9 year old grandson's behavior getting worse

[lafer53]

Two years ago I wrote and wondered if my grandson had ODD. He has been officially diagnosed as ADHD and ODD, for which he was prescribed Ritalin. He lost so much weight that his parents took him off of it for the summer. He gained back 12 pounds but now that school has started he refuses to take any medication. His behavior is getting worse and I now fear that he really has antisocial personality disorder. He has a high IQ and can converse on a very intelligent level if its something he wants to talk about but he has absolutely NO regard for anyone other than himself. He has to be the center of attention every minute. He's already been called down to the principal's office for hitting and even kicking kids just because he felt like it. His little brother is developing behavior issues due to the bullying he constantly gets. He is always just plain mean. He actually delights in it. He has no respect for authority and it's getting harder and harder to get him to do anything he needs to do. He now has no friends. He always brags about himself yet won't work at anything so his performance is pretty low. The screaming, disrespect and defiance all go without saying. He seems pretty responsive to my husband and I (although can turn on a dime if he doesn't like what we say), so he spent a lot of time with us this summer. I had him doing video games where he had to guess correct answers on how to handle situations, I had him guess people's emotions by looking at faces, and we talked endlessly about the "right" thing to do. He had no problem getting the right answers, he just refuses to do it himself. He went through a year of counseling to no avail. The psychiatrist told my daughter that they don't really treat ODD as nothing is effective. She joined an ODD support group but stopped visiting the site because the people offered no hope at all. We try to be positive with him but he is always angry or annoyed. My question is, is there a doctor out there who will try some kind of medication to level out his personality a bit? Is there a specialist anywhere in the country who will see him? I'll take him to any state I have to. I am convinced it is a physical defect in his frontal lobe and would love to have them do an MRI. My biggest fear is that he'll end up in prison if he can't learn to get along in society.

[lafer53]

Thanks for the input. I will pass this info on to my daughter.

I found the thread "Is my child a sociopath?" on this site and see a lot of similarities with some of the other children, but as of right now he has not threatened to kill anyone or harm any animals (he actually has a cat that he says is the only thing he loves), so I feel there is hope. He does kick and hit his parents, though. He actually went for some sensory processing help last year. They said he can spin for hours and not feel any affects. The frustrating thing is, because he is smart and fairly manageable at school, they refuse to give him an IEP so he gets no financial help. My daughter can't afford all the therapies, especially since he has shown no improvement after them.  I think we should try to get him back in therapy with a different person, but finding one is hard and finding time in their already overpacked schedule is difficult. No matter what I just want him to know how much we love him, although I do suspect he's nicest to my husband and I because he usually gets undivided attention from us. I will definitely look at all the links you mentioned.

[Sandman2]

There are other options to taking ADHD medications if swallowing is a problem.   There is a liquid med, a patch, and several can be sprinkled on food.  Here is a link to all the meds out there and how they can be used.   http://www.leeheymd.com/charts/adhd_1.html
  And his problems are certainly not from bad parenting.  
Here are some links that should help with dealing with the ODD
      http://www.additudemag.com/slideshow/26/slide-1.html?utm_source=eletter&utm_medium=email&utm_campaign=October
   http://www.additudemag.com/adhd/article/9868.html?utm_source=eletter&utm_medium=email&utm_campaign=July
   I am also wonder if he has Sensory Processing Disorder as he has some of the symptoms (and it would explain a lot).   Check out this link on SPD and look at the symptoms, signs of dysfunction, how does it feel sub categories.   http://www.sensory-processing-disorder.com/
   This is also a good shorter link on SPD - http://www.additudemag.com/slideshow/178/slide-1.html

[lafer53]

In the title of the post I mentioned he was 9. No, his parents have not given up, but they have been to classes and support groups with little (actually virtually no) success. They live close to me so I would take my grandson to give them a break and would try and work with him when he's with me.

We were all on a family outing yesterday and when it was time to leave, he didn't want to and started ranting and raving with really nasty, rude remarks. This is not just a kid with ADHD, he has full blown ODD (exhibiting every single symptom every single day) and like I said, the worst part is he has no empathy or understanding of anyone's feelings but his own. It's hard to explain how difficult he really is. He is constantly blaming everyone else for things and cannot see how he has any personal responsibility in anything. The ADHD medication helped some with focusing, but he will not swallow anything whole so is limited to what is able to be chewed or crushed (I've tried every technique in the book, invested in special cups, straws, etc.) We've explained that he may have to go back on it if he starts getting in trouble in school, altho that doesn't mean he'll do it, but the ADHD meds still did nothing for his ODD, chronic meanness or horrendous attitude. Like I said, the psychiatrist at Children's Hospital of Pennsylvania said they can only treat for ADHD. Also, due to issues present at birth, such as hypertonia, a very large forehead, difficulty eating and being soothed, etc, I feel it is a biological problem and not something from bad or neglectful parenting. There has been no trauma or abuse either. I am just wondering if anyone knows of any other doctors or hospitals that have successfully worked with children like this, who are on the cusp of antisocial personality disorder.

[Sandman2]

  It would be a huge help to know how old he is.   And, yes, his ADHD needs to be treated.   untreated ADHD does lead to ODD.  The weight issues are common and can be overcome.  
   Since he spent a lot of time with you this summer, I am assuming his parents have kind of given up?  They are the ones who really need to get more information on how to work with ADHD kids.  It does start in the home.
     It is tough to get a teenager to take meds.  Not as tough for a middle school kid (that's why I asked the age).  Sometimes, they have to learn the hard way.  But, what is important, is that they get the right kind and dose of the medication.   Here again, depending on his age, information for him is key.