One of the things I struggle with as a parent of a child with neurological issues is really grasping everything.  There are times when I feel that I have a handle on things and there are times that I worry about all kinds of issues.  Does he have other psychological and behavioral issues?  Is he suffering from clinical anxiety, does he have ODD, what is immaturity, bad behavior and what is executive functioning deficits?  Sometimes I think I might go mad with all of the questions running around my head!

One term that I have heard fairly often and frequently worry about is ODD, Oppositional Defiant Disorder.  Many parents have not heard about this disorder but it apparently is one of the most common psychiatric problems in children affecting around 5% of the child population.  It also affects a high percentage of children with ADHD … around 30 to 40% of those with ADHD also have ODD. In fact it is exceptionally rare for a child to only have ODD; ODD is commonly associated with ADHD and depression/anxiety.  Oh that lovely comorbidity thing again!!

So what is ODD?  One of the best descriptions I have heard of ODD is by Jim Chandler, MD, FRCPC.  (http://jamesdauntchandler.tripod.com/).  According to Chandler, “ODD is a psychiatric disorder that is really just the far end of the stubbornness spectrum.  The line that divides being just difficult and stubborn from ODD is a set of diagnostic criteria.”

The criteria for ODD are:

A pattern of negativistic, hostile and defiant behavior lasting at least six months during which four or more of the following are present:

• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply with adults’ requests or rules
• Often deliberately annoys people
• Often blames others for his or her mistakes or misbehavior
• Is often touchy or easily annoyed by others
• Is often angry and resentful
• Is often spiteful and vindictive

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

Now why do I worry about this so much and why am I confused?  I think any parent of child with ADHD probably struggles with getting their child to cooperate with homework, chores and the other necessities of life.  Our son often throws fits and refuses to cooperate.  This is pretty much a daily occurrence.  Are they outrageous, knock down fits?  No.  He occasionally has an outrageous fit but not often.  But why does he throw these everyday fits:

• Is it because some times he gets his way?
• Is it because of executive functioning deficits which cause a low threshold for frustration?
• Is it a side effect of the medication?
• Is it a transition issue?
• Is it because he is exhausted from school?
• Is it signs of ODD?

I think this is the most difficult part of our son’s neurological challenges – not knowing the answers to everyday occurrences.  Am I doing something wrong?  Am I doing something right?  What should I be doing?  And the internal battle of questions rages on and on in my head non-stop.

I decided to do some research into ODD for today’s blog post because it is an area I have been concerned about but have not really had the time to research.  What I found to be the key criteria for ODD is spitefulness and vindictiveness.  This coupled with a blaming others for his or her mistakes or misbehavior are key signs of ODD.  According to Chandler, “the destructiveness and disagreeableness are purposeful.  They like to see you get mad.”  It is this description that turned on the lightbulb for me.  Our son often refuses to cooperate but he is not spiteful or vindictive. He is “oppositional” mostly because he does not want to do what I am asking not because he wants to see me get mad.

To read Jim Chandler full pamphlet on Oppositional Defiant Disorder, please go to http://jamesdauntchandler.tripod.com/ODD_CD/oddcdpamphlet.pdf.  It is a straightforward description with examples that I found to be tremendously enlightening.  Most other sources of information that I found online stuck with the Diagnostic and Statistical Manual of Mental Disorders definition as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior.  Most sources of information are very clinical with very few examples.

So I am happy to say that our son’s stubbornness does not seem to fit within the range of Oppositional Defiant Disorder.  Yeah!  Cross that off the list, for now (J).  So now I need to worry if it is a side effect of the medication ….. sigh.

This post can be found at: http://jozikids.co.za/blog/2009/11/27/adhd-and-the-holidays/

ADHD and the holidays

By Angel Swemmer, a  mom to a teenage-almost-adult ADHDer and what I write is purely my opinion on things I feel strongly about, based on my experience as an ADHDer parent. Author of the blog Angelsmind

Are you dreading the holidays?

Does the thought of spending time with friends and family scare the bejeebers out of you?

Well, if your ADHDer is anything like mine, then he (or she) is a handful at the best of times and I don’t blame you.

Like me, you probably also have- or have had- a dilemma with friends and family battling to deal with your ADHDer, or struggling to understand that ADHD is a disability.  And if you medicate your ADHDer then you’ve probably also had flak for doing so. Maybe your parents or family members “…don’t believe in ADHD…” and don’t agree with how you are treating the condition. Perhaps you even have close family and friends whom you haven’t even told about your child’s ADHD- for whatever reason…

The holidays make all this a lot more difficult than usual.

As it is, a simple Sunday lunch with the family can be a nightmare for ADHDers and their parents. In the holidays- even if you do not actually go away- you will most likely be spending a lot of time with close friends and family over the silly-season, so you can multiply the nightmare comparison by a factor of 10, at least.

