Oppositional Defiant Disorder (ODD)

Parent Q&A

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  • The time has come to admit there may be a medical diagnosis for what my child has-not just a passing transition stage....for years.

    Does anyone have an suggestions for a psychologist who can help my child directly and/or counseling for parent-child communication so that our household is not filled with ongoing arguments on a daily basis. (Even when I step back from one, which takes a heap of effort, they keep pushing to pursue it.). It is exhausting and impacting a lot of aspects of life. They are in middle school.

    Any guidance is gratefully appreciated.

    Hi there -

    My heart goes out to you. It's extremely difficult to live in such an environment. We have an ASD 1 kid, and a lot of our interactions were like yours until we started working with Whole Child https://www.wholechildca.com/ . Officially, they offer ABA services, but we learned so much about our child, and how to set up his living circumstances to not overwhelm him (including how to communicate with him). We are now down to about 1 meltdown a week - from daily meltdowns and fights.  They might be able to help you, or at least point you in the right direction. Don't give up hope! 

    Hello! I also have a son in middle school with Oppositional Defiant Disorder as well as ADHD. It is so, so hard. Initially he was treated at Kaiser for years and dozens of medications with no success. Then we took him to the Amen Clinic in Walnut Creek and he has been on different medication from them which has helped greatly. Of course this was out-of-pocket. I am happy to connect and share some other major things that have been very successful in helping him: please ask the moderator for my email info if you would like. It is truly exhausting and very difficult for anyone on the outside looking in to understand. My heart goes out to you.

  • Seeking Therapist for Oppositional Teen

    (1 reply)

    My lovely, funny, smart 14yr old has had escalating anger during conflict at home--toxic name calling, destroying property, walking out and leaving the house, making physical threats and intimidation. He has not responded to negative consequences or rewards, he just digs in. We've worked with a therapist and they've been helpful but I really need someone who won't just listen but can provide hands-on parenting techniques and coaching that works specifically with oppositional kids. I'd prefer a male and someone in the Oakland/Berkeley area but would be flexible if they are great with teen boys (and their parents!) on issues around impulse control, anger and conflict. Thank you!

    I highly recommend the Parenting Strong Willed Kids class that Kaiser offers, I believe you don't have to be a member to take it. I know several families that have taken the class and we have been using the class manual to guide us in parenting our oppositional, strong willed teen. It has been extremely helpful with concrete advice on setting the appropriate boundries for a teen with this sort of temperament as well as giving him more space in certain areas so that he doesn't feel the need to power trip via rebellion. The book is called "Changing Destructive Adolescent Behavior." Strong willed kids are more likely to engage in destructive behavior and less likely to accept parental input or use the mistakes of others as learning experiences for the themselves. There's a stubbornness, curiosity, lack of fear and desire to experience things first hand. One key to becoming a more effective parent is realizing that you don't have "control" over your child, but you do have "influence." Trying to control will lead to rebellion when strong willed teens want to show they can't be controlled. 

  • We are leaving Kaiser and will be paying for therapy out of pocket.  We live in Martinez, and prefer Walnut Creek, Orinda, etc but are open to the right person near Oakland.

    We have an adopted child who has always had issues with bonding, attachment and opposition/definance.  He has recently been diagnosed with ADHD- Inattentive, Oppositional Defiance Disorder and Reactive Attachment Disorder.

    We have been told that EMDR therapy might be good for his trauma as a toddler.

    We are looking for someone who isn't too soft but who is direct and holds our child accountable for his actions etc (if that makes sense)

    Thanks!

    Alexis

    We've used Virginia Keeler-Wolf and know many others that have used her, as well.

    http://www.attachmentadoption.net/clinicalstaff_virginia.html

    Hi,

    I have the same kid—adopted, attachment disorder, ADHD. I can tell you that EMDR was a huge waste of time and money for us. Didn’t help a thing. Ditto for most child therapists. They really just don’t understand these kids. The one therapist I met who does and who helped us a great deal is Virginia Keeler Wolf. Her office was kind of by Montclair so maybe wouldn’t be too hard to get to as it’s just on the other side of the tunnel. 

    Best of luck to you. 

    We took our adopted daughter to Anna Weisberg this summer for a short course of very specific treatment as part of our overall treatment plan.  We all really liked her. Her offices aren't exactly where you asked but nonetheless seem probably convenient to you.  You might consider her for treatment or to ask for other referrals:  http://www.astepforwardinc.com/AnnaWeisburg/

    We are on a similar journey, though not as severe as  you describe.  Sending you solidarity!

