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

anonymrs

Mon, Oct 16 2023, 7:10 pm

amother Whitesmoke 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).

Can you share the name of the therapist or pm me? Thank you!

amother

IndianRed

Mon, Oct 16 2023, 10:30 pm

amother OP wrote:

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?

About the choice not to medicate an ADHD child because he is doing well at school:
A common misconception about ADHD is that if a child is doing well at school, the child doesn't need to be medicated.
You mentioned he possibly has ODD, which are tough behaviors to deal with !
B"H he is doing well at school, however, how miserable is he and you and your family at home because of this child's inflexibility and dysregulation ? How respectful is your child of his parents and siblings ? How is his Kibud Av Va'Em (one of the Asara HaDibros) ?
Isn't the most important aspect of your child's character how he behaves towards his parents and his siblings ? If this child's difficult home behaviors continue, what type of husband or father will he make ? A demanding and stubborn husband and father.
Your child must be in 4th grade, right ? He probably has a "mild" case of ADHD, because it isn't showing up at shool yet. Children with mild learning disabilities can do well in school until the learning gets more challenging, which it does in 5th grade and 6th grade in Maryland.
I strongly recommend you reconsider medication. ADHD is highly treatable with medication. Many ADHD medications have been used for a long time, and their effects are well known.
Hatzlacha !

amother

IndianRed

Tue, Oct 17 2023, 12:07 am

Our pediatrician will not prescribe intuniv without first starting a stimulant medication. He says that intuniv generally doesn't work well by itself, and it works best when paired with a stimulant medication.

Our pediatrician said that focalin has the least amount of side effects among the ADHD stimulant medications.

There are stimulants available in extended release (ER) form, for example focalin or vyvanase.

amother

Olive

Tue, Oct 17 2023, 12:13 am

amother IndianRed wrote:

Intuniv helps more for impulsivity while stimulants are more effective for symptoms such as inability to focus, procrastination, runaway thoughts.
Interesting that your pediatrician says focalin has the least side effects. I wonder what the science behind that is. In general stimulants are either amphetamines or methyl amphetamines. The differences are in the coatings I believe which can control the way they are released.

amother

Junglegreen

Tue, Oct 17 2023, 12:28 am

Quote:

Our pediatrician will not prescribe intuniv without first starting a stimulant medication.

My child was diagnosed by a psychiatrist, not by my pediatrician. DS did not have focusing issues in school, it was more behavioral at home and with peers, similar to what OP is describing. The psychiatrist was very optimistic about trying Intuiv before starting any stimulants and bh we found it successful

amother

IndianRed

Tue, Oct 17 2023, 12:42 am

amother Olive wrote:

Thank you for the info.

The Pediatrician said that among the stimulant drugs (for ADHD), Focalin has the fewest side effects.