You’d think an ADHDer would thrive in this season of noise and colour and excitement, but what it really does is make them needier when it comes to their demand for immediate gratification- and it makes them come across as even more hyper and disruptive than usual. ADHDers battle socially. They don’t read social cues and they cannot read body language. The bright lights, colours, crowds and the pressure to meet holiday deadlines and interact socially, quickly sends an ADHDer’s brain into overload. And this is when they become difficult to handle even for people who love and understand him.

One of the first things that fall by the wayside when Christmas holidays start is the daily routine. You sleep late, eat later, eat “junk”, shop, gallivant, visit friends and family, and in some families you no longer medicate* your ADHDer.

Read the rest of the article here: http://jozikids.co.za/blog/2009/11/27/adhd-and-the-holidays/

The Wonderfulness of Me

If you took all of the things that were special about me,

You could put them all together and call it AD/HD.

No better, no worse, just different that’s me,

I’m really not crazy, please try and see.

Like a talented wizard in a world full of “Muggles”,

It’s no wonder all you see is frustration and struggles.

As I daydream and drift, you think no one’s there,

But nothing could be further from the truth, believe me, I swear.

I see your impatience as my mind starts to wander

But, you don’t know the depth of the thoughts that I ponder.

For creative thinkers, get lost in deep thought, which leads to the illusion that they cannot be taught.

I know trying to reach me can give you the blues, but I wish for just once, you could walk in my shoes.

To see things through my eyes, you would be amazed, at the speed and sheer volume my thoughts seem to blaze.

I’m not lazy or stupid, if only you knew, how truly difficult it is to limit myself and think like you do.

But, I can see things that you’ll never see,its like second nature, because I am me.

With lightning fast reflexes, I can switch gears,

To be firm and inflexible is the worst of my fears.

I’m calm in a crisis and know just what to do,

For I’m in great company, Mozart, Edison and Churchill to name just a few.

So show me some patience, as I’m patient with you.

Just a little tolerance, it’s long overdue.

Please try and understand me, along with my AD/HD, It’s a very big part of the wonderfulness of me.

Credit to author: Robert Tudisco

I found this poem on a blog called Angel’s Mind, a mother of a young adult boy with ADHD.  Here is Angel’s link http://www.angelsmind.co.za/2009/12/04/a-new-adhd-poem/.

One of the areas where I constantly struggle is helping our son find his areas of talents or what I like to call, his essence. Our children are like my husband and I. We are good at a lot of things but not outstanding at any one thing. We are good athletics, we enjoy music, we like books and politics, we enjoy giving back to the community and so forth. We are not the next Rembrandt, Tchaikovsky, Michael Jordan or Mother Teresa. Nothing is glaringly obvious.

Couple this with the fact that most of the time and effort with our son is currently focused on academics. He is absolutely exhausted when he comes home from school. He works hard, thank goodness, and cooperates with his teachers and, new this year, he actually LIKES school. I have so much to be thankful about. But some days when he gets home from school, he looks like he has been through a war.

We value play time and are mindful of balancing work with play time. But we have over an hour of homework each night and it is very difficult to fit everything in. He does play sports on Saturdays and seems to enjoy it but it is not clear to us that sports is his THING either.

Why do I worry about this so much? Our primary goal with our son with everything we are doing is to develop is self confidence and his self esteem. That is starting to develop academically because we are able to send him to a school when he can learn differently than the mainstream and be successful. I want him so much to experience success in something outside of school that he truly loves.

Getting him to try new things is not easy. He gets anxious and worried about new activities. Often when we start up a new sports season, he has trouble with the first few weeks of the activity – it is a transitioning issue.

Maybe this worry is more about me than him? I just want so badly for something to come easily to him that he truly truly loves … given that he has to work so hard in the other areas of his life.

So this blog post is not a Karen offering a suggestion blog post – it is one where I am reaching out to you for help. Do you have any suggestions or thoughts?

• How do we fit in the time for him to explore his interests?
• When is the right time to pursue drum lessons or karate or whatever else?
• Is maintaining a balance between play time and work time enough for laying the groundwork for future interests?
• Do I need to just chill out and believe that with self-confidence and academic “success”, he will figure it all out?

Would love to hear from you regarding how you enable the “essence” of your child to shine through all of the struggles!!!

MEET CHARLIE OUR GUINEA PIG

As many of you know, having a child with ADHD or working memory issues creates a challenge when trying to get them to take responsibility for multi-instruction tasks. We have had a difficult time getting our son to be independent and to take on responsibility. Some of this is probably our fault. He works so hard with his learning disabilities and ADD that we probably baby him too much otherwise. However, he was begging – BEGGING for a guinea pig. Even though we really did not have ANY desire to have another pet in the house (we have a Havanese dog and a Beta fish), we decided to use the opportunity to teach responsibility and to increase his independence.

At the pet store, we made a very hard deal with my son. He had to take responsibility for caring for the guinea pig with my help. If he did not, then we were going to give the guinea pig away and he was going to have to pay us back for the cost out of his allowance. We emphasized the deal several times and made him repeat it back to us several times before we even bought the guinea pig. So we bought the guinea pig and named him Charlie.
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