  • Hello,

    I am looking for a local therapist/psychiatrist/psychologist who offers parent training for parents who have children with ODD or Conduct Disorder.

    Thanks!

    Caroline

    I know first hand how difficult it is (my 11yo has many of the characteristics though we haven't been given that particular label). We've been working with Dr. Keith Sutton - he has offices in Marin and SF. He has a clear multi-step process and while I can't say it's fixed, I am feeling like the good outweighs the bad more often than not. I do know he's out of the office until the new year, but I would highly recommend him: http://www.drkeithsutton.com/. Good luck.

Archived Q&A and Reviews


Questions

Behavior Therapist for 8 year old with ODD and ADH

Sept 2010

I'm looking for a Behavioral Therapist for my 8 year old step-son. He's been diagnosed ODD and ADHD. I'm also looking for a great child psychiatrist to talk about treatment of these and get a second opinion. Thank you annon


Celeste Schneider is excellent; I highly recommend her. 510 595 0780 Her office is in Rockridge. Ian


Check out the Anat Baniel Method for children. it is really exceptional for all types of behavioral problems. She works on a very different theory than traditional medical providers and it has done wonders for my son with a neurological disorder. We see Lauren McLeod in Albany 510-237-0935 anon


We are currently and for the past year, having great success with our child and our family (separately) at the Ann Martin Center on Grand Ave. 510 655-7880. Satisfied


Need help with teen's oppositional defiant disorder

Oct 2009

Hello, I am searching for help with my 15 yo son who was diagnosed with oppositional defiant disorder at age 10. We have been through every conceivable avenue - neuropsyh evals, lots of therapy, special schools, wilderness camp and residential treatment. He's graduated successfully through all programs, but once back at home he backslides. I work full-time and am a single parent. I cannot provide the 24/7 care and attention that are provided by staff at the programs. I have a younger son as well, and our home life is dominated by my older son's constant defiance and arguing. Does anyone have experience in dealing with this successfully? I need help. desperate


Do you know about Ross Greene and Stuart Ablon's books, The Explosive Child and Treating Explosive Kids? (both available through Amazon). Dr. Ablon, who is a clinical researcher in the department of psychiatry at Massachusetts General and a professor of psychology at Harvard, also has a website: Think:Kids.org. Check out the research on that site that describes the impressive success they have had using their method in residential settings. Their philosophy is very compassionate toward kids with ODD and other ''challenging'' behavioral issues and views kids with oppositional defiance-type behavior as having developmental delays that are neurologically-based. The treatment method is evidence-based and uses a collaborative problem solving (CPS) approach that helps kids to develop the skills they are lacking in areas such as frustration tolerance, emotional regulation, and problem solving among others. My husband and I have attended trainings on the east coast and in LA and the CPS approach was the only approach that we felt was effective in working with our son who has these type of challenges. It has given us hope and made a big difference for our family. Using CPS


I'm sorry I didn't see your original post but I'll back up the recommendation of the book, The Explosive Child. If you decide you need professional help, you should call Dr. Brad Berman in Walnut Creek. Years ago when I first I called I got the recording saying that new patients wouldn't be accepted for 8 to 12 months. I left my anxious message - basically my darling, funny, angry, smart, difficult, explosive child was blowing up our family life. I got a call not long thereafter and we took our child to Brad for the next six years. THANK GOD. Brad really knows this field & loves kids. He coached us thru the teen years and was a total advocate for us with school. He is a straight talker and treats kids with respect and compassion but he also tells them what THEY have to do to make life better for themselves. Since I didn't see your post I don't know how desperate you are or aren't. But here's his number just in case: 925-279-3480. The practice is called Progressions: Development and Behavioral Pediatrics. been there in spades


Evaluation for ADHD or ODD in 7-Year Old

April 2008

On and off since she was 3, I have received feedback from my daughter's teachers that she is uncooperative and even defiant, will insist on doing things in her own way rather following directions. When she was a preschooler, I mostly chalked it up to ''normal'' developmentally-appropriate behavior. She has always been keenly aware of her environment, very observant, and has had since infancy a tendency toward reacting to stimuli in a big, often exaggerated manner. This goes, too, for any so- perceived insult or injury.

