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Avatar universal

7 Year Old with possible ODD?

We are all at our wits end with my 7 year old grandson.  He was a "floppy" baby with very poor head control until about 6 months but was only slightly delayed in some areas of development so the doctors all ignored it. He didn't smile much as a baby and had a low affect.  He also had a large head and double hair whorls in the back (which my daughter thinks I'm insane for mentioning, but who knows?)

Fast forward 7 years, and his behavior is out of control.  To this day he still can't look people in the eye (even his parents or myself) and constantly yells at us as if we are all stupid. While he ignores anyone talking to him directly, he demands you listen when he talks, which is incessant and way above normal volume level. He sometimes delights when others are hurt and has total disregard for others' feelings. In addition, he exhibits almost all of the qualifying behaviors of Oppositional Defiant Disorder. While being bright academically, his teacher says his behavior is rapidly deteriorating at school.

He comes from a stable home life and his parents have used charts/rewards/withdrawal of privileges but nothing has worked. They have put him in counseling but he seems to have gotten worse.

So my questions are–-how is something like ODD diagnosed and who should he go to for testing? I should add that it would be near impossible for them to pay for a private evaluation because they are financially struggling. Obviously the child psychologist is not seeing some of these issues and just wants to continue with a behavioral chart, which is not working.  Could these behaviors somehow be related to his floppiness as a baby? Would this make improving his behavior more difficult? I am so frustrated because he always seems to slide under the radar and my concerns have been brushed off. It is now apparent to his parents that he is out of the range of normal for a 7 year old boy. I am really scared for his future. Any suggestions would be appreciated.
21 Responses
189897 tn?1441126518
COMMUNITY LEADER
   He is a smart kid who has learned how to manipulate his environment.  The problem lies not with any problems he had when he was a baby, but what he was allowed to do after about age 3.
  The child psyc rightfully sees his problem as behavioral problems and is trying the reward system to break the pattern.  Personally, I don't believe that system will work that well for kids of this age.  And frankly, probably won't work until around age 10 or 11 - if at all.
   For kids of this age, the rules for behavior modification are that there must be immediate, short, consistent consequences.   Do not expect overnight miracles.  It has taken him awhile to get to this point and it will take a while to relearn control.
    Also, smart kids very quickly learn that the best way to avoid consequences is to pretend they don't work.  So the parents try something else and something else and something else.  And the child keeps doing the same old thing.  Also, and more importantly, for any consequence to work it has to be consistently repeated, and repeated, and repeated.  It can take up to three weeks for the child to realize that you mean it.  For example, taking away his privileges or toys is ineffective.   "out of sight, out of mind".   Its much better to take him away from playing with them (a timeout), and then return him to them.  You can only take  away his things once.  You can remove him many times.
    The second thing you need (and the school needs) to do is to stop saying "don't do that".   You need to take action.  Typically, a short timeout.  And that is repeated every time he messes up.  Skip the rewards, the praise, the warnings that he will lose his weekend fun, etc.  When he messes up - immediately deal with it.  And do it again and again and again.
   I am a little surprised by his behavior at school.  Does a have a relatively inexperienced teacher?  Did he have these problems in first grade?
     Also, kids do need to be taught how to handle their anger.  There are a couple sets of books aimed at this age group.  One is, " How to Take the Grrrr Out of Anger" (Laugh And Learn). That and several more are found here - http://www.amazon.com/Take-Grrrr-Anger-Laugh-Learn/dp/1575421178/ref=pd_sim_b_7
          Another good set is the," Don't Rant and Rave on Wednesdays!" The Children's Anger-Control Book. That and others in the set are found here - http://www.amazon.com/Dont-Rant-Rave-Wednesdays-Anger-Control/dp/0933849540/ref=pd_sim_b_1
         You might want to check out,  "SOS Help for Parents," by Lynn Clark.  It has an excellent system for using timeouts.
          I seriously doubt that he is ODD.  And you should be very thankful.  He would be much, much worse.  It is possible that he might have ADHD would could be causing the problems at school.  Here is a link for that -
    http://www.help4adhd.org/en/about/what/WWK1
    I am also the CL on the ADHD forum.  If you have any questions about ADHD please feel free to post here - http://www.medhelp.org/forums/ADD---ADHD/show/175
  Hope this helps!
Avatar universal
Thanks for your input.  I think the books you mentioned look helpful, especially the ones for him.  I also like your idea of immediate, short, consistent consequences and that is certainly something we'll all work on.

