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.

http://tracyalloway.com/

Tracy is an expert in the area of working memory and shares “everything working memory” on her blog. It is an academic research expert’s resource for the lay person. She talks about current events, research and how working memory correlates to learning issues. It is extremely informative and not presented in academic lingo.
 
 
Tracy Packiam Alloway

Tracy Packiam Alloway, PhD, is the Director of the Center for Memory and Learning in the Lifespan at the University of Stirling, UK. She is the author of over 75 scientific articles and two books on working memory in children with learning problems, and has developed the world’s first standardized working-memory tests for educators published by Pearson. Her research has received widespread international coverage, appearing in outlets such as the Guardian, Daily Mail, Scientific American, Forbes, US News, ABC News, and NBC. She is much in demand international speaker in North America, Europe, Asia and Australia. She provides consultancy to the World Bank on the importance of working memory.

She was recently awarded the prestigious Joseph Lister Award by the British Science Association for bringing her scientific discoveries to a wide audience.
 
 
Sample Blog Post

http://tracyalloway.com/index.php/working-memory/iq-is-not-a-benchmark-for-academic-success/

Is Working Memory the New IQ?

IQ is often thought to be synonymous with academic success. Indeed groups like MENSA perpetuate the idea that high IQ is a prerequisite for high achievement in school.

Yet, the traditional reliance on IQ as a benchmark for academic success is misguided. There are many students who have either high or average IQ who struggle in school. Instead of doing well, they end up in the lowest ability groups in language and math. In my own research on various government-funded projects, I have come across many students like this. This is very troubling. If their IQ is in the average range, why aren’t these students achieving their potential?

Perhaps there is something else at work that explains why some students succeed while others struggle.

I undertook a study to look into this issue. I tested children at five years old and again at eleven and found that a child’s success in school is down to how good its working memory is regardless of IQ score.

The finding that working memory, rather than IQ, is what we need to look out for has important implications for schools. As opposed to IQ, working memory problems can be easily addressed by teachers so students can still achieve their potential.

It is vital that IQ is not taken as the be all and end all to intelligence. I believe that all children could fulfill their potential, regardless of IQ or background, as long as working memory is assessed and problems addressed. The key is to move away from IQ as the main predictor of success and focus on working memory instead.

www.myaddblog.com

Tara McGillicuddy, the author of http://myaddblog.com, is a woman with ADHD who is a professional ADHD Coach. Her blog is full of useful information about books, seminars, support groups and personal insights into the mind of a woman with ADHD. It is an insightful blog that helps anyone dealing with ADHD.
 
Tara McGillicuddy

I am a Senior Certified ADHD Coach and a woman with ADHD.

Tara McGillicuddy is an Senior Certified ADHD Coach . She has been educating and supporting people with ADD through her website Living with ADD for several years. She is also the director of ADDClasses.com.

Tara is a professional member of the ADHD Coaches Organization and the Institute for the Advancement of ADHD Coaching.
 
 
Sample blog post

This blog post can be found at http://www.myaddblog.com/2009/04/adult-adhd-and-thinking-the-worst.html

Adult ADHD and Thinking the Worst

It’s quite common for Adults with ADHD to automatically think the worst and jump to the wrong conclusions. Some of it is do to impulsivity and some of it is due to past experiences. When Adults with ADHD have a poor self image we automatically think the worst about ourselves and it’s quite often not the case.

So when you are thinking the worst about yourself stop for a few moments to ask yourself if you have all the facts. If you don’t then it’s probably a good idea to try and get them. As adults with ADHD we beat up ourselves enough for real things and we don’t need to beat ourselves up for things that may not even be true.