973741 tn?1342342773

Is your child's defiance normal or a psychological/neurological disorder?

Parents around the world know kids are challenging.  Tell them to wear a coat on a chilly day and you may be met with an emphatic NOOOOO!!!!  Where do you draw the line of what is normal push back and what is over the top reactions or even to the point of a disorder such as Oppositional Defiance Disorder?  Is it hard to tell?  

Here's info on ODD https://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/symptoms-causes/syc-20375831.

This is prompted by a discussion friends of mine were having that wasn't the nicest but they'd seen a 6 year old boy refuse to do anything their parent wanted and this is the norm. It then resulted in some saying the parents were terrible and not doing their job, and others saying there is something wrong with the kid.  What are your thoughts?
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I don't have an answer but am struggling with this same question. I posted years ago when my grandson was 7 - he is now 12 and totally out of control. I have been saying all along that it is something physical, from birth, as he had many abnormalities over the years. He had very loving and supportive parents, but never showed love, empathy or the ability to understand others' feelings. He always flew into rages and could never accept blame or responsibility. When his brother was born six years after him, he gradually became mentally and physically abusive to him. Over the past 6 years the whole family has fallen apart from the constant tension of trying to deal with this out of control child - his parents are divorced, the ex -husband is acting extremely irrational, my younger grandson is traumatized. They have seen therapists but never get anywhere. He's now on  Abilify and Risperdol, which at least keep the outbursts under control somewhat at school,  but his father wants him off the Abilify due to possible diabetes connection (he gained 50 lbs on it.) The psychiatrist thinks it's parental, yet these issues had been going on for years and years and the parents only got divorced a few months ago.  I would love to find someone to do an MRI, as I've seen studies where there are brain abnormalities in some children with ODD, but I don't know how to find a doctor to do it and if we had the information, don't know if there is anything that can be done to treat it. It is now to the point of survival - my daughter is struggling financially and has to work 2 jobs, and my ex son-in-law is suffering from erratic anger and depression. While they share custody, my grandson is getting extremely hostile towards his mother. She has no control over him at all, and it's getting scarier the bigger he gets. He's very smart and was in the gifted class, but now he refuses to work and is getting horrible grades. I am worried he will start with CD, as I have little hope for him getting the proper support he needs from his parents. (We don't live in the same state so our help is limited.) I would love to have him get an MRI just to validate that I wasn't crazy all these years witnessing disturbing and abnormal behavior.  Thanks for letting me ramble on. If you know of any psychiatrists or place to get answers, I'd appreciate it!
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Oh, I feel for you.  What is going on is difficult....and now, not having a complete family unit makes it even more difficult.
Both Abilify and Resperdol will cause weight gain.  If I were to recommend going off either one, it would be Risperdol as its side effects on boys are much more serious.  But either way, both of them need to be tapered off.  Not suddenly stopped.

I think the MRI idea you are talking about is the research done by Dr. Daniel Amen to use brain scans to diagnose and treat AD/HD.  You could get his book Healing ADD and read about it.  But, it would be expensive to get a brain scan.  However, it does bring up a very good point and that is the adhd link.
Risperdol and Abilify don't really solve the problem....they just mask it.  He has many of the traits of a child with add or adhd.  I am guessing that because he is so intelligent, that that was never tested. Howevcr people with a high intelligence can have adhd..  https://www.additudemag.com/adhd-and-high-intelligence-iq-plus-attention-issues/     Now however, it sounds like he no longer can count on his native intelligence to get by in school and is dying on the vine.  That actually is pretty common for kids with undiagnosed  ad/hd..

I would definitely try and find a psyc to get a second opinion about what is going on....because what is happening now is certainly not working and will only get worse.   It is also possible that the school could do an evaluation for adhh/add as I am pretty sure they are now getting worried about him.  But a child psychiatrist specializing in adhd would be the best choice.

