of this to say that you are not alone and also to see if you have ever tried taking him off of stimulants to see if his behavior improved? Please do talk to the doctor about it before you take any action. Alternately have you looked into drugs such as Abilify?
February 10, 2020 at 8:57 am #141493
Our youngest son has also had problems with tantrums and understanding consequences hasn’t ever done anything because he simply lacks the maturity and control.
Over the years we have learned that stimulants can increase irritability and make our son even quicker to anger, so it is paramount to make sure the ADHD meds are right. We have tried ALL of the stimulants over the years. Concerta at 54 mg worked the best for years but then everything seemed to stop working when he turned 13.
He is now on the lowest dose of Vyvance, 10 mg, and we also use 50 mg of Strattera to help even out his behavior. He has communicated that he focuses better at school on 20mg of Vyance, but we get too many tantrums at night – which is why we dropped him back down to 10mg.
We also had our son tested to see if he was on the Spectrum when he was younger, at 7, and they concluded he was not. We added a pediatric Neurologist when he turned 13 and he concluded that he has very high functioning Asperger’s and so it is more like Asperger tendencies. We just used this information to read and research more as we are looking out to bring out the best in him. My son already has a pretty thorough 504 plan in place with accommodations at school – no changes there.
We also discovered he has executive function delays – particularly “neurological switching” and what you are describing sounds similar so please consider looking into that with a pediatric neurologist.
One important thing to let you know was that we did a blood draw with his pediatrician at his annual exam and found out he was very D3 deficient. We have now added Omega3’s and D3 pills to his daily routine and I think those have really helped.
It is a beat down every single day for us. Our son has moments of lovely, he is very smart, we are just praying that as his matures his rigidity towards change will lessen.
February 10, 2020 at 9:43 am #141505
I’m assuming you have an IEP in place with his school. The one thing that has helped us the most with my child’s behavioral issues is placing him in an E/BD program (Emotional/Behavioral Disability). If your county has this program, I’d highly highly recommend trying to get him placed in it. It is made for children with ADHD, Asperger’s, ODD, and behavioral dysregulation.
In my county, the classes are mixed (K-1, 2-3, 4-5) and small (7-10 kids at most) and there is a teacher, assistant teacher, and 2 behavioral techs, plus a quiet corner and a whole other private area with dimmed lights and sensory play to “chill out”. We get detailed behavioral reports sent home every day with scores per hour and activity for several behavioral goals. The idea is to move him through from stage I (basic behavioral goals) to stage 4 (advanced) and eventually reintegration into a normal classroom setting. Meds have helped some (Ritalin), but this has helped even more.
February 10, 2020 at 10:28 am #141520
This is a FWIW contribution. Not direct advice. Just about an adult’s long trajectory.
My ex Sig other — per descriptions his own mother gave me of times when she had no idea what was happening – exhibited signs of ODD when he was young ( there were some descriptions dental and dr appointments where the Drs told her never to darken their door again). All this was long before anyone knew of ODD or ADHD etc.
The negative thing from this that he always retained was a mulish refusal to change ideas, and inability to hear feedback or intuit others’ feelings. He sometimes needs to be removed from a situation – or hear it from a neutral source (PBS) to see the other side. He also was likely hyperactive, but that was channeled into sports and constant activity (altho’ smallish, he was good at most sports) As an adult, his “hyperactivity” was channeled into much better than average mechanical abilities and work that required making things ( he did get a Mechanical Engineering degree, altho’ had to return to school as an adult to settle down to do the academic work) He had the ability to keep at anything he was interested in doing – and nothing else ( Could there be some ASD in this. Yup)
SO blah, blah: the point: he has made many friends over the years. He’h had good jobs – not those requiring a lot of people skills – but has done the best in starting /running his own businesses ( a horrible delegator, but that’s another topic). I have had him drive me nuts with obsessiveness about some issues. But he made a very full life, using all of his traits – – Not perfect but full.
February 10, 2020 at 11:01 am #141536
Parenting is hard but parenting a child with ADHD, ODD and ASD – the struggle is real and you are not, I repeat NOT alone. I am a parent of an eleven year old that has all of these and I saw it in him since he was 2. I won’t get into all of my story here but wanted to say a few things to hopefully help aid in your situation. My son was diagnosed with ADHD at age 4 since that was the earliest any physician would see him to test him even though I was seeing signs at age 2. Along with this I was seeing signs of ASD and had him tested not once but twice at very highly recommended facilities only to find out years later that he was missed for high functioning ASD because the psychologist was looking for low function attributes instead of high. Long story short, he was tested at age 8 for the 3rd time with results that he was indeed high functioning ASD. With these two diagnoses accompanied ODD, executive functioning disorder & auditory processing disorder. I too have spent much time and money on therapies, research, testing etc. teaching coping skills & behavior strategies to your child is definitely helpful. Saying & explaining less and using quick phrases instead can go a long way. When you start to see tempers arise & verbal arguing from your child as he is talking over you try using the word ”stop” calmly as he may just be perseverating over something he may not be able to explain which looks like arguing & giving the parent a hard time. Remind him to use his words and that you are on his side, they you are there for him trying to understand his needs & want to help. I I could go on and on with ideas and strategies but I’ll stop there. Currently, my son takes aderall and his daily supplements in the morning and intuniv in the evening one and a half to two hours before bed. This has helped with his attention deficits, impulsive behaviors and Sleep. Also, after testing for food sensitivities/allergies, he is now following a gluten free diet which has helped tremendously with his ODD, mood swings & tantrums. Just a quick side note, Food sensitivities can cause areas of the brain to become highly inflamed leading to deficits, mood changes etc. By removing these food sensitivities it allows the brain to become less inflamed Resulting in opening up areas that were one blocked to start functioning again. In my son’s case, it was gluten, dairy & soy to be the problem causing factors. Since we have removed gluten completely and most foods with dairy & soy it has allowed my son to finally find peace and calmness within himself. His moodiness, arguments and tantrums (ODD) have decreased by at least 90% if not more. It’s truly been a huge difference and I highly recommend getting the food tests done. He is also making progression in areas of executive functions both at school and home as we continue to work on coping skills as well as other areas of need. In ending, This is where we are at now as we continue to fight and look for answers in our own journey and battle with these disorder ms. I hope by me sharing it will help you in yours. I’m not sure where the next chapter will lead us too but this is what we have found to work for us for currently. ADHD & ASD are both spectrum disorders. A person on the spectrum can be very different from one individual to the next and no two journeys will ever be the same. Please remember to breathe and be mindful through your daily tasks and searches for answers. There is no right or wrong way in doing things & finding help. You have to find what works best for your child & family. I truly wish you much luck as you continue with your journey of fighting and advocating for your child. May peace and many blessings be with you and find you soon. 😌
February 10, 2020 at 11:10 am #141538
My son wasn’t diagnosed with ODD, but had a lot of anger issues. We ended up trying neurofeedback and it helped tremendously with his anger.
