ADD/ADHD

Do any of you have an official diagnosis of ODD with your ADHD/ADD child? Are you on an IEP and how does the ODD diagnosis change the IEP, if at all?

I am curious. I believe firmly that DS who was diagnosed with ADHD at 3 1/2 had ODD as well.... or at least tendencies. To my horror he was suspended from school last week (in FIRST GRADE!) for a problem in PE (I'll spare the details). This was the second time in two days the principal was involved in an incident with him. AND he's already made a visit to one of the principals office several times this school year. There seems to be a pattern with him, though. It always seems at high stimulus, unstructured times (i.e. PE, lunch, recess) when he has the most issues. The defiance comes out (for example) when it is time for him to do something he doesn't want to..like line up to go inside from recess. He has literally RUN the opposite direction towards the neighborhood that backs up to the school.

I was going to ask also what do you do in times like this? At home I try to avoid high-stimulus situations as much as possible (like no going to grocery store with me, etc). He has already had recess taken away indefinitely. He does get some downtime and is allowed to sit somewhere quietly and draw (which he LOVES doing)... but I don't like the idea of him not being able to have the physical activity he needs.

So the day after the suspension we were able to get an "emergency" appt with psych doc. Doc recommended a book, "The Explosive Child," which I bought today and changed meds. He was/is taking Focalin XR (10mg in am and 5 in afternoon) but suggested a BRAND NEW medicine called Intuniv. It apparently was succesful in clinical trials in kids with ODD. It is a non-stimulant (but NOT like Strattera...b/c I asked about that b/c we had bad experience with Strattera) and has to build up in the system. The med apparently was originally for High Blood Pressure. Anyone else trying out this med? We've only been on for three days so can't say how it's working yet.

Thanks for the input!

Hi, Intuniv is a longer acting for of Guanfacine( Tenex). Tenex, and Clonidine( Catapres) have  been used to treat ADHD for quite a while. It tends to help with sleep, and impulsiveness. He will need his BP monitored, and watch for marked drowsiness. Intuniv is fairly new, just recently approved by tha FDA, my Grandmother was Rx'd for her Blood Pressure just this week...

I have never dealt with ODD,  but if it is anything like a rebellious defiant preteen, I feel for you.  While there are no meds for ODD, it has been treated successfully in several kids I know with Behavior Therapy.

Has he been re-evaluated by a Neuropsych? To get it written into an IEP you would need that diagnosis, and probably the Psych report.  It may also be time given his very young age at the intitial diagnosis.

Hi Jenn.

You just EXACTLY described my son. The only difference is that his defiant behaviour is only at school. I can take him shopping with me and I have no problems at home. DS is ADHD combined type (and gifted) with no ODD identified.

He has trouble lining up...doesn't like to wait his turn. And if things don't go his way he bolts out of the classroom. I have had to do 3 parent withdrawals (these don't go on his record) in the last 7 school days.

He also now knows if he doesn't like the way the day is going he just acts out and gets to go home.

I have my son on bifentin (a long acting ritalin - only available in Canada) and I don't see it helping much with the impulsiveness. However, when DS isn't at school I don't need him on meds as he is easily controlled outside of the school environment. He does karate after school and has few issues and the meds are worn off by the time he goes.

I think I'm in the school's speed dial. The VP just loves to hit my button on a daily basis.

If you ever need someone to bounce ideas off of in the exact same boat feel free to email me through my profile.

In terms of the Explosive Child. This is the method that our school uses. Or at least that they say they use. They don't properly use the Ross Greene approach and often allow a blow up before they figure out the collaborative problem solving.

I feel for you. It's a good thing I have a good sense of humour with all of this.

My son sounds very similar. He's in 2nd grade and has a ADHD and ODD diagnosis. We strongly suspect Aspergers as well, but the neurologist diagnosed him ADHD and ODD. Anyway, we have the same struggles - lunchtime, PE, recess, hallway all seem to be high trigger times for my DS. Has your DS had an OT evaluation through the school? This year we've found that sensory breaks and a sensory "diet" throughout the day help him. They are taking him from the playground as recess ends and doing wall pushups, or a stretch band or other sensory things to help him wind down after recess (as well as 5-7 other set times throughout the day) - rather than putting him in line, and expecting him to behave. The sensory breaks help him keep his body regulated, but also get him out of the classroom and into a quieter hallway for a few minutes - which also helps him regulate himself). My DS has a lot of sensory type issues that exasperate the situation during unstructured activities (hallways, lines being huge triggers for him... crowds, loud activities, also). The school is working with us on his IEP, and are well aware of his behavior issues.

I read the explosive child last year - it is a good book, but hard to implement (IMO). We have not started DS on medication, but are looking to trial something sometime soon, I think.

DS has been evaluated by school for sensory issues. That is actually the first thing they did back when he was in pre-school. His teacher then noticed his sensory issues... which has a lot to do with some of his behavioral issues too. When we re-evaluated his IEP last year, they reduced his OT time. I personally think it needs to be increased and his access to a para needs to be increased. He does much better one on one. He had a para FT in pre-school but not now. We are re-evaluating next week b/c of his PE incident the week before Halloween.

Since he has gone back to school and since he has started this new medicine he has been doing GREAT! So I don't know if it's the medicine working or if it's HIM being afraid/embarrassed for what happened in PE. Which i think it's the former rather than the latter... he is remorseful after he has one of these meltdowns,  but being only 6...his memory about that kind of stuff isnt like an adult.

I still don't think he has earned his recess back yet. He does get a break during the day to de-stress and sometimes he gets to run around hte gym, other times he will draw (which he loves to do). PE is only every third day :(