There are several good articles at this link that will give you more information on the whole adhd thing....https://www.additudemag.com/category/understand-conditions/adhd-essentials/symptoms-adhd/

I hope this helps.  
Thanks for your input, Sandman. You also answered me 5 years ago, and I read up on some of the things you recommended at the time. He has been diagnosed with ADHD, ODD (he scored 89% on that test) and, because they couldn't really pinpoint his situation, said he's on the autism spectrum with a very high IQ I might add. So yes, he's seen psychiatrists, psychologists,  went to classes for social skills in school, went to OT for his low tone and has an IEP.  His parents went to a class, also. Nothing has helped. And nothing has made a difference in the issues that I was most concerned about 5 years ago and am still today. The kid has no empathy. He has no love or attachment. His mom could be throwing up in front of him and he couldn't care less, just get annoyed if it interfered with him. As a matter of fact, he is just constantly annoyed or angry. You cannot have a normal conversation with him. No matter what the subject, if you say black, he says white. If you show interest in anything he's doing, and ask a question about it, he snaps at you as if you're stupid for not knowing. He's irrationally violent and very often cruel, but if you say please don't be mean he goes ballistic on you. It's apparent in pictures of him through the years that he often has a blank stare in his eyes. And in some videos on my computer that he made when he was 8 or 9, you can see this really angry flash that comes across him at various times. These things are not ADHD. Being floppy and not able to hold his head up until 6 months old, not making eye contact as a baby or child, missing milestones when young, never experiencing joy unless he's beating someone at something -  these are not all ADHD.  Doctors are not allowed to say a person under 18 has anti-social personality disorder, but he clearly exhibits the characteristics of it (without the charming part).  His psychiatrist doesn't want to do anything more until he sees the therapist, but my daughter has been waiting for 8 months to see the one he recommended.  I wonder if there are any other parents/grandparents out there who have been through something similar. I guess I would like an MRI to see if there is really any hope that things can change or if it's a brain deformity, because I know there is no history of abuse, neglect or trauma. I'm at a loss as to where to find a doctor to do it. By the way, he's on Adderall and Abilify, not Risperdol. Thanks for listening.
It was interesting (in a kind of sad, scary way) to go back and read our original posts.  There are some things i noticed now, which I did not notice then...but, so much was going on.   The one thing I have learned a fair amount about in the last 5 years is autism.  And its sad that that diagnosis was not made sooner as it really is something that the sooner treatment can start, the more successful the  treatment.  How long ago was the autism diagnosis made?  I am kind of assuming it was last year?  Was he in elementary school then?

It unfortunately sounds like he has both adhd and autism.  That is actually common enough that there are several articles on that (I'll link to those later).  I am guessing that due to his intelligence and adhd, the autism was hard to define back then.  I am also guessing (due to his age) that he has recently left the relatively comfortable zone of elementary school and entered middle school.  I have seen kids with adhd try and keep it together during the day and then just melt down when they finally get home.  I can't imagine what a child with autism must be going through.    So I am curious if his behavior has gotten much worse since the start of the school year? And then you throw the divorce into the mix and it really stirs up the pot.   Given all that is going on....new school?, autism, adhd, divorce.....I would not be surprised to see him falling apart.

The school needs to be more involved.  Since he is getting failing grades....they probably are also getting worried.   They need to know about the autism diagnosis and they need to probably radically change how he is being schooled.  This would be especially true if his behavior is much worse this year.   I think there would be the possibility that if his school day becomes less of a struggle for him, he will be easier to live with at home.

And living with at home is also a key phrase.  How you deal with an autistic child is different then dealing with an adhd child.  And your daughter has to deal with both...ouch.

Here are two pretty good articles on autism and adhd.  Both of them have suggestions on treatment.  But, more importantly they also attempt to explain how autism difffers.....and it is different.

The first article is - https://www.additudemag.com/autism-aspergers-adhd-symptoms-in-children/

The second one is - https://www.additudemag.com/autism-and-adhd/

And for a list of all of the articles from this site on autism - https://www.additudemag.com/?s=autism        And, I think the more that you and your daughter can read up on  this the more helpful it will be.

Finally.....getting in to see the therapist the psyc recommended.   Wow, 8 months of lost time!  The psyc dropped the ball there.  If she can't get in to see the therapist soon, she needs to look for another one that is trained in dealing with autism.   Actually, she needs to attend her self, because what she can do at home will be just as important.   And, on the same note, the school also has to get involved.

Oh, quick thought on meds.  Glad he is not on risperdol!   There are other anti-anxiety meds that the psyc could try on him that work well and don't have the weight gain issues.   I am also wondering if his adderall dosage has changed in the last year or two?  If he still is on the same dose, it may be wearing off early and making life at home just that much more difficult.  Adderall XR should last 8 to 10 hours and Vyvannse can last 12 to 14 hours.

If I can be of more help, please ask.  Or if you just want to vent,  that is ok too.   Just please, don't wait 5 years to get back to me to let me know how things are going.   Best wishes !
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