I must add that I didn't use the ODD possibility lightly.  He exhibits all 10 symptoms of it on a regular basis (usually daily).  He also has had social issues from day one and while he can be affectionate with his mother and father at times, he has never shown any signs of wanting to be with them or missing them when they are not there, almost like he has no attachment to them. For being bright,he has no concept of hurting other people's feelings (or hurting them physically for that matter) even though his parents and I have discussed it repeatedly with him. It's like he just does't get it. He is usually quite mean spirited and annoyed with the whole world 24/7.

I have also never seen him stay seated at a table for an entire meal or walk more than ten feet without karate chopping, jumping or running. In my mind he is hyperactive at the very least, but again has not been diagnosed with anything. He is in first grade this year (he just turned 7) and last year had a lot of impulse control issues in kindergarten, even though he was one of the oldest kids in the class. I don't know what the issues are this year, but I'm assuming it's the same type of things - disrespectful to the teacher and others, hits kids when mad, doesn't listen, won't stop talking, etc.

Again I emphasize that I believe his parents are doing a good job.  My daughter in particular is extremely patient and doesn't resort to screaming or getting caught up in power struggles. As spouses, they do not have arguments in front of him and are respectful to each other.  This is why it's all the more puzzling as to why he's so mean and spiteful, and what makes me wonder if there is some wiring in his brain that is a little off. But I will certainly pass along the information you provided for me and also check out the ADHD forum.

Thank you for taking the time to answer my question. If you check back in a few months, I'll let you know how things are going. Hopefully there will be some improvement by then.

Avatar universal
This is a follow up to my original question.  My grandson has been in counseling now for over 3 months and his behavior is getting worse. The counselor now recommends complete testing because she has recognized that he has an inability to relate to others socially and has a lot of anger and anxiety.  She also now feels the low tone (the floppiness as a baby that I mentioned) has left him frustrated at not being able to master a lot of skills that child his age can do, and when he feels inferior he lashes out both verbally and physically. He's been ostracized in class and on the bus and is earning the reputation among the kids as "bad". We are now battling with the school to have him tested, but because he is doing well academically and is even recommended for advanced math, they are fighting it, even though the teachers complain of his behavior. His parents are also in counseling for him and have started the Total Transformation Program.  The situation is heartbreaking and exhausting all the way around. At this point there is really nothing good to add, except for the confirmation that I have not been over-reacting all these years.  I'm hoping he can get a proper diagnosis and then the proper help he needs.
189897 tn?1441126518
COMMUNITY LEADER
  Has any one looked into Autism?  And yes,  I think testing would be an important step.  
973741 tn?1342342773
That is really hard when the schools have these policies regarding IEP's and testing.  you are just trying to do what is best for your child.  Can you search your area for an 'advocate' that can assist you?  We have those in our city and they are pit bulls that accompany you to meetings, explain things to you and help you fight for your rights.  I think that would be very helpful to you right now.

now, my situation is different and I don't mean to imply that I've been through what you have with your son.  But there are some minor similarities.  My boy has sensory integration disorder.  He has mild motor planning or dysjpraxia  and new activities as a young child were very difficult for him.  he avoided them completely or threw a fit.  It also made him feel like he was different than other kids.  He had social issues and kids also stayed away with him;  Parents actually complained about him. Ugh, makes me sad remembering.  We started with an occupational therapist and worked n his sensory issues.  Things improved but boy, those early years did a number on him.  He still had his sensory issues/dyspraxia/social issues even though they were better along with some bad feelings about himself.  

So, I strategized.  I set my son up for success.  I tried to find something that he thought he was good at.  I helped him do the activity signing him up with lessons to get better, practice, etc.  So, he developed some niche things that are 'his'.  This really helped with his confidence.  He also is smart and we make a big deal out that.  We accentuate the positive and minimize the negative.  That really helped us.  I took the stance with peers that helping him fit in was good and finding one friend was our goal.  It took a little work as my son was a bit of a target to some pretty mean kids.  BUT, finally, he has a small group of friends that appreciate him.  I would pick him and his friend up after school, bring them to our house, work hard to make sure his friend had a good time, helped my son with social skills along the way during the play date.  As he did better, his confidence grew.