She has a chronic genetic medical condition for which she must undergo frequent diagnostic procedures and examinations, to which her response is often uncomfortably ''over the top,'' eliciting anything from disapproving clucks to eye rolling to speeches on more effective boundary setting and accusations of poor parenting, whether implicit or explicit, from care providers. She takes a laundry list of medications to treat her medical condition.

Her father and I separated when she was an infant; I am a chronic depressive ''in recovery''; her father is an alcoholic unwilling to recover, with whom she spends most weekends. I get little emotional input from him: his ability to perceive, analyze, and act upon matters psychological seems stunted.

Our daughter is actually quite precocious, reads well beyond her class level, and exhibits many signs of above-average intelligence. Her current teacher has recently approached me to say that her in-class outbursts, lack of cooperation and outright antagonistic attitude have reached ''critical mass'' and that we need to take action.

With all I do to maintain her physical health, the added stress of behavioral issues to be handled seems overwhelming! I wonder if she has ADHD or Oppositional Defiance Disorder, and would like a recommendation for someone to do a full psychiatric assessment, taking into account all the physiological and environmental factors in play. I am very reluctant to put her on yet another medication, so I'd prefer someone who is not a puppet of the Big Pharma! I look forward to your input... Mom with Plate Piled High


Hi, my daughter sounds like yours in some ways (and not in some other ways). She is above-average intelligence, highly sensitive to social actions (perceived often as being not- liked), highly sensitive to her physical environment (she is diagnosed ''tactile defensive'' in the sensory integration dysfunction group), and has tantrums regularly at home - big ones. She is also 7.

We tried being evaluated and treated by an occupational therapist (trouble in the ''occupations'' of daily life - not work therapy). We also looked at food or other allergies (negative). We spoke to a psychologist who knows child anxiety and have since seen a child psychiatrist. An eval from a psychologist or a developmental pediatrician would be a great start. If they feel it necessary, they can refer ''up'' to a psychiatrist.

The next hurdle would be where to go and how you can pay. Depending on your health insurance, or if you have a mental health benefit, you can look at a few different options. We obtained a referral to Oakland Children's Developmental and Behavioral unit - very highly recommended for things like ADHD vs ODD vs SID vs others. It took FOREVER to get the referral accepted (like 10 month). Then we had to get authorization from our health insurance. That took at least a month. With the time in between (my fault) and then the time it took to schedule an appt after receiving authorization, we have a total wait time of 14 months!!! However, the eval will be covered as well as the follow-up appt by our regular medical insurance. We opted to see the psych before this appt bcs things were feeling dire. And we sought out an OT outside of this group for the same reasons before. Things went a little out of order, but they seem to be coming together.

So, perhaps the first stop would be your pediatrician for a referral if you want to be seen by a develop/behavioral specialist or a psychologist. Or, you can seek out your own psychologist or develpmental ped. I would recommend trying to get to Oak Children's groups bcs I've heard from EVERYONE we've talked to that they are the best - and they will certainly be familiar with kids on other meds and will have access to specialists in those areas too.

Good luck!!! parent of sensitive kid


Sounds like you are dealing with a lot. I can imagine it is really draining sometimes. It also sounds like SHE is dealing with a lot. Were I in your situation, I would check out therapy before going into meds. This area is chock full of excellent children's therapists who specialize in a whole smorgasbord of situations. I had similar concerns about my oldest child, who is also very intelligent and sensitive and ''over-the-top'' (but doesn't have medical conditions). He has been in therapy for almost 2 years and the change has been beautiful. anon


Honestly that does not sound like ADD or ADHD at all. A child with ADD will have trouble organising their stuff when you ask them to clean their room. If you leave them alone to do it you will find everything separated into piles but not put away. A child with ADHD will be very high energy and be prone to breaking things in your home. Keep in mind being the child of an alcoholic and a chronically depressed person is much harder than you probably realise. She is taking her cues from both of you, and the behaviour and emotions of depressed people and alcoholics appears 'excessive' to other adults. Even without those factors it is very hard for young children when their parents are no longer together. When you add in the fact that she also has to deal with a physical condition that makes her different, she probably feels horribly conspicuous and different from other children. On an aside even as an adult I hate going to hospitals and being poked and prodded, and that the medical staff are acting disapproving about your daughter's behaviour seems really inconsiderate. My advice would be to find a therapist for her to talk to so that you can really find out what is bothering her. I have a gut feeling that if you can find a way to help her feel more in control and happy that she will behave better. My grandfather was an alcholic and my grandmother was depressed and it was very hard for my dad and his sisters. They all had 'excessive' behaviour as children and adults. My father was only able to stop once he found a good therapist in his forties, but his sisters still act inappropriately. Sadly as an adult other adults are pretty unanimously unwilling to put up with that kind of behaviour. anonymous


