Tuesday, August 10, 2010

I think my 13 year old has ODD?

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Questioner: Anonymous

Subject: 13 yr old w/ODD?

QUESTION: I am trying to decide if I buy the preliminary diagnosis our 13 yr old (my step-son) has received of being ODD. He has always had behavioral issues at school, mostly attention seeking/class clown behaviors though. There were some acts involving physical altercations this year, but only one of them involved open aggression toward another student, and that behavior has not reoccurred to date.


Nevertheless, b/c of numerous other minor infractions, he was suspended and very nearly expelled. His grades are very poor and not reflective of his abilities (mostly Cs, Ds and Fs in the core subjects). He does consistently break rules, and unless he is being supervised, there is little chance he will do the right thing if it is conflict with what he wants. He was rude and disrespectful on multiple occasions to a couple of his teachers but he was "flip", never hostile or threatening and usually trying to show off to other kids.

He is rarely rude or disrespectful at home. He has occasionally stolen in the past year, and probably more than I'm aware of, based on his lack of remorse over the incidents I did find out about. He seems unwilling to accept responsibility for his actions, even when the consequences for them have been thoroughly discussed before hand. He relies upon a willingness to lie his way out of trouble or into whatever it is that he wants at the moment, which doesn't work very well, since he is constantly getting caught.

He does seem to know the difference between right and wrong, and he insists that he is a "good" person, even though he admits to consistently thoughtless, dishonest and deceitful behavior. We have two cats that he is always very affectionate and caring of.

But he is rarely surly or openly hostile. He craves attention to the point that he seems to have little value for his own esteem, whether it is good or bad, but instead puts all his energy into pretending to be what whomever he's standing in front of wants him to be. He's like the prototypical politician that is charming and sincere even as he is plotting to take you for everything he can.

I will give him this - he is relentless in his pursuit of NOT doing something. He gives up easily on having or wanting to do anything that requires effort, but when it comes to NOT doing something, you have never met a more stubborn kid. He moved our woodpile back and forth across our yard - a half acre - nearly the entire year because of chronically lying about his behavior at school, homework and classwork and a million other ridiculous lies.

No amount of pointing out to him how his lying about the incidents were the sole reason for putting him in the same place over and over again made any difference. No amount of devising strategies for him to "confess" so as to avoid the "lying" consequences were effective. He would regain his freedom and privileges only to re-lose them within a couple of days. I tell him all the time that if he ever directed that incredible relentless determination to anything positive, he could achieve anything - period.

The school wants to enter a diagnosis of "emotionally disturbed" into his file and I am reluctant. I don't like labels and I'm not all that impressed with our public school system's willingness so far to provide meaningful interventions for other issues he faces (though bright and creative, he shows signs of dyslexia and has a pronounced auditory processing disorder and has responded well to treatments we have gotten for him outside the school setting). I want to believe that he is a good kid with big issues, but his willingness to look anyone directly in the face and tell the biggest whopping lies and have absolutely no sense of remorse over it (or whatever he's done or not done that he's now lying about) is very disturbing to me. I would like the school to work more effectively with us and maybe the diagnosis would do that, but then again, maybe it will just be a label he will have to overcome long after he's resolved whatever issues he's struggling with ...

We have begun counseling (only just) but we have to make this decision about his school related diagnosis pretty quickly. Do these behaviors sound like an ODD kid? Particularly, the lack of open hostility toward people?

Thanks for your help.


ANSWER: Dear Anonymous:

You are right to be concerned about a diagnoses being placed upon your son. I am concerned thought about several patterns of communication I noticed in your writing about him.

It is very easy for us as parents to get caught up in negative behavior of our children and inadvertently become part of the problem rather than the solution. Two things I noticed is 1. The negative descriptors of your son's behavior and 2. The minimization of his behavior or excuses which follow each description of bad behavior.

Bad behavior does not mean a child is bad however, they need to know the behavior does not have an excuse or we marshmallow the communication of what is wrong. It needs to be clear it is wrong.

The positive I picked upon was his ability to care and be concerned for his animals. This is a strong positive.

Are you sure he is not remorseful or you only don't see any remorse. How much are you having to assume and how much is being communicated?