What you wrote about being floppy as a baby and not being able to do things and other kids being mean to him just reminded me of my experience.  So, don't know if helping him explore something (anything ) that is extracurricular that he likes would help with his internal negative feelings but it might.

good luck  
Avatar universal
It's been several long months since I last posted.  Since the school was unwilling to test himt, my daughter was finally able to get him tested at Children's Hospital of PA.  Unfortunately, all of our fears were founded.  He's been diagnosed with ADHD, ODD, impulse control issues, some sensory issues. They are reluctant to make an Asperger's diagnosis at this point. They recommended him stopping his weekly visits with the therapist as it's only made his behavior worse. They suggest trying medication for ADHD, so my daughter is exploring that option even though she was really opposed at first. He has gone for some OT and sensory sessions, but my daughter is fighting the school to get them to do it as their financial resources are completely drained.

This is the biggest heartbreak of my life. A little out of control behavior is OK, but the saddest thing is that the child is always angry.  He never has any joy at all.  Any question you ask him, he just yells at you like you are stupid. If he is not 100% controlling the situation, he freaks.  He is basically very mean spirited and thinks it's funny when others are hurt.  He has also developed an obsession with a girl in his class and talks how he'll beat up anyone who likes her.  He refuses to do simple chores - I mean how can you physically force a child to put cat food in a bowl?  It's like living with a time bomb and shocking how hateful and nasty he is on a continual basis.

I know we need to adjust our expectations about him, but it seems like he suffers from a serious mental disorder. For the most part he has held it together in school, but home life is a disaster and there is never a pleasant moment. I have serious concerns about his future and I am having trouble coping when I'm with him.  Seriously, sometimes I want to beat the c*** out of him because he does such outrageously mean things. Do you have any support groups that you could recommend?  I have a feeling this will be a long, hard fight.
973741 tn?1342342773
Is he passionate about anything such as a sport or subject?  Just asking because sometimes we can help a child channel energy productively and it helps with the negative issues.  I know you have an uphill battle but don't give up!  I thought my son was doomed for a hard and difficult life years ago and with targeted help for him, he's doing fine.  He has rough days but what kid doesn't.  Things WILL get better.  peace
Avatar universal
Thanks for your encouragement. Unfortunately due to his low tone, most sports are out.  The only thing he loves are his Legos. He's a whiz at putting them together but then he tears everything apart. I am hoping if he goes on meds for the ADHD, he will be able to better focus and enjoy things more.

Glad to hear things are going better for you and your son. I appreciate the support you've given me!
973741 tn?1342342773
my son (s) love legos as well.  This is a GOOD thing to love.  And these days, they have so many things that legos can lead to.  Both my sons just finished a lego robotics course that was an after school enrichment class.  My son has done a lego engineering course as well.  

If you work on his focus (and he IS only 7)---  you could work on making his love a legos into something productive.  While they are pricing, look into camps that use legos.  We have a few places that do this in our city and they are usually associated with STEM and we've found everything we've done with these lego classes to be worth it and fun!  

I always try to build on the positive.  

803938 tn?1403748253

Rather than putting him on a ADHD medication, I would suggest discussing an antidepressant with his doctor. You say he never has joy at all, that sounds like depression to me.
189897 tn?1441126518
COMMUNITY LEADER
   So, last Oct I said, " I seriously doubt that he is ODD.  And you should be very thankful.  He would be much, much worse.  It is possible that he might have ADHD would could be causing the problems at school."  
   So I am not very surprised to hear that he does.  Nor am I surprised to hear about his behavior.  When you have been blamed for something for years that you have very little control over - you start to take defensive measures.  I have also seen many kids who try and hold it together when at school and when they finally get home - they have a melt down.  And NO, he does not need an antidepressant, but the right ADHD med might make a big difference at school.  You do have to realize that he has years of behavior that he has to unlearn, and that won't happen overnight.
   Everybody involved with him has to learn all they can about ADHD, what it does to a child, and how to deal with it.  A good place to start is with the book -  "The ADD/ ADHD Answer book," by Susan Ashley.  Its around $12 on Amazon.  I probably recommend it the most on the ADHD forum.   She also has a great section on 504 plans in school which I think that you are going to need.
   I have lots of other resources if you have any specific questions.  I do have one more question.  You said, "Unfortunately due to his low tone, most sports are out."    Yet, you also said he is always moving, karate chopping, etc.   Does he seem to not move very well to you?   By the way, team sports for kids with ADHD can be agonizing.  Individual sports like swimming (Think Michael Philps) can be very helpful.
Avatar universal
Sandman2, yes he is always running around and karate chopping, but his physical coordination is really poor and he has little strength in his hands and arms--he really can't even squeeze a ketchup bottle.My daughter is fighting to get OT at school because his handwriting is so light and he does minimal work because he gets tired. He took karate for a while but couldn't really kick or chop with any strength. He's just learning to ride a bike but doesn't want to it because it's too much work. He won't put his head in the water, but he does seem to like running, so maybe track would be a good idea some day.

