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Why Is My Child So Angry and Defiant? An Overview of Oppositional Defiant Disorder

40 percent of children with ADHD also develop oppositional defiant disorder, a condition marked by chronic aggression, frequent outbursts, and a tendency to argue, ignore requests, and engage in annoying behavior. Begin to understand your defiant child here.

Every parent of a child with attention deficit disorder knows what it’s like to deal with ADHD behavior problems — sometimes even the most well-behaved child lashes out, or refuses to comply with even the most benign request. But almost half of all parents who have children with ADHD live with severe behavior problems and discipline challenges on an almost daily basis.

That’s because 40 percent of children with ADHD also develop oppositional defiant disorder, a condition marked by chronic aggression, frequent outbursts, and a tendency to argue, ignore requests, and engage in intentionally annoying behavior.

How bad can it get? Consider these real-life children diagnosed with both ADHD and ODD:

– A 4-year-old who gleefully annoys her parents by blasting the TV at top volume as soon she wakes up.
– A 7-year-old who shouts “No” to every request and who showers his parents with verbal abuse.
– An 11-year-old who punches a hole in the wall and then physically assaults his mother.

“I call them tiny terrors,” says Douglas Riley, Ph.D., author of The Defiant Child and a child psychologist in Newport News, Virginia. “These children are most comfortable when they’re in the middle of a conflict. As soon as you begin arguing with them, you’re on their turf. They keep throwing out the bait, and their parents keep taking it — until finally the parents end up with the kid in family therapy, wondering where they’ve gone wrong.”


“I Can’t Take It Anymore!” Our Best Advice for Parenting a Child with ODD


The strain of dealing with an oppositional child affects the entire family. The toll on the marital relationship can be especially severe. In part, this is because friends and relatives tend to blame the behavior on ‘bad parenting.’ Inconsistent discipline may play a role in the development of ODD, but is rarely the sole cause. The unfortunate reality is that discipline strategies that work with normal children simply don’t work with ODD kids.

Fortunately, psychologists have developed effective behavior therapy for reining in even the most defiant child. It’s not always easy, but it can be done – typically with the help of specialized psychotherapy.

Looking for Links

No one knows why so many kids with ADHD exhibit oppositional behavior. In many cases, however, oppositional behavior seems to be a manifestation of ADHD-related impulsivity.

“Many ADHD kids who are diagnosed with ODD are really showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.”

Another view is that oppositional behavior is simply a way for kids to cope with the frustration and emotional pain associated with having ADHD.

“When under stress — whether it’s because they have ADHD or their parents are getting divorced — a certain percentage of kids externalize the anxiety and depression they’re feeling,” says Larry Silver, M.D., a psychiatrist at Georgetown University Medical School in Washington, D.C. “Everything becomes everyone else’s fault, and the child doesn’t take responsibility for anything that goes wrong.”

Riley agrees. “Children with ADHD know from a young age that they’re different from other kids,” he says. “They see themselves as getting in more trouble, and in some cases may have more difficulty mastering academic work — often despite an above-average intellect. So instead of feeling stupid, their defense is to feel cool. They hone their oppositional attitude.”


Nagging, Logic, and Spanking Don’t Work on an Angry Child. These Strategies Do.


About half of all preschoolers diagnosed with ODD outgrow the problem by age 8. Older kids with ODD are less likely to outgrow it. And left untreated, oppositional behavior can evolve into conduct disorder, an even more serious behavioral problem marked by physical violence, stealing, running away from home, fire-setting, and other highly destructive and often illegal behaviors.

Getting Treatment

Any child with ADHD who exhibits signs of oppositional behavior needs appropriate treatment. The first step is to make sure that the child’s ADHD is under control. “Since oppositional behavior is often related to stress,” says Silver, “you have to address the source of the stress — the ADHD symptoms — before turning to behavioral issues.”

Says Riley, “If a kid is so impulsive or distracted that he can’t focus on the therapies we use to treat oppositional behavior,” he says, “he isn’t going to get very far. And for many kids with ADHD and oppositional behavior, the stimulant medications are a kind of miracle. A lot of the bad behavior simply drops off.”