February 10, 2020 at 11:46 am #141551
Hello – so nice to see we’re not alone. The struggle is real. Our doctor is recommending a low dose of Risperdone, or Latudiv – reading the side effects really scares me, so we haven’t gone there yet. Reading the post above, we tried Neurofeedback Therapy in the fall, sadly it didn’t work. The doctor came highly recommended from our therapist. My son is 12 with ADHD and ODD. I have a 10 year old that also has ADHD, takes Quillivant – no ODD, thankfully! Hugs to all on this journey!!!
February 10, 2020 at 12:49 pm #141548
As a therapist i have conducted ADHD evaluations using the materials of Dr. Daniel Amen for over 10 years. You can explore his information and start an evaluation on his website here https://addtypetest.com/. I found that many of my clients who exhibited behaviors like ODD or were diagnosed with ODD often suffered from Overfocused ADHD
“In order to focus, it is necessary to continually be able to shift your attention. People suffering with Overfocused ADD have most of the ADD features, but rather than not being able to pay attention (they also have difficulties with , they have difficulty shifting their attention; they become hyper-focused on certain things while tuning everything else out. These folks tend to get stuck or locked into negative thought patterns and behaviors. This type of ADD is often found in substance abusers as well as the children and grandchildren of alcoholics.
Common symptoms in Overfocused ADD
Core symptoms of ADD
Excessive or senseless worrying
Getting stuck in loops of negative thoughts
Oppositional and argumentative
Tendency toward compulsive behaviors
Difficulty seeing options
Tendency to hold grudges
Difficulty shifting attention from subject to subject
Tendency to hold onto own opinion and not listen to others
Needing to have things done a certain way or they get upset
May or may not be hyperactive
Overfocused ADD SPECT scan findings show increased activity at rest and during concentration in the anterior cingulate gyrus, as well as decreased activity in the underside of the prefrontal cortex, cerebellum and basal ganglia.”
They often were hard to redirect even if they logically knew the consequences were bad.
These individuals exhibited a lot of anger when attempting to redirect them.
My own son also suffers from this type of ADHD and we had to fix a lot of holes in the wall together as he grew up.
According to his materials and my experience in working with these individuals giving them a stimulant to help attention (if needed) combined with a small dose of an SSRI like Zoloft (most often used since the FDA approves its use with children), prozac , paxil, etc. gives the most benefit. These antidepressants increase Serotonin in an area of the brain that tends to “get stuck” when Serotonin levels are low. I have seen these children becomes much more flexible and Oppositional often within a few days.
The other condition on his web site labeled “ring of fire” ADHD (sometimes diagnosed ADHD with bipolar tendencies) is often associated with intense short lived anger and is usually helped with Intuniv but your child’s behavior appears to be more in line with the overfocused ADHD which often does not respond well to Intuniv.
This is not intended to medical advice or providing a diagnosis. I encourage you to explore the website mentioned above.
I hope this helps,
February 10, 2020 at 6:50 pm #141645
My 12 year old grandson was diagnosed while he was in preschool with Sensory Processing Disorder and ADHD. He now also has Anxiety Disorder, ODD and to make matters worse, raging hormones! It’s always been very challenging but with the ODD and puberty things got pretty bad in the past year. We chose years ago not to medicate and we were advised that with the fluctuating hormones of puberty it wasn’t a good idea to start now. After much research we started him on Lithium Orotate (Amazon) This is not the prescription lithium, and Niacinamide (Amazon). Please, please research these in regards to ADHD and ODD as they have made a significant difference in his behavior. He is still on days a moody preteen but he is much more reasonable and calm…manageable vs crazy out of control! We also have him on Joy-Filled Supplement…great product! (Amazon), Omega 3, low dose iron, vit d3, magnesium glycinate, multi with zinc, l-Theanine and melatonin and lemon balm to sleep. We have renewed hope and wanted to share this in hopes it can help others who are struggling!
- This reply was modified 2 weeks ago by jmt8090.
February 11, 2020 at 12:04 am #141655
I have ADD, and also a low tolerance of fools and immature people.
Often, I just ignore nonsense and illogical stuff.
Is this ODD?
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