The ADHD would be tiring but bearable. The thing that is so difficult is his complete lack of compassion, total selfishness and overall nastiness.  I don't really think he has been "blamed" for his behavior over the years.  He's never been berated or abused and gets love and praise. As I said before, his home life is very stable and my daughter has always been good at trying to teach him kind, considerate behavior and models it as well. Yet he treats other kids (and his mother) horribly and is constantly manipulating them to get things from them (even though he won't share a thing with anyone.) He flat out told me he only wants to be with me if I buy him stuff. Shouldn't a child of this age exhibit some love and concern for others, or at least his own family?

I will definitely check out the book you recommended. I may be watching him on and off over the summer so want to make sure I have plenty of resources. I'm also looking into projects we can work on together. I really want to learn the correct way to respond to him because I want him to feel like my husband and I are always there for him. But I admit I'm at a loss right now.

By the way, I did buy "Don't Rant and Rave on Wednesdays" for him. He thought it was funny (he does have is a good sense of humor) but really wouldn't make any correlation between his behavior and the book.
Avatar universal
I think he could use a little mood elevating, too, but I'm not the doctor!  I think it will probably take a while to get medication worked out. His father was really against it at first but is starting to see the need.  We'll see how it goes.
Avatar universal
I am going to look for a lego project for the summer. I've heard of those robotic ones and think they are a great idea.I'd also like to find a really interesting and exciting book to read to him (albeit in short doses!), maybe one like Harry Potter or Pirates of the Carribean.  I've never heard of Lego classes, but will look into it. I did just take him to Legoland over spring break and would say that is his one true love!

As always, everyone's suggestions are appreciated!
Avatar universal
BTW, I just saw you are French. J'adore toutes les choses françaises! I've been studying French on and off for the last few years (I started in high school many years ago but decided to try and pick it up again.) It was a lot easier when I was younger!  My sister and I will be returning to Paris this August. I try and visit France every couple of years.
803938 tn?1403748253
Your grandson could definitively be on the spectrum, several signs are pointing to it. My son is Asperger - and so am I. When my son was diagnosed, very young, the psy had told us: we may need to put him on an antidepressant around 6-7 if he has too much anxiety but absolutely no ADHD medication for an Asperger child. Which is why I warned you to be careful with that. Both him and I have ADHD, I don't plan to medicate him for ADHD.

My son is almost 4 and we can see a little bit of defiant behaviour in him. Tonight we had an example, he eas very good all day long with me but refused to sit at dinertime (after his father came home), while laughing. I decided to not give him a bath as usual, something he loves, he was really upset. We did keep the rest of the night ritual, including "acting" where we perform for him for a few minutes right before bed, he loves that. I think removing one fun thing but keeping the rest is what we'll try from now on and see how it goes. We shall remind him of the consequences of today the next time we have a similar bad behaviour. I also told him I was very disapointed in him for behaving the way he did, while reassuring we love him. As an Aspie, I am always thinking hard how to raise my Aspie son knowing he is so similar to me. I myself was raised by an Aspie father, I try to keep the good and remove the bad of my own education.

My son has his tantrum moments but he my is also extremely compasionnate and always super helpful.
You need a lot of authority with an Aspie child. My son will try to manipulate my husband (tonight's tantrum was an example) whereas he know it's much harder with me as I have stricter rules. For instance we can go shopping him and peace, whereas if my husband is with us, it oftentimes turn into a drama. An Asperger child will need clear rules at home.

Your grandson seems to have a coordination problem, my son was recently diagnosed with DCD, check it out on the Net, there are useful advices. Handwriting: one suggestion is that the child has a computer to type. Myself I had a terrible handwriting, lost me points on my homeworks and probably did not always win me friends among my teachers eventhough I was a very good student.