Did the school test for a learning disability? Sometimes children will act out as a way of distracting people from noticing they are struggling to learn. Remember children do not want to be different from other children and will go to extremes to be similar, be liked, and accepted.

I find myself wondering if he has an adult in his life who lies? Has he been exposed to violence? Has anyone been verbally or physically violent around him? Lying is often a symptom of Substance abuse or addiction affecting a family.

I find myself curious about the wood pile movement. Seems a bit extreme and punitive however, that is my personal opinion.

I imagine you both needs some positive experiences to strengthen your relationship. Your writing me speaks volumes that you want the best for this young man. It is pretty important you find a way to have positive experience for both of you. Watch words like 'always' and try to find him doing things well which you can praise him for such as how he treats the animals. Possible building on these relationships will evolve to reaching for new and more positive behaviors.

Also, when it comes to diagnosis ask for a second opinion or even two opinions. These should be in person assessments!

Dealing with these type of challenges as a parent is the hardest thing you will probably face in life! Build on the positive and I things will get better.

Sincerely,

M Kay Keller

 ---------- FOLLOW-UP ----------

QUESTION: Thanks for your quick response. It is difficult to accurately convey all the relevant details in e-mail but, in response to some of your questions and observations, I hope I can provide more information to clarify.

I'm sorry that my e-mail seemed to suggest we are minimizing or making excuses for Bryce's bad behavior. I can assure you that we do not. Whenever Bryce breaks the rules at school or at home, we have always made it clear to him that the rules are the rules and he is responsible for his choices. If he tries to say he didn't understand the rule or forgot or he is wrongfully accused,(or the rules are unfair!) we explain how sorry we are about that and hope that the consequences will help him remember or better understand next time. As far as being wrongly accused, we explain to him that b/c he has chosen to be consistently deceitful and dishonest with us in the past, we cannot take his word over the school's. We hold Bryce responsible for his inappropriate behavior even in response to someone else's inappropriate behavior, making it clear to him that one is not an excuse for the other.

However, in describing his behaviors, I did want to put them in context. He is rarely openly hostile and most of the serious trouble he has gotten into at school was related to talking out in class or horseplaying with his friends, and usually related to showing off. I thought it was important to make that distinction b/c ODD seems to be associated with hostile, anti-social behavior. I actually worry about him being too friendly and too eager to warm up to people. But we have repeatedly, over the years explained to Bryce that talking out in class is disrespectful both to the teachers and to the other students (and to himself), and that we strongly disapprove. We have tried different types of interventions over the years, from tokens to incentives to punishment to discourage this and other misbehaviors, NONE of them effective.

We even tried spanking him, but that made us all feel so awful that, whatever beneficial disciplinary effects it might have had were far outweighed by the lingering sense of ugliness it carried with it, even after the spanking was over. Moving wood across our yard became the only thing we could punish him with once he lost all of his other privileges, (TV, X-Box, friends over, sports-because of his grades), and was reserved for only the most serious infractions, usually blatantly lying to get something he had not earned, or to avoid responsibility for consciously choosing to break a rule or rules. He lost each of these things in succession as his behavior did not change. In fact, the greatest change we saw was in the creative ways he came up with to try and continue his behavior but avoid the consequences. He is very creative.

Bryce, once in trouble, becomes a model child until he is out of trouble, and then returns to the very behavior that got him into trouble in the first place: acting out in class; lying about assignments, refusing to do his assignments; disobeying simple school rules (like wearing a belt!) lying about homework (having it or completing it); misusing his lunch money (to the point we had to FINALLY make him use his OWN money for lunch); stealing, from objects to money, from us and from other children; sexual harassment(at school), which involved him saying VERY inappropriate things to or about female students (always with his friends, showing off). None of these things were isolated incidents but have recurred over and over again, despite the consequences and all of our attempts to convey to him how unacceptable his behavior is to us and society at large.