But ADHD medication is seldom all that’s needed to control oppositional behavior. If a child exhibits only mild or infrequent oppositional behavior, do-it-yourself behavior-modification techniques may well do the trick. But if the oppositional behavior is severe enough to disrupt life at home or school, it’s best to consult a family therapist trained in childhood behavioral problems.

The therapist should screen your child for anxiety, depression, and bipolar disorder. Each can cause oppositional behavior, and each calls for its own form of treatment. The therapist may also recommend cognitive therapy for the child, to help him cope effectively with difficult situations.

Carrots and Sticks

In most cases, however, the treatment of choice for ODD is parent management training, in which the family therapist teaches the parents to change the ways they react to their child’s behavior — both good and bad. Between weekly sessions, the parents practice what they’ve learned, and report to the therapist on their progress.

“Basically, parent training is about carrots and sticks,” says Brady. “On the carrot end, you work on giving your child praise and rewards for cooperating. On the stick end, you lay out clear consequences for misbehavior, usually involving a time-out or the removal of a reward.”

Parent management training is often highly effective, with the child’s behavior improving dramatically in four out of five cases. Parents who undergo the training typically report greater marital satisfaction, as well as improved behavior from their other children.

While some parents balk at the notion that they are the ones in need of training, “they have to learn how to stop getting into the arena with the child and descending to the level of squabbling,” says Silver. Parents often feed the problem by delivering overly harsh or inconsistent discipline. Instead, parents must reassert their authority by setting up well-defined rewards and punishments, and then implementing them consistently and dispassionately.

“My most important rule is that parents should not take ODD behavior personally,” says Riley. “Remain calm and friendly whenever you intervene. Oppositional kids have radar for adult hostility. If they pick up your anger, they’re going to match it.”

Riley recommends a “two free requests” approach: “The first time you ask your child to do something, give him two minutes to respond. If he doesn’t obey, calmly tell him, ‘I’m now asking you a second time to pick up your coat. Do you understand what I’m asking you to do, and what the consequences are if you don’t? Please make a smart decision.’ If you have to ask a third time, the prearranged consequence kicks in — the TV goes off for an hour, or the video game is taken away.”

Positive Opposites

Rewarding good behavior or punishing bad behavior isn’t a revolutionary concept, but with oppositional kids, it’s easier said than done. Parents must rein in their impulse to yell or spank. At the same time, they must learn how to substitute “non-aversive punishments” such as time-outs or the loss of privileges.

Many parents of oppositional children are so focused on bad behaviors that they’ve stopped reinforcing positive ones. Yet positive reinforcement is the heart and soul of parent management training.


“I Won’t Eat That!”


“Invariably, parents come to treatment with the idea of suppressing, eliminating, or reducing problem behavior,” writes Alan Kazdin, Ph.D., in Parent Management Training, a manual for therapists. But according to Kazdin, director of Yale University’s Child Study Center in New Haven, Connecticut, parent training emphasizes the concept of “positive opposites” instead. “For example,” says Kazdin, “parents are asked what to do if they want their child to stop screaming, slamming the door, or throwing breakable objects. The answers involve reinforcing talking quietly, closing the door gently, and handling objects with care and not throwing them.”

Kazdin maintains that helping parents learn to praise good behavior is one of the toughest challenges therapists face. He says parents are often “hesitant to praise a behavior or to use reinforcers in general because they feel the behavior ought not require any intervention. ‘My child knows how to clean up his room, he just refuses to do it,’ is a typical parental comment.”

Enthusiasm Counts

When parents do offer praise, they should be enthusiastic. “An unenthusiastic statement of ‘Good’ is not likely to change child behavior,” says Kazdin. Praise should specify the praiseworthy behavior and, ideally, include some non-verbal gesture. For example, you might say, “It was wonderful the way you played so quietly while I was on the phone!” and then give your child a kiss.

