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Impulse Control Disorders and ADHD

Dealing with ADHD & ODD

My soon to be 5 year old son has been diagnosed with ADHD & ODD.  We’ve literally just started treatment (Stratera and therapy).  Our first attempt to help was doing martial arts. We’ve tried that for the past 4 months but it’s not helping at all.  He was just expelled from daycare for repeatedly hurting other children.  Needless to say, our family is burning the candle at both ends in trying to deal with his issues as well as taking care of his older brother and work full-time.  We’re very hopeful that things will get better with meds and therapy.  Right now we’re just trying to make it through one day at a time.  Any advice/support/tricks of the trade would be greatly appreciated.

Replies

I feel for you.  I have been where you are and am seeing progress in the past year.  My son is 8 with ADHD and ODD. We have come close to being expelled from daycare and before and after school care. 

What has helped us is age, there is a big difference in where we are today and when he was 5, 6 and even 7.  He will be 9 in a couple of months.  The other is therapy and a psychiatrist who is also a pharmacologist and really understands the medications for ADHD and ODD. 

Therapy was a god-send.  He actually graduated from therapy, for now, in January, after 17 months.  I will enjoy this time, as I believe we will be back in someday.

My son is on 20mg Daytrana, 5 mg of generic Ritalin on school days.  The Ritalin is fast acting and works until the patch kicks in.  And he takes 1 mg Intuniv every evening. 

I have seen a huge difference since he started taking Intuniv.  He no longer crashes when the meds wear off and he is generally much more pleasant.  When he does, he is either hungry or tired like any other child.  I should also note that my son is in a special program in his school, there are no more than 10 students in the classroom and 3 adults (teacher and para-educators) in the room at all times.  This has been wonderful for him.  All of the children have something, ADHD is the most prevalent diagnosis. 

You need to find a doctor or specialist that knows medications.  It is a lot of trial and error, but you will find the right one or combination for your son.  As he gets older, you will see differences, as well.  Remember, our guys are about 3 years younger in maturity than other children their same age. 

For ODD, too, I let a lot of things go.  I could spend all day arguing with my son, but I refuse to, it just isn’t important.  I am very firm on the important things, but you really have to pick your battles. 

Good luck!

Posted by cmullen17 on May 07, 2014 at 9:52pm

Thanks.  It helps to know that we’re taking the right steps to help get things under control.

Posted by CathieWard on May 07, 2014 at 10:06pm

Stick with the Martial Arts because it is not a quick fix, but one which will constantly challenge & help to more fully develop his focus and attention.  In addition, having a constant reminder from another outside source of the rules of showing respect (for self & for others) and never using physical aggression for anything other than self-defense will be invaluable.  There are many Martial Arts Academies which are, for lack of a better term, cheesy.  They are more like after-school play-group with a Karate Kid theme.  Make sure it is a “real” martial arts studio that teaches these traditional values right alongside the techniques.  In these places, oppositional/defiant behaviors will simply NOT be tolerated.

Also, be aware that in terms of overall efficacy, Strattera is less effective than any of the stimulants, and that the side effects can become intolerable for some (& can lead to behaviors that may look like a worsening of ADHD).  It also has one side-effect that is very troublesome—ideations of self-harm.

Posted by BC on May 07, 2014 at 10:54pm

I find it interesting that at 5 your son was diagnosed with ODD.  My son is 4 and has been diagnosed with ADHD, Anxiety, and SPD.  I am pretty sure he has ODD but every doctor I see says he is too young to diagnose.  It’s so frustrating.  My son has been to 5 different day cares/private schools in the last 3 years.  Finally, we have him in public special education pre-school (9 kids and 2 teachers) and a social skills group for kids on the autism spectrum.  Although he isn’t on the spectrum by today’s definition, he has all the social difficulties as those that do.  The social skills school has been a blessing.  They offer positive, consistent, creative and entertaining social skills development.  My son has also been on Ritalin (did not work for him), Aderrall, Celexa (did not work for him) and Intuniv.  Intuniv seems to be the best.  Because of his social skills, swimming seems to be the best way to exercise for him.  He won’t run/walk, bike, play, etc for any extensive period of time to wear him out.  Swimming is the exception.  He always wants to go and will do it until it wears him out.  In fact, I have been taking him swimming since he was 6 months.  It was the only thing I could find that would wear him out when he started crawling.  He is also in OT.  We have many sensory items at home, trampoline, crash pad, chews and fidget toys.  I am able to retire next year and can’t wait to not have to be on the constant hunt for special schools and child care.  I have worn myself out over the past couple of years.  I am very happy to hear others say that the behaviors get better in a few years.  Lord I hope so.  Best of luck to everyone!

