Aims, one of the parenting podcasts I listen to had an episode on ODD recently, and the guest they were interviewing (who had done the research and written a book) explicitly said that 3 year-olds (one of the hosts has 3-year old twin boys) are just like that, and a toddler arguing all the time and refusing to hear "No" is not a behavioral disorder, it's just them being toddlers.

It's the last sentence that's the key:

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

Like with any other behavioral disorder, there's a wide spectrum from normal to diagnosible, and it's not a disorder until the behavior is causing "clinically significant impairment."

Here's the link if you want to listen. I thought it was really interesting stuff.

As far as medicating goes, I don't remember them mentioning any kind of medication for ODD - most of it was just how to talk to your defiant kid so they'll listen.

most of it was just how to talk to your defiant kid so they'll listen.

I find waving the gun around is pretty effective.

"clinically significant impairment."

I'll have to do more reading and find out what that point is.

I recognize a lot of the symptoms as ones I had in SPADES as a teenager and it led to a lot of Bad Stuff for me, but I would venture to say that for me, anyway, it was undiagnosed depression that led to me acting out in a severe fashion.

I wonder if there has been anything showing that ODD is a symptom of a bigger thing? Admittedly, the NPR piece was brief and presupposed you knew something on ODD and I haven't had a bunch of time to reserach it this morning, but I swear, just hearing what they said on NPR got my hackles up. I sometimes feel like every kid (overgeneral me? Nahhh) has some kind of something wrong with them and that more often than not it seems to me that medicating them is the answer given. Kids are supposed to be a-holes sometimes. It's what makes them kids and what we, as parents, get to hold over their heads for the rest of their life! If I'm medicating my kids into Stepford Kids, how am I supposed to make them feel like shit when they're 30 for acting a fool when they were 15? Won't anyone think of the parents?

Aims:

I know Em's only three, but she does half of these and I am pretty sure that it's not some damned disorder. What the hell? Are we medicating kids for any kind of negative behavior now? I'm on board with ADD and ADHD, but this? Seems like totaly hippie-dippie bullshit.

Jessica:

Like with any other behavioral disorder, there's a wide spectrum from normal to diagnosible, and it's not a disorder until the behavior is causing "clinically significant impairment.".... As far as medicating goes, I don't remember them mentioning any kind of medication for ODD - most of it was just how to talk to your defiant kid so they'll listen.

What Jessica says is true: ODD is not your garden-variety, regularly scheduled, developmentally necessary, separation of self from parent, hormonally enhanced, defiance. Like AD/HD it is not so much a matter of "everybody who ever has any of these symptoms needs meds", which would be silly and unnecessary, as "everybody has these symptoms sometimes, people with the disorder have them enough to cause serious impairment in many areas of life".

One of the residents I work with has ODD. Dealing with her is different than dealing with someone who just does not want to be bothered, as well as different from someone who just needs to explore independence. If you ask her if she wants to take a bath, she will say "No!". If you ask her if she wants to take a bath while handing her a towel and wash cloth, she will say "No!", turn the water on, start taking her clothes off, and take a bath. If you simply hand her the towel and wash cloth without talking about it, she will run the water, start taking her clothes off, and take a bath. It's always fun to explain the subtleties of getting her to actually do stuff with new staff members who have had "Not violating clients' rights" drilled into them, with no reference to a true point of resistance. Because many new staffers will assume that that "No!" is sacred. No means no, after all. But she will say no and do yes very happily. Ask her if she likes you, and she will say "No!" while smiling and hugging you.

Post Toasties.

I should mention that if she truly does not want to do something, she flat out will not do it. There have been times when I handed her the towel and wash cloth, and she said, "No!" and walked away. This is her point of resistance. And at that point, we do not force the issue. But I have had new staff members try to tell me it was a violation of her rights to hand her the towel after she said "No". And bear in mind that this is a woman who recently celebrated her 50th birthday. This is not a phase for her. Kids who have ODD - as opposed to those who are in a stage of development which calls for a certain amount of defiance - will not simply get better by outliving their toddler or teen years.

At what point in time or at what benchmark do you (general you, not you, Windsparrow! YOU TELL ME!) determine that it is not a phase and is to the severity of the disorder?

I'm guessing that's why psychiatrists go to all that medical school. I figure it's probably like depression -- everybody gets blue, but when you can't get out of bed and are on the verge of getting fired, there's a problem.

I totally get your skepticism, Aimee, but I think like most mental illnesses, we're talking about the pathological version of what otherwise might sound like normal behavior. Er, if that makes sense.

Kids are supposed to be a-holes sometimes.

Andi already said it much better than I could, but -- ODD is more than a kid being a pain in the ass sometimes, just as depression is more than being down in the dumps once in a while. t edit (Or, what Emily said succinctly while I was blathering on like the uncaffeinated blowhard that I am.)

Yeah, there are unfortunate incidents where a doctor (or the parent) wants to medicate *anything* other than "my kid is a sunny happy perfect child who never throws a tantrum and can concentrate on his homework for hours at a time." And that's wrong.

But a good clinician has a sense of the difference between a kid being a kid and a kid having an actual disorder.

(Or, What Andi Said.)

I think like most mental illnesses, we're talking about the pathological version of what otherwise might sound like normal behavior. Er, if that makes sense.

That totally makes sense to me. Sometimes, I feel very old and crochety when it comes to newly emerging findings in disorders and such. Probably too many years of being around the parents in that use their children's very real issues to dismiss very bad behavior. My mom has a student that bites. He took a huge chunk out of Em's leg a couple of weeks ago. He's 4. He knows better. He has no mental development issues or slowness. He does have spina bifida. And the kid's mom says that the biting is a side effect of his spina bifida. Which, I just shook my head at. Pretty sure, and if I'm speaking out of turn, sj, please say so, but I'm pretty sure that a) it's not a side effect of the spina bifida and b) that if it was sj biting kids and teachers, her mom wouldda put the smackdown.

(Also, I really hope I'm not coming off as an a-hole cause I'm not trying to, really. I'm posting quickly between Boss being out of the office. If I am being an asshole, my sincere apologies.)