Appropriate rewards and punishments vary from child to child. The more creatively you tailor your program to your child’s specific abilities and needs, the better. But as Russell Barkley, Ph.D., professor of psychiatry at the Medical University of South Carolina in Charleston, writes in Your Defiant Child, “Creativity is always an asset to child-rearing, but it can’t hold a candle to consistency. Consistency in the way you treat your child — the way you set rules, convey expectations, pay attention, encourage good behavior, and impose consequences for bad behavior — is the key to cleaning up your child’s act.”

Never lose sight of the fact that oppositional kids usually have a great deal to offer, once their behavior is under control. “Oppositional kids are also often quite engaging and bright,” says Riley. “They tend to be optimistic and very much their own person, with their own way of looking at the world. Once you work through their defiance, there’s a lot there to like.”

 

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A Stanford dean on adult skills every 18-year-old should have

Written By: Quora

This question originally appeared on Quora: What are the skills every 18 year old needs? Answer by Julie Lythcott-Haims, Author of NYT bestseller How to Raise an Adult; former Stanford dean; podcast host.

1. An 18-year-old must be able to talk to strangers

Faculty, deans, advisers, landlords, store clerks, human resource managers, coworkers, bank tellers, health care providers, bus drivers, mechanics—in the real world.

The crutch: We teach kids not to talk to strangers instead of teaching the more nuanced skill of how to discern the few bad strangers from the mostly good ones. Thus, kids end up not knowing how to approach strangers—respectfully and with eye contact—for the help, guidance, and direction they will need out in the world.

2. An 18-year-old must be able to find his or her way around

A campus, the town in which her summer internship is located, or the city where he is working or studying abroad.

The crutch: We drive or accompany our children everywhere, even when a bus, their bicycle, or their own feet could get them there; thus, kids don’t know the route for getting from here to there, how to cope with transportation options and snafus, when and how to fill the car with gas, or how to make and execute transportation plans.

3. An 18-year-old must be able to manage his assignments, workload, and deadlines

The crutch: We remind kids when their homework is due and when to do it—sometimes helping them do it, sometimes doing it for them; thus, kids don’t know how to prioritize tasks, manage workload, or meet deadlines, without regular reminders.

4. An 18-year-old must be able to contribute to the running of a house hold

The crutch: We don’t ask them to help much around the house because the checklisted childhood leaves little time in the day for anything aside from academic and extracurricular work; thus, kids don’t know how to look after their own needs, respect the needs of others, or do their fair share for the good of the whole.

5. An 18-year-old must be able to handle interpersonal problems

The crutch: We step in to solve misunderstandings and soothe hurt feelings for them; thus, kids don’t know how to cope with and resolve conflicts without our intervention.

6. An 18-year-old must be able to cope with ups and downs

Courses and workloads, college-level work, competition, tough teachers, bosses, and others.

The crutch: We step in when things get hard, finish the task, extend the deadline, and talk to the adults; thus, kids don’t know that in the normal course of life things won’t always go their way, and that they’ll be okay regardless.

7. An 18-year-old must be able to earn and manage money

The crutch: They don’t hold part-time jobs; they receive money from us for what ever they want or need; thus, kids don’t develop a sense of responsibility for completing job tasks, accountability to a boss who doesn’t inherently love them, or an appreciation for the cost of things and how to manage money.

8. An 18-year-old must be able to take risks

The crutch: We’ve laid out their entire path for them and have avoided all pitfalls or prevented all stumbles for them; thus, kids don’t develop the wise understanding that success comes only after trying and failing and trying again (a.k.a. “grit”) or the thick skin (a.k.a. “resilience”) that comes from coping when things have gone wrong.

Remember: Our kids must be able to do all of these things without resorting to calling a parent on the phone. If they’re calling us to ask how, they do not have the life skill.

 

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Mental Health Empowerment Day Event

MENTAL HEALTH POSTER

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Will My Complex Kid EVER Catch Up?!

WRITTEN BY JEREMY DIDIER

As parents of complex kids, we have “big picture” concerns for our children. We know our kids are 3-5 years developmentally behind their same age peers, but knowing that doesn’t prevent us from focusing on their apparent lack of progress.   We worry about their future, and we ask ourselves, “will my child ever catch up?”

