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.)

Anyone else hear about the study on adopted vs. natural children and tendencies for mental issues as teenagers? If not, one of the mental disorders they talked about was Oppositional Defiance Disorder.

I came across one seriously delusional character on the Time Faith boards who would diagnose everyone who disagreed with him with ODD.

I meet a kid with ODD, at least that's what his dad told us. It looked like there was some sort of cognitive behavioral therapy going on -- right behavior got rewards and wrong behavior took away thing like library trips. Now I only saw this kid a few times - so this is all speculative sort of stuff. The only outburst I saw was behavior I would have expected from a much younger child.

but when you can't get out of bed and are on the verge of getting fired, there's a problem

My nephew got kicked out of the Navy during boot camp for being ODD. This was not something that they take lightly, he was given multiple personality tests, psych evals, etc. What tipped it all the way over to be kicked out was that he threatened to blow up a school teacher when he was in 10th grade. He was expelled from that school and yet neither he, nor his mother, seemed to take it seriously. And his mother is a school teacher. (I despair.) The nephew has ADD, too, so it's one whole big ball of difficult to diagnose. He was so severely disappointed, because he really wanted that, but he just can't stop himself from being a total a-hole. Love the dude, but he can be very difficult to be around for long periods of time.