ADHD/ODD 4 yr old with a big heart! HELP

[Tmedlock]

I have a beautiful little 4 yr old girl with ADHD and ODD.  She is incredibly smart,  and we can already tell that she will not have the learning problem that her brother (also ADHD but not ODD) has.  We have a loving family with both parents living at home...  Our issue is that her ODD is really ruining her pre-school environment and I'm not sure what to do!

We have her set up with a psychiatrist who agrees that she is definitely a strong-willed ADHD/ODD child.  She is not medicated b/c of the age.  Here are just some examples... She loves to pick a fight with a weaker-adult... (luckily, my husband and I don't put up with it, so it is more controllable at home).  Last week alone, she cut a girl's hair  - I mean CUT IT!!! because she "really wanted to" and she "Knew it was wrong".  Yesterday, she took apart the toilet in the preschool bathroom because she "could" and today I got a call that she choked a little boy in the gym because he upset her.  Another example is a few months ago, she was eating breakfast in the caferteria at her school and a little girl annoyed her, so she took the back of her head and pushed it into the bowl of cereal.  If she can't sleep at naptime, she will steal other's pillows and blankets to wake them up and just annoy them.

Now, I don't have ADHD or ODD, so this is all new to me.  My husband does have both, but was not diagnosed until he was older.

We need help!  My little girl is very sorry after she does these things, but can't seem to push down the impulses to do the behaviors upfront.

HELP PLEASE!!!!!!!!!  I love her so much, and there are times when she is absolutely delightful, but she has a "switch" that just goes off in her head and she becomes a little terror.

Any advice??????

Thanks so much,

Frustrated mommy

[Kevin Kennedy, Ph.D.]

Your description does not offer strong indications of Oppositional Defiant Disorder. If the ADHD symptoms (particularly the impulsivity) are severe, and the stakes are high (e.g., being able to act successfully at school), you might well consider pharmacological treatment even though your daughter is young. Sure, it's best to hold medication in abeyance if possible with very young children. But, if the child displays a biologically-based neurointegrative or emotional disorder, and the condition is a severe hindrance to mastering the demands of the age, then medication can be a useful and sensible intervention.

[portuguese mom]

I am not an expert and I am sure Dr. Kennedy will have good input for you. As a non-expert,  I do not believe that ODD exists at this age. If she was formally diagnosed by a prefessional child mental child specialist, the ADHD is probably severe and is causing her to behave in this manner. In such cases, I believe that medication is recommended at this age. You should talk to a child psychiatrist or child development dr. that specializes in ADHD and see if you can try to medicate her.  Also, make sure that her school is appropriate for her.  Maybe the school has too many children and noise for her disability. This could cause her to behave like you stated.  The school also needs to be aware of her disability and have a behavior plan for her.  Good luck.

[Tmedlock]

Last night we had another visit with the psychiatrist, and he wants to put my daughter on medicine to see if it will help.  I am all for this, and he is the 3rd doctor we have been to with these issues (Primary care, Psychologist and now a psychiatrist).

Here is the issue, my husband (who has not been part of these visits) is concerned about putting her on the medication and wants yet ANOTHER opinion.  He wants to ask one of his professors, however, that professor does not know my child and has not observed her.

He is worried aboutt the long-term effects.  Funny thing is, he is on Straterra for his ADHD (husband), son is on Focalin for his ADHD, and now somehow b/c my little girl does not have the learning disability with her ADHD, but instead has the behavioral issues, he doesn't want to medicate her.

Any advice???  I'm very frustrated.  As a mom, I know she needs something or she will soon be kicked out of school.....  

[Kevin Kennedy, Ph.D.]

With such a family history, pharmacological treatment is reasonable. Let the results speak for themselves. It could be a very useful intervention for her.