Adding to our worry-fest, we continue to struggle with the daily dramas, often lamenting that we’re fighting the same battles with our children over and over, day in and day out:

‘Brush your teeth.’

‘Put your shoes on.’

‘Did you put on deodorant?’

‘Get out of bed!’

‘Get off electronics!’

‘Did you eat breakfast?’

Understandably, it sometimes feels like nothing ever changes. Will our kids with ADHD & other complex issues ever function as independent adults? If they can’t remember to brush their teeth, what’s going to happen to them out in the real world?

The Brain Doesnt Fully Mature Until…

While some research suggests that the ADHD brain may not fully mature until the age of 36, at the very best we know that it doesn’t fully mature until age 26 to 28.  So it is easy to see why we parents lose hope.

Ellen Kingsley explains in ADDitude magazine, “The brain’s frontal lobes, which are involved in ADHD, continue to mature until we reach age 35. In practical terms, this means that people with ADHD can expect some lessening of their symptoms over time. Many will not match the emotional maturity of a 21-year-old until their late 30’s.  So, while most people graduating from college take time to adjust to adult life, people with ADD need more time, more family support, and more professional help. 

Now, I know THAT can be exhausting to think about. But it’s also promising – because it speaks directly to the question whether your kid will ever catch up. And the answer is yes! It’s just going to take time.

Hope is in the Successes

Here’s the thing.  Our kids ARE making progress. They are learning and growing and getter better every day. It’s just happening a lot more slowly than we would like. And because it can feel painfully slow, it’s incredibly easy to miss.

Have you ever gone to visit a friend or a loved one you haven’t seen in a few years?  Or looked at a picture of yourself or your parents from 5 years ago?

What did you notice?

Were you surprised to see that Aunt Susan is now in awesome shape? Or that your brother had a buzz cut? Maybe your mom had a broken arm that Christmas of 2013, and the picture reminded you of how much help she needed in the kitchen that year. Perhaps you’d completely forgotten how challenging that time period was for her (and for you!)

When we see people every day, it’s easy to miss the subtle changes. But over time, those subtle changes can and do add up to significant differences. In our children’s case, those differences are PROGRESS!

Looking backward to look forward….

Speaking for myself, when I take the long view, I’m able to see that 3 years ago, my child with ADHD and Autism still needed help getting dressed practically every single day of the school year. I clearly remember thinking – worrying — that he would continue to need help getting dressed every single day of his life.  And I’d be lying if I said that despair didn’t occasionally creep in.

But now, this year, that same child got up, dressed himself (without assistance) and was ready to leave for school on time 95% of the year.

Now that’s progress!!

Don’t give up before the magic happens….

If I only focus on the immediate, in-my-face challenges, like the fact that his social skills have a long way to go, or that he’d still rather play Minecraft than eat, sleep, or leave the house, then it’s easy to miss his leap forward in morning self-care. I could get stuck in the short term, day-to-day grind and miss the miracle of his slow but steady development. I could fail to SEE the change; he’s actually catching up!

Progress is a Process

So, the next time you’re feeling particularly frustrated or gloomy about your child’s forward movement, or when you’re quietly asking yourself, “will my complex kid ever catch up?”– remember to LOOK for the changes that have happened in the last months or years.  Chances are, your kid is progressing just fine, you just need some perspective to truly see the changes.

Time with our kids does indeed fly by. Our complex kiddos help slow that clock down — just enough to make us appreciate the beauty of each little step!

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“Mozart Helped Me Focus My ADHD Brain.”

Focusing the ADHD brain can be tough, but music is a proven tool for engaging the brain and minimize distractions. But why? Learn more about the science behind certain melodies and how they work to keep your attention.

 

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Don’t Ban the Spinners – Teach Kids about Fidgeting and the Brain!

By: Cindy Goldrich

Have you seen them yet?  They are small objects that kids spin around with their fingers like a pinwheel and they come in lots of different patterns and colors.  Kids are having a blast seeing the different ways they can spin them on their bodies, and battling who can make theirs spin the longest.  Many parents are reporting that their kids are spending less time on their smartphones as their hands are kept busy with the spinners.  Some kids are noticing that they can focus better when their hands are occupied.  So, what’s the problem?  They can create a big distraction.  As a result, some schools are now banning the use of Spinners in classrooms.

