I've been searching the site to try to find some info on ODD. My son was just diagnosed with ODD and mild ADD. I've posted here before but now I have a diagnosis. We started him on Concerta yesterday but we didn't notice much of a change. He seemed slightly more cooperative but he still threw a huge fit when we were at my husbands parent's for dinner. We had to leave. I'm having a really hard time finding some information on how to deal with his fits. He runs away from us, crys, screams, says hurtful things.....He doesn't respond to any disciplinary measures such as taking priveliges away or sending him to his room. He just physically won't go and we have tried carrying him but he's strong so when my husband isn't home it's impossible for me to do this. I've read a bit about ignoring the fit but I'm afraid we are beyond that working. Does anyone have any thoughts/advice on specifically what to do when he's in a fit of rage? Should we try ignoring him?

Slowly we are gathering enough information to start implementing a behaviour program but right now I really need some advice on the fits. I"m reading a behaviour management workbook but haven't finished it yet. It doesn't talk much about the fits.

Thanks for listening!

Here is some great information for you on ODD http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm

It's very important to get an appropriate behavior plan in place. You may need to go as far as finding someone that does Behavior Modification Therapy.

Your son may need his dose of Concerta adjusted. You should not see "mild" affects. You should see significant affects. Please be aware though that Concerta does not fix mood issues. It can help some of us that are irritable by the overload in our brains, but beyond that, it's really not going to help a great deal with moods. Some times it can exacerbate mood issues, so if his moods get "worse" then talk to the doctor immediately.

There are other medications that can help with moods, that work well with AD/HD meds. Clonidine is a great one for ODD, with minimal side effects, that is used often with AD/HD meds. Sometimes this is used just to help kids sleep when meds keep them awake. It does not work well for severe mood issues though.

If you haven't done so yet. Read the book "The Explosive Child" by Ross Greene. It's a really fantastic book for ideas on how to deal with explosive children. It gives you tools on how to keep them from getting to the explosion part, because once they are at that point, they really are out of control, and there is no reasoning with them.

If he is truly "raging" as in hour long fits of rage, then you may want to get a second opinion on the diagnosis. That is typically something beyond AD/HD, and Early onset Bipolar can mimic AD/HD.

Make sure your rules are clear and consistent. We have behavior problems with my son as well, and I've found that picking our major issues, and having consequences that are used just for those issues works very well. For example, if he has an unsafe day (which means hurting himself or others in any way, trying to hurt himself or others, threatening to hurt himself or others, or destroying property) then he loses t.v. privileges (his motivation). The only way he can earn them back is by having a full safe day. Find your child's motivation and use that for the discipline, or reward tool.

Good luck!

Thanks LadyM!


You know it's funny because I read The Explosive Child about 3 years ago and thought that my son had some of the issues brought up in the book. I did find it helpful but still wasn't going for a diagnosis. I don't think my son has a severe case of anything though (your question about the rage for 1 hour). His anger comes and goes and some days he won't have any episodes at all. Sometimes this can go on for weeks and then he hits a wall and is angry all the time for days or weeks. Our problem before is that we never really knew what was going on with him so didn't really know how to handle it. We have never stayed on track with a behaviour program because when he starts to get better we let things slide. A big no-no with his problems! Anyway, I'm going to get the book and read it again. I'm sure I'll get even more out of it now that I know that's what we're dealing with.

As for the meds., our pediatrician wanted to start by treating the AD/HD to see if that alone would help with the anger. I'm assuming they want to start with the least amout and build from there. My problem with it is that we don't go back to see him for 4 weeks! Do you think this is too long to go without an adjustment or is this normal?

AndreaM

My daughter was experiencing rages (hitting, screaming, throwing things, slamming doors, etc-frightening period for us), mostly related to school but also to being told "no". We started a behavior plan while going through the diagnostic period (LD, ADHD, ODD, anxiety, depression: ruled out bipolar for now). One thing that helped was for us to tell her calmly that we would discuss the issue when she was calm and remove the object of her anger (usually a parent). Then (when she was calm) we would praise her for calming herself down and try to work out the problem.
She started 18mg concerta the last few weeks of school and we saw some small improvements. She is now on 27mg and is doing wonderfully. When she gets mad, she can now quickly calm herself to work out the issue rather than going into the full rage. For us, the behavior modification and concerta combination is better than without the concerta, but I could not imagine trying to use meds without the behavior modification.

When school starts again, we may need to increase the concerta, as we do not know if it is enough to cover the challenges of concentrating in school and for homework.

Your doctor is totally doing the right thing by starting low and moving up. You never want to start high and go down, like some doctors try to do. I don't personally think it's totally necessary to wait 4 weeks (only my opinion), but that is standard practice with a lot of doctors. Our doctors just let me check in after a week to tell them how things were going, and made adjustments from there.
If you aren't seeing anything significant in a week it may not hurt to just give them a call and let them know youare seeing some benefits but nothing major. The most they can say is "we'll see ya in 3 weeks":p .
I would give it a week though. Effects from stimulants are immediate, but there is a bit of an adjustment period. How you feel on day 1, is not how you feel on day 7, so I think it's a good idea to get through the adjustment period.

Watch your son closely too and see if you can pin point what is setting him off. My son would blow so much that it seemed like anything and everything would set him off, because it just happened so often, over seemingly nothing. He doesn't rage, but he has a flash temper - boom, then calm in about 10 minutes. After watching him real close I've found his main triggers are sensory related, or transition related. This has really helped me reduce his tantrums, just knowing what sets him off.

Definitely read that book again though, even if you don't use the exact techniques, it still has some really great eye opening things in it.

Good luck!

Have you ever noticed any connection between diet and rages. My two kids seem to have wide mood swing based in part on what they've eaten. My youngest especially is usually very mellow, but recently has had some major outbursts involving hitting, biting, and throwing rocks!:eek: In her case, I think it's milk products and dyes that make things worse. We already had her on soymilk because she gets a facial rash on milk, but we still let her have cheese and ice cream occasionally -- those seem to be the problem times. My kids went to a birthday party yesterday and today --- oh boy :faint: -- they are both unbelievably reactive and upset about every tiny little thing. When a rage is set off over a coloring book or crayon, I have to wonder what else is going.:eyebrow: I'm not suggesting it's only diet, but I do think there are some foods that make the problem worse for kids with emotional regulation issues.

Waiting four weeks to adjust meds is pretty standard, but also unnecessary according to a workshop I attended at ADDA. According to the doctor who was speaking he generally moves a kids dose up after a week and an adults dose up after only a couple of days when dealing with stimulents. Sometimes stimulents will initially make rages worse. It did this for my daughter and myself. I eventually adjusted and did much better. My daughter wasn't on long enough to find out whether she would adjust. Good luck in working through this!


Take care,
Scattered