As far as showing remorse, I have seen very little from Bryce, and I often talk to him about it, asking him how he would feel if he were treated the way he is treating others. He always agrees he would not like it. However, when I ask him why he would choose to treat others in a way he admits will make them feel bad, and that he knows is wrong, he shrugs his shoulders and says something to the effect that he didn't think about it at the time, or that he thinks it's "different". And, Bryce NEVER shows remorse until he is caught. He can lie and deceive for weeks on end (which he has done on more than one occasion) and look you in the face so sincerely and insist he is being truthful right up until the moment you present him with the evidence of his lying, and only then does he show any remorse, and it's almost always in the form of begging and pleading for another chance.

What is even more disturbing to me is that he will lie even when he knows that he WILL be caught, e.g., his grades or behavior at school, which are all conveyed to us weekly via e-mail and the school website. He will continue to talk in class even when he knows the teacher has given him a warning and the next thing is a lunch detention (or a Saturday, after so many, or, by the end of the year b/c he had been in trouble so much, suspension (his last before expulsion!).

I asked him why he would deliberately choose to continue to act out when he KNOWS he will get into trouble, and then be angry about getting into it (to the point that sometimes he got into even MORE trouble at school for being disrespectful) and I'm certain that he doesn't understand himself. What I don't understand is why, instead of empowering him, the thought of accepting responsibility makes him feel powerless, and I have seen that over and over again. Have you ever seen this? I feel as though he's gotten something mixed up in his head about it and somehow, the idea that he DOES control himself (he's NOT helpless as he so often wants you to believe) is far more frightening to him than the fact that by choosing to NOT be responsible, he is doomed to repeat the same mistakes, and suffer the same consequences over and over again.

Many of these behaviors sound to me like ODD. But he is capable of incredible sweetness and he's very resilient and I do believe he WANTS to do the right thing, right up until the moment it's time to do it. Perhaps he's just maturing later than other boys?

Bryce has been tested several times over the years because of his behavioral issues and his consistently poor performance. Despite having characteristics of dyslexia and his very noticeable auditory processing disorder (he has always struggled with language and still has some slight problems with enunciation and syllable order) as of his most recent testing/evaluation a month ago, he is still within the "normal" limits for his age group academically, (though, in my mind, the standards are disgracefully low) and is even excelling in reading, of which we are very proud, particularly in light of his dyslexia. Bryce has proven from time to time that he is capable of doing the work; he simply chooses not to do it. We have tried many different interventions to help him. Since Bryce will not participate, it has proven very difficult to identify what is helpful and what isn't.

I do believe that, b/c Bryce's dyslexia and auditory issues were not identified until he was in the 3rd grade (prior to that he lived with his Mom in a very disruptive setting), that he did learn frustration very early, and that he, at some level, still believes he is incapable. I do believe that all of his acting out in class and resistance to doing the work, at least initially, was related to trying to distract others from his sense of incompetency (and not ADD or ADHD, as the school initially labeled him). But we had thought that as we encouraged him and he learned that he could learn, his acting out would gradually taper off.

It has not and has actually gotten worse, even though he has had some successes at school and even though he now loves to read (when he came to live with us, he could not read at all). It is obvious to us that Bryce is a bright, quick-witted child - all you have to do is engage him in discussion to figure that out. When he is interested in something, he is quite capable of focusing on it and learning it, including certain topics at school (he really enjoyed American History this year and got an "A" on that part of the course. He also enjoys Greek mythology.)

Bryce's early development was chaotic and his mother did, on and off, struggle with substance abuse and addiction (which ultimately led to the divorce). Until recently, her life was very unstable and Bryce was homeless for a while when he was in her care, and moved frequently. Once he came to live with us, there were periods where we wouldn't hear from her for months and did not know where she was. I know this was very difficult for him, and I'm certain I was a poor substitute for his Mom, never having any children of my own and not much experience (or healthy role models) to draw upon.

There was a custody fight (unbelievable that we had to fight!), and though more civilized than some, I know Bryce was exposed to more of that than he should have been. Lying was obvious a big part of his Mom's rationalization for her substance abuse and other poor choices, and she has continued to struggle with it. She is, however, doing much better over the past year and a half and I am very proud of her and grateful for her ever increasing willingness to parent and to work with us to parent as a team. She really has come a long way and seems, for the first time since I've known her, really on the road to long-term sobriety.