“But I finally had a way to fit in!”

Kids who have ADHD have been encouraged to fidget for years as a way to help them focus and control their constant movement.  Now that there is a tool they can actually use and seem like a cool kid – they are having to give them up along with everyone else.  Why?  Because many kids are becoming distracted while using them or by others who are playing with them.

Use as a Tool – not Toy!

For years, through my Teacher Training and Parent Coaching, I have been educating adults about the value of fidgeting and encouraging them to teach children the same.  I have asked that teachers keep a box of fidgets in their classrooms so that those who benefit from movement can do so without fear of shame or embarrassment.  And it works.  Here is what I teach:

  1. Teach ALL kids that everyone’s brain works differently. Fact – some people are able to focus better when they move.  You should know that for people with ADHD, there is a consistent pattern of below-normal levels of the neurotransmitters Dopamine and Norepinephrine in the brain’s prefrontal cortex, which contribute to maintaining alertness, increasing focus, and sustaining thought, effort, and motivation – but you don’t need to explain that to the kids. My goal is to not put a spotlight on “those” kids.  They have enough spotlight on them already.  I want to normalize the need for different styles of learning, not make it hierarchal as if one is better than the other.  It’s how we learn to manage our differences that is important.
  2. Demonstrate “fidgeting in the background.” I hold up a long rubber stick (you can see what it looks like in my article “Can’t You Just Sit Still and Pay Attention?”) and move it in my hands as I speak.  I am showing that I can effectively engage in conversation as I move the object without it negatively impacting my ability to speak and listen.  The object is my “secondary focus”.  It’s in the background.  It’s a TOOL that, if I was someone who did struggle because of lower levels of the necessary neurotransmitters, would be very beneficial in activating my brain.
  3. Distinguish if it’s being used as a TOY. Then, I demonstrate that if I start paying attention to the object in my hand, perhaps manipulating that long rubber stick with intention to make it into a pretzel, then I am no longer fidgeting, I am PLAYING.  The object has become my “primary focus”.
  4. The fidgeting cannot be Distracting to others or Destructive. Next, I start tapping my rubber stick on the table as I continue to speak.  I am showing that I have no trouble holding my thoughts and speaking clearly, however, of course this is distracting – and annoying – to others around me.  And if I swing the stick around, I risk knocking things over or hitting others accidentally.  I have now clearly demonstrated that there need to be rules and expectations around appropriate fidgeting.

So, what is the take away here?  Let’s not ban these Spinners.  Nor those Fidget Cubes that some others kids are using.  Use this as a teachable opportunity!  Our goal as educators and parents is to help children learn about themselves and how they can best learn and function in the world.  Let them experiment with different tools and techniques.  Set your boundaries and expectations.  Perhaps they can keep the object out of view of others, using it with their hands in their laps or keeping it in the pocket of their sweatshirt.  We want them to know how to best function while in religious settings, in movie theaters, and anywhere else they are around other people.  Don’t ban the objects – teach all kids the distinction between Tool and Toy.  Let’s celebrate and let kids with ADHD who need movement finally get to do so without stigma.

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Spinning Fidget Toys Have Some ADHD Experts Reeling

By: 

In case you haven’t noticed, a small gadget called the spinner fidget toy is getting a whole lot of attention. Ironically, it’s supposed to be doing exactly the opposite. The spinner has three prongs that radiate from a central ball bearing. When the centre is pinched, the prongs can be coaxed into a mesmerizing spin that can last for as long as your skill level will allow. Spinner toys come in all kinds of colours, are priced between five and ten dollars, and are perfect for spinning and swapping.

As an adult, I can see the appeal of gadgets — my smartphone has many. And I’m not so out of touch that I can’t recognize child-friendly fun when I see it! These spinners look like great entertainment, truly, which should be the hallmark of any good toy. But as a psychiatrist diagnosing and treating ADHD in children and adolescents, it’s the marketing spin that has me, and some of my colleagues, reeling.

