9 yr old ADHD/ODD refuses therapy - what now?

amother

Mon, Oct 16 2023, 10:42 am

My 9 year old son who has ADHD and possible ODD is doing great at school for the most part bH, but at home he is extremely inflexible and dysregulated. I started taking him to play therapy, but in line with his inflexibility and refusal to do anything he doesn't think is exciting, he decided he doesn't want to go anymore and flat out refused to come to his last appointment. He says it's because it's boring and he doesn't like talking about things. I've taken him to a few different therapists and this one is by far the most engaging with fun activities, etc. but he says it's still boring and he won't even consider trying a different therapist. I tried incentives, but no go. We considered medication, but since he is doing ok in school, we are holding off.
What now?

mha3484

Mon, Oct 16 2023, 10:50 am

Instead of therapy or in addition, I really like the explosive child for this because it takes feeling and behavior out of the conversation. Your not discussing how did you feel when this happened or getting into a deep discussion about behavior, both of which my 9 year old really does not like. If I ask him how he thinks he can solve his own issue with X I get great responses from him.

amother

Mon, Oct 16 2023, 10:52 am

mha3484 wrote:

Thank you. I have tried this, but he also refuses to discuss problems/solutions, and even when I do get him to discuss something and we come up with an agreed-upon solution, he doesn't stick to it. He's so impulsive that he just does whatever he wants at that moment.

amother

Mon, Oct 16 2023, 11:07 am

Echinacea wrote:

Use rewards. What is something he really wants and have him earn points by going to the appointment and participating. The reward should be earned relatively quickly.

I tried this but he won't go for it unless it's something really big and he doesn't have the patience to earn something over a long period of time. He's not interested in small incentives, and I am not willing to buy him an mp3 player every week.

amother

Honey

Mon, Oct 16 2023, 11:12 am

Teach him now that you are the boss
Pick your battles. If this is important and it’s working, do whatever it takes to get him there. Like forcing a toddler to take his meds.

You know your child the best. How can you convey to this child this is non negotiable

You would never let him run into oncoming traffic. How do you enforce that?

mha3484

Mon, Oct 16 2023, 2:13 pm

amother OP wrote:

I have another son who was like this and honestly nothing got better until we medicated. Everything we tried to teach him was like theoretical because he could not actually implement it in the moment.

amother

Mon, Oct 16 2023, 2:20 pm

mha3484 wrote:

Thanks to everyone for the replies. Responding specifically to this one - how do you do medication when the issues are only at home? The typical ADHD meds are stimulants and appropriate only to be taken during the day, and bH he's fine at school.

amother

Mon, Oct 16 2023, 2:22 pm

amother Springgreen wrote:

This was my dc. Conventional wisdom at the time was the parents need to be in therapy. So dh and I paid top dollar for a therapist who specializes in this. Yes, we became much better parents but my dc was the same until we treated dc for pandas.

We thought this was PANDAS at first, but after being on antibiotics (and other supplements) for 5 weeks with ups and downs and no sustainable significant improvement, I'm starting to wonder if he's just changing because he's getting older.

mha3484

Mon, Oct 16 2023, 2:33 pm

amother OP wrote:

My son had issues in both places. So for us it was really necessary. My son got a lot out of taking a non stimulant for the impulse control called Intuniv. It did a lot for him to help him control himself and it doesnt wear off like a stimulant does. He also took strattera for focusing but if you have no school issues you likely dont need that part. But its really worth a conversation with an MD because the ability to self regulate as he gets older is really important.

amother

Whitesmoke

Mon, Oct 16 2023, 2:34 pm

Are you me? Lol - you sound exactly like my son. I have a therapist work with my son in the guise of woodwork/guy activities (drones, building - not sure but stuff guys like). He works with him and in the work does the therapy.

He also goes to karate - I find that physical activity with a "man figure" that is in charge is amazing.

I don't agree with showing him you are boss- that's sure to backfire. And meds did more harm than good (we tried that for a long long time)

Hugs- not easy at all.

amother

Mon, Oct 16 2023, 2:41 pm

amother Whitesmoke wrote:

Wait a sec this sounds incredible - totally up my son's alley. I'm sure we're not in the same location but how did you find a therapist like that?

And yes - showing him I'm boss completely backfires.

amother

Whitesmoke

Mon, Oct 16 2023, 2:58 pm

amother OP wrote:

I'm in Lakewood area. My son is on the spectrum (very high functioning so almost invisible to the untrained eye) so I was looking for someone that had some knowledge of autism but was not at all interested in ABA (since that too would backfire with my son), someone that could form a relationship with my son - and figure him out.

I believe back in the day these kids had a diagnosis called conduct disorder. Now it's called ODD. I've heard it called pathological demand avoidance. Bottom line is this type of kid will never listen unless parent is doing what kid wants. If you don't have a kid like this you can't understand and will think traditional behavior modification or some other parenting strategy will work.

I think the guy I have that does woodworking does something of a mix between floortime, nurtured heart and just plain excellent mentor.

As an aside, did you ever do nurtured heart approach course? NOT because it will work to make your son magically listen but for yourself. I'll explain. I found that dealing with this type of kid made me into a witch- I was always so negative and angry with him (and the world for that matter Smile

It's very VERY difficult to parent a kid like this - where you almost feel like you want to give him up (that's a normal feeling - I learned) Nurtured heart just helped me be the happy, loving, positive person I always was EVEN WHILE dealing with this difficult kid. It did not make my kid behave better but it made me into a happier mom (at least some of the time).

amother

Mon, Oct 16 2023, 3:06 pm

amother Whitesmoke wrote:

That is incredible that you have found someone like that! YES, I did nurtured heart but a few years ago - it was very effective at that age and I really should double-down on it again; his behavior is so much more difficult to deal with at this age that I'm skeptical, but thanks for the reminder.