I do not mean to suggest that we have been perfect parents. In fact, I think it is almost ironic that you got the impression that I was making excuses for Bryce in my original e-mail b/c it suddenly occurs to me that I am so uncompromising when it comes to accepting responsibility that this may be why Bryce is so afraid of it. I will have to discuss that with our therapist!

Thanks for being optimistic; I will try to be so also. Lately, it has been difficult since it seems like nothing is working and Bryce is only getting worse. How can a child with this much support and all of these resources available to him not improve? How can we be failing so utterly? I realize that we aren't doing everything right, but it seems like we are doing a lot right ... shouldn't that show up somewhere?

Please forgive my venting and frustration; I'm just out of ideas, and it is difficult to focus on the positive aspects of my relationship with Bryce when he is constantly lying to and manipulating us. I have become so suspicious of him that whenever he initiates a conversation with me - something most parents would be thrilled about from their 13 year old - I assume he's covering something up, or buttering me up for something, and I am usually right. What's truly ironic is what a bad liar Bryce is ... sometimes I think every lie he ever got away with, at least in the short-run, was only b/c we so wanted to believe him and avoid more negative interactions with him.

We will take your advice and seek a second (or third!) opinion. As troubling as his behavior is, I don't want him labelled with something so serious unless it is accurate and the label will offer more benefit than detractors.

Thanks for hearing me out and letting me vent. Writing about it to you has helped me clarify some of my feelings and perspectives even to myself. And that gives me hope that things will eventually get better.


Answer: Dear Neen:

The background information was very helpful. Knowing what he was exposed to in his formative years is very helpful.

I look at the things we have control over and the things we don't. Please don't delude yourself that if you do everything right this will turn out right in the end. Children still have to make their own choices and this child will have to make his own choices as well.

You did a good job of hearing most of what I said in my last e-mail. However, I am still concerned about the punitive behavior. PUNISHMENT does not work. It is not effective. You and he just get caught up in a NEGATIVE relationship. I am not saying to he should not have consequences. I am just not sure they need to be PUNITIVE.

I think you both need more positive experiences and it is imperative to set up positive experiences as soon as possible and as many as possible to turn this around.

Re-read this writing and tell me how many negative descriptions are used compared to positive ones. (I am not judging you anyone can end up here, even professionals!). Just do this for me please.

Now, as for the diagnosis. There is not reason for any child to receive a label EVER. The only reason for diagnosis is for the insurance purposes. These diagnosis are so that money can exchange hands and they mean nothing more than a professions need to classify and describe behavior. They are not the person! I can tell you are not willing to write this child off however you also need to ACCEPT him for who he is. You cannot undo what he has been exposed to, you can only learn to love him for who he is and focus on his strengths.

I think you made a major breakthrough when you realized how hard you may have been on making him take responsibility for his actions. Any of us wants to run if we know we are facing punitive actions. Any of us is more willing to take responsibility for our actions if we know someone understands we made a mistake!

I think maybe his "other life" frightens you and you maybe trying to correct too much too quickly. It will take a lifetime to undo what he has been exposed to and anytime a child is exposed to addictions they are exposed to lying.

Know I know this seems like you have a hard road ahead of you and you are not having much fun (only you can start to have fun and insert more fun into this relationship) however your strength is that you don't let him manipulate you which is what he has learned to do. He is not doing this because he is a bad kid, he has learned to do what he does and it has worked for him in the past. He is just learning know that it doesn't work anymore and he is testing it over and over again to see if it will work again. Believe it or not you are giving him a new way to view the world and it is a good thing.

You may not see the results of your hard work for years. I don't see much about his biological father doing the disciplining here. I have to warn you that when the step parent takes on the role of the disciplinarian (something I passionately discourage) a child will build strong resentment. The main course of parenting needs to be by the biological parent not the step parent.

The spanking was not a good idea. It only lowers self esteem and ads to the problem so I am glad you figured out this does not work. I do believe in the POWER of positive reinforcement. I believe and prescribe to the power of positive reinforcement so strongly that I state any child can be turned around by the use of CONSISTENT positive reinforcement. You just have to find out what he values. You have to know what he considers of value.

Best Wishes!

M Kay Keller