Spinners are being touted as more than toys.

 If the hype is to be believed, they are fidget toys — toys that enhance focus during cognitively demanding tasks. Fidget toys have specific meaning in clinical circles. They are regarded as non-medical interventions that provide just the right amount of arousal to keep the brain engaged, but on something other than the toy itself. Fidget toys — if they are doing their job — enhance focus on work, while just plain toys focus attention on play.

When I speak with children and adolescents with ADHD in my practice, many fidget. It’s not surprising to see a teen tearing the label from a water bottle, or picking at the edge of the table as we speak. It’s tempting to assume these patients are distracted as they fidget, rather than listening intently. At times, parents will request more focus and less fidgeting–and teens will typically respond with, “I’m listening!” or “I don’t even know I’m doing it!”

For many individuals with ADHD, movement enhances focus. But the key to an effective fidget toy, whether it’s squeezing a stress ball or peeling the label from a water bottle, is that engagement with the item happens largely without awareness, as focus lands elsewhere. With spinners, the focus seems to be landing on spinners, and that makes them distractions, not tools.

In ADHD, attention is easily thwarted by distractions. A text message, the honk of a horn, a background conversation — all can pull a brain with ADHD away from the task at hand. And when attention is pulled by something far more entertaining, it’s tough to re-focus and get work done. Effective fidget toys are tools, not toys with bells and whistles that entertain and delight. They enhance focus by fading in the background, not by spinning in the spotlight.

So, here’s my clinical spin. Spinners don’t enhance focus. They demand it. Even a cursory search on the internet proves the point. YouTube videos show spinning experts performing all kinds of tricks with this wildly popular gadget. Try spinning it on a pencil! Try spinning it your nose! Try throwing your spinner from one hand to the other! These tricks go beyond mindless spinning. They require intense focus and dedicated practice. It’s only a matter of time, I suspect, before Spinner Competitions emerge. It might not take 10,000 hours to become a spinning expert, but a good chunk of time and practice will probably earn a child some serious playground popularity.

Schools are banning spinners in classrooms, and this makes sense from a learning and focus perspective. Fidget toys should not be distracting for the students using them, or for other students around them. But to ban all fidget toys from the classroom would be a mistake, placing children with ADHD at a significant disadvantage.

An assessment from a clinician experienced in ADHD is the first step in determining what kinds of fidget toys would be most appropriate for a student with attention difficulties. Fidget toys deserve a positive spin as effective tools for supporting focus. But the spinner fidget toy needs some serious rebranding from an ADHD perspective. Quite simply, it’s a cool tool for fun, not focus.

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Gamifying ADHD

Family life can be chaotic at the best of times. Add ADHD or other learning disabilities to the mix and it can be tough for families to get through a regular day. Brili is an app that empowers parents and children through its real-time daily activity guide, monitoring and fun reward system. Kids stay motivated and on track while parents see positive improvements, less negativity and lower stress, both at home and at school.

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heartWhat the ADHD Experts Say about Coaching for ADHD

We recommend that you hire an ADD coach to assist you in the process. Get yourself a coach to help you stay on track- Kate Kelly and Peggy Ramundo. Authors of You Mean I’m Not Lazy, Stupid or Crazy?!
Coaching, it turns out, is one of the most powerful and effective ways for people with ADHD to achieve success.- Thom Hartmann. Writer of 7 books on ADHD who has ADHD.
Coaching is the single most effective tool in ADD self-management.- Dr. Edward M. Hallowell, M.D. Author of several books on ADHD who has ADHD
Coaching intervention can make a real difference in how people with AD/HD negotiate their own particular deficits and cope with life on a daily basis- ADDA - Attention Deficit Disorder Association

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About Take Flight Coaching

The name "Take Flight Coaching" was inspired by travel as a metaphor for living. Travel encourages and expands skills and qualities such as exploration, discovery, self-reliance, recognizing strengths, planning, awareness, and an overall openness to following what might be a completely foreign path in order to get where one wants to go.

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