Our child 8, has many similar behavioral issues (no med). Lifestyle circumstances different: though father and I divorced 5 yrs. Same with school/teachers. Struggled with behavior since d.of sep, and before. Spent 3 yrs trying to arrange psych-eval/neuro-psych diagnostic. Very familiar with docs in area/psychologists/neuropsychologists. Got excellent advice on selecting a practitioner. Spent 50 hrs in Jan., interviewing/researching.

Beginning work with neuropsychologist Terry Doyle, Oakland. Practices with 2 assistants, and is able to intake clients faster as a result. Appears to be very thoughtful/ thorough/non-reactive. Spends 2X as long with tests/writing report than all others interviewed. Painstakingly answered all calls and emails prior to our commitment (totaling more than 4 hrs). Spent an addl 1.5hr meeting in her office, 1 of 15 willing to respect/encourage parents to take time/precautions necessary to choose right person to do eval. Knows info is important- not to mention subjecting your child to this (our child terrified/resistant to doctors/specialists). Available/willing to answer all questions, including emailed list of tests free. Others would speak for 20 mins, not return calls, request we pay them for addl info/interview. This tells me she will be as thoughtful/thorough during testing, and following (important!). Trained MD with addl Phd in psych. Maintains a full psych. practice.

Aside from above, chose her b/c she seemed to offer qualifications that would see our child from both perspectives so as not to focus solely on a bio-chem, nor psych. Testing time w/children is over the course of 4-5 visits and totals approx. 13 hrs. 15 hrs to write report/review/provide recommendations with you. 2 hrs meeting with parents prior to get hist. 30 hrs total; $5300.

Thought it better to do process once,spend 2X as much time/$$, and try and get it right, than to come away with mis-diagnosis, or no new info/tools. Encourages process as an ongoing relationship. Just beginning-can't give final consensus of work. Our's will begin next wk, 6 wks to set up. Adamantly against meds/ADD diagnoses, etc., unless very thoughtfully considered, and no other treatment option. We've explored many holistic options: therapeutic schools, occupational therapy, sand tray, homeopathy, counseling, diet/cod liver oil, IEP, and other assessments. maimiti


If you have insurance you might find a good neuropsychologist to do thorough testing. In Berkeley, Caroline (Kai) Johnson, PhD is excellent. If in an Hmo, call to find who they will allow you to see. A neuropsychologist can do testing that is often much more discriminating and helpful than just your pediatrician doing an exam. Even if your child has ADHD for example, you still will want to find out about her particular strengths and weaknesses within that category which the test data will show. The psychologist can help you translate the results into what you need to do from there. Good luck. terry


Your case is going to be a complicated one, and you will need a team approach to piece together what is going on with her and create a plan to help her.

The various team members could be: 1) developmental behavioral pediatrician to lead the team; 2) pediatric psychiatrist to do the psychiatric/emotional evaluaton, 3) pediatric neuropsychologist to do a full assessment of her cognitive profile. The team should then create a plan TOGETHER that integrates and prioritizes her treatment. I am surprised the school psychologist has not been brought in to do testing. At this point, I would pass on this and go directly to a private neuropsych assessment.

So...where to start. Some suggestions:

1) Ann Martin Children's Center, 3664 Grand, Oakland 655-7880, www.annmartin.org.

2) The Development and Behavioral Pediatrics center (a dept. of Childrens Hospital) at 5220 Claremont, Oakland, 428-3351, http://www.childrenshospitaloakland.org/healthcare/depts/behavio r_overview.asp

3) start with the neuropsych evaluation, Dr. Carina Grandison, 286 Santa Clara, Oakland, 763-9795. She can give you expert, compassionate advice and also do the full assessment.

I am wondering where your pediatrician is in all this and why s/he has not been guiding you in this. Perhaps you need a new pediatrician.