En effet, je suis francaise! It's great at you are studying it again! I'd love to go with you to France this Summer, we went there last August but are not going this year, halas. Have fun!
189897 tn?1441126518
COMMUNITY LEADER
      I really know very little about your son, but I do know that 3 year olds can be defiant.  I really don't think that refusing to sit at dinner time is that big of a deal.  How long had he been sitting before dad came home?  I will say that all research on behavior modification says that it needs to be immediate and consistent.  In other words, waiting till bath time probably won't be the reinforcement that you want.  Also at this age, him remembering what happened last time, is kind of doubtful.  Next time.  Try a quick timeout - remove him from the table for 3 min for a time out and then let him come back.  Just be remind full that a child of this age likes to move.  And if he does have ADHD, he really likes to move!  To punish him for something that he cannot control will really makes things worse.   There are certain things you do for a child with Aspie and there are certain things that you do for a child with ADHD.  Some of them are the same - like routines.  But it is super important to make sure that you know what they do or do not have control of.  Since I am also the CL on the ADHD forum, I have lots of good information if you need any suggestions for his ADHD.  Best wishes.
189897 tn?1441126518
COMMUNITY LEADER
      The idea for buying "Don't Rant and Rave on Wednesdays", and others like that is to give you and the child a common vocabulary so that you can discuss other ways to do things.  It is a book that should be read more then once.  Then when he does go nuts - later on you talk about what could he have done.  The trick is then to try and get him to do this before he goes off the deep end.  It is a learning process.
   And yes, I am sure that he has never been "blamed' for his behavior over the years.  But I am pretty sure that his behavior has been pointed out to him by many adults.  You tend to get defensive after awhile.  It is extremely common for this to happen with ADHD kids.   And its tough to change this mind set.
   You know I still kind of worry about the physical coordination and strength.  He is only 7 and they aren't known for that.  I am hoping that you just aren't aware of what a 7 year old is capable of.  But, I do think that it is really important to talk to his teacher and see if she has noticed the same thing!   Because if he is really behind the other kids of his age group, then there is something else going on.  ADHD will not cause this problem.  So I really do think that if he is really having these problems with coordination and strength that it is very important to investigate this.  Keep in touch.
189897 tn?1441126518
COMMUNITY LEADER
   Regarding his coordination and strength issues, I was helping another parent and suggested they look into sensory processing disorder.  I gave them this link - http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html
  and in doing so noticed #3 " Poor Muscle Tone And/Or Coordination"  It really sounds like him.  It may be that he has more then just "some sensory issues".  If he was not diagnosed or seen by an OT, then I think that it is important that this be done.

Avatar universal
I'm not sure what he was diagnosed with OT wise, but there are several on that list that sound like him. While it's great to get a diagnosis, that's just a starting point. They did take him for OT twice a week but between that, his therapist and the special play group, it was too financially draining to a family already in financial crisis. Plus in 8 months there was no improvement and took more time per week than they had. Now they want the parents to go to group training. I believe these things are necessary but in some cases just not possible. They also have a toddler, they have jobs, the husband is in school at night and they can't afford babysitters.In an ideal world money wouldn't be an issue and the mom could stay home and work with her child 24/7. Even fighting with the school to get OT done takes an incredible amount of time and energy (which she hasn't succeeded at yet).

I was wondering if you have any opinion on the "Gift of ADHD Activity Book:  101 ways to Turn Your Child's Problems into Strengths."  I'm thinking at least I could try some things with him when I see him.  I'm also perusing the  ADHD forum you mentioned.
189897 tn?1441126518
COMMUNITY LEADER
   Oh boy, I feel for them.  There plate is very full
   I haven't read the book, but it should be helpful.  Kids with ADHD will hyper focus on something that they like.  If you can find out what that is - it will be something that you both can spend a lot of time on.
    You might want to introduce his parents to this link - http://www.medhelp.org/forums/Sensory-Integration-Disorder-SID/show/1396
     Specialmom who is the CL (you may have seen her posts here also) has a son with SIDs.  She does a lot of in home stuff with him to help.  And she will share it all with them.  And actually its a site that you might also want to check out and read some of the posts.
    What is interesting is that a child with ADHD does not typically go to an OT.  One that has SPD (or SID) does.  The parents should really talk to to OT and find out how much of a problem the OT thinks that the sensory is.  It does make a huge difference in how the child is treated.  Sensory is a relatively new thing and many doctors just are not tuned into it.  I will be curious to see if they do try meds and if they work.  I do think that kids can have both conditions which makes it really tough.
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