Posted by Dawnie on Jul 18, 2014 at 3:24pm

Our new therapist has said the same thing about “we can confirm ODD yet at his age”.  They’ve said for sure that he has impulse control issues.  He’s been on Concerta for a little over a month and has been home with a nanny all summer.  She has a younger sister with the same issues as my son.  We are so blessed to have found her (care.com) as she has helped him so much as well.  When he plays with the neighbor kids and gets mad, he just walks away rather than get physical with them.  He also is having less melt-downs than he used to. 

My husband is so not on board with any of the therapy things I’ve wanted to do.  He’s even taken him out of Martial Arts.  The therapist and I think he should stay in.  I’m on the fence as to whether I should ignore my husband’s opinion and do what I think is best for my son or respect my husband’s wishes.  For now I’m doing the latter and waiting to see how kindergarten goes in the fall.  If he starts having troubles then I may push back and insist on Martial Arts again.  My son also LOVES swimming.  He also is really enjoying riding his bike and “playing baseball” (going out and have someone pitch balls to him he’ll hit them off a tee).  He seems to have a real talent with hand-eye coordination as he’s just turned 5 and can hit a wiffle ball without a tee.  Maybe I’m just a biased mom though.  We’re hoping to get him on a team next spring, but we’ll have to see how things go. 

My relatives that don’t see him on a regular basis feel that he’s less aggressive and defiant than he used to be.  We’re not sure if it’s the meds or the therapy or just the lack of social interaction with other children. 

I don’t know if they have any programs like you mentioned for social skills, but I think they would be very helpful.  I’ll have to check with his school.  They sound fantastic.  My therapist has also said that things will get better as time goes on.  Most importantly knowing that I’m not alone in these struggles helps me keep my hopes up.  I love these discussions.  Thank you all for your thoughts/experiences.

Posted by CathieWard on Jul 18, 2014 at 3:41pm

What are the actual reasons your husband gives for unilaterally deciding to take him out of martial arts?  Just curious…

Posted by BC on Jul 18, 2014 at 4:46pm

Before when he was there, he wouldn’t participate in class, just run around and hit/tackle mostly his brother but a few times other kids.  He was asked to leave class a few times because he was disrupting the class too much.  So, my husband felt that we weren’t getting anything out of the class so it wasn’t worth paying for it.  Now he fells that mentally, my son wouldn’t “get it”.  My therapist (and I) feel that it’s not important for him to mentally get it right now.  It’s more important for him to have an outlet to hit/kick the bags and hear about self-discipline as well as being in a situation where he has to interact with other kids. 

The biggest problem is that my husband while never officially diagnosed, has ODD tendencies.  Even his own mother will tell you the same thing.  Therefore, therapists/doctors/authority figures are people he will disregard anything they say.  He feels he already knows everything (another ODD trait) and doesn’t need anyone to tell him what to do.  Seriously, he will do the opposite of what he’s told to do just to prove that no one will tell him what to do.  He’s refused to attend any more therapy sessions because the therapist doesn’t know what she’s talking about.  My husband took one psychology class in college and therefore knows everything there is to know.  I do think he sometimes will have good insights on ODD because of his issues. I’m smart enough to know that I’m not an expert at anything, but I will reach out to experts and read/research as much as I can to do whatever I can. 

My husband makes lots of unilateral decisions in our household which drives me crazy and causes many fights.  Just like with my 5 year old, I have to pick my battles.  At the end of the day, my kids are my priority.

Posted by CathieWard on Jul 18, 2014 at 5:02pm

My husband was also very resistant, first to admit that our son was different and the whole family needed help and second to our son starting medication.  It was a rough two years and almost ended our marriage.  It finally took the daycare telling him that our son would never be able to pass Kindergarden if he couldn’t follow directions.  I’m not sure what happened but my husband did a 180 and fully supports all the therapies and medicines, once we found doctors we both were comfortable with.  We still haven’t found the right mix or dose or type of medicine.  It’s hard.  Like you, it helps to know I am not alone.  :~)

Posted by Dawnie on Jul 19, 2014 at 12:40pm

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