Also, a last piece of advice. Your daughter will probably have a combination of medical, cognitive and behavioral factors which are being demonstrated. Please remember:

1. Even if the majority of her problem is behavioral, it is not willful or under her control. She is behaving in the only way she knows in order to survive. She can't just ''stop doing'' something and making her feel bad will only make it worse. The moral judgements by teachers and others send her the message that something is wrong with her, as if it were her personal choice to behave that way. Her anxiety level is very high; when your anxiety level is high you don't have mental room left over to attend to what is going on (eg learning); so it looks like ADHD but in reality the anxiety can cause the inattention.

2. Know that she is working very hard to just cope with life. She probably comes home from school exhausted. Do what you can to comfort her, give her rest and relaxation, and plenty of time in a non-stressed environment.

3. Reassure her that you and she together will figure out what is going on, that you will help her, that everything will turn out ok, that you love her, and that she is a special, wonderful person. Tell her that every day!

Good luck to you. anon


You might also look into the possibility that your child is gifted and bored to extreme frustration with school. When you choose someone to do testing, you might want to make sure that the person is also an expert on gifted kids as they sometimes have very different behavior patterns that won't be understood by someone unfamiliar with gifted kids. There is a webpage called Hoagie's that you can google and it has lots of reference material for gifted kids and various problems that sometimes go along with this. Some kids have disabilites along with the giftedness, which can be confusing. Anyway, good luck! Laurel


Oppositional Defiant Disorder in 5 year old?

Feb 2007

I suspect my 5 year old daughter may have ODD. But I cannot be sure. She is disobedient, gets easily frustrated, argues a lot with us, and ignores requests and orders. She never takes responsibility for her misbehavior. Her father is very stern with her, and I am always trying to negotiate (with her and between the two of them). She does not respond to anything. She has also started ignoring her teacher in her kindergartner class, to the point that it has been suggested that something is quite not normal with her. Any parents out there of children that have been diagnosed with this disorder who can tell me what is normal behavior and what is not? And any recommendations for a psychologist, therapist or OT who can help with a diagnosis? Thanks! Anon


My sister had ODD. This is something that usually becomes apparent in adolescence and should be every parents worst nightmare. I'd take your kindergarten teacher's suggestion to heart and have her evaluated by a specialist. Your pediatrician should provide a referral. I suspect that at 5 your kid may have attention deficit disorder, which predisposes kids to ODD in adolescence, which is something you DO NOT want to have to go through. -still annoyed with my sister


8 year old who is defiant with tantrums

August 2006

I have an 8-year old son who has major sensory issues and has a difficult time socially. He has poor eye contact and dislikes hugs from most people. We just returned from a trip with another family with the same age children as ours. He had a very difficult time holding himself together and had tantrums often, especially when things didn't go his way. It was difficult because with that large of group, I was trying to keep peace and make sure he didn't run away in public places. I need help, advice and anything you can PLEASE give me. I've spent $$$ trying to help this and I'm without hope at this point. It is very difficult on our family and especially his 12 year old sister and 10 year old brother. Do you know of a therapist in the East Bay who could help our family/him or another avenue?


You might consider neuropsych testing for your son. This testing can give a picture of the complex interplay between neurological, cognitive, psychological, social and emotional functioning. A good tester can then give you reccomendations regarding help for him at school, at home and any further treatment. Places you can call for testing: The Ann Martin Children's Center in Oakland; West Coast Children's Center, still in El Cerrito, I think; or Kaiser in Oakland has some good folks Melissa


Preschooler who may have Oppositional Defiant Disorder

Sept 2002

Can anyone recommend a child psychologist who works with preschool age children? My son may have Oppositional Defiant Disorder, so we are trying to find someone who can work with us to confirm diagnosis and plan treatment. We have called a number of folks in the area already, but they no longer take preschool-age children (VERY frustrating!) Any information would be extremely helpful.


I recommend Dr. Elea Bernou. She does very thorough child assessments, including neuropsych, cognitive, learning, and psychological issues. She is also great with kids and thoughtful in her recommendations and feedback. If money is an issue she supervises some interns who do assessments at a lower fee. phone 510-841-8484.


Diane Ehrensaft (near Childrens Fairyland in Oakland) is excellent with young boys. We were reluctant to take our son to therapy when he was 7 years old. But he was miserable, angry, and a roller coaster of emotions with no apparent source. School and knowledgeable parents all separately recommended Diane. She was and is wonderful. Diane was not quick to diagnose, did not assume it was environmental (it was not), and was not quick to recommend medication. She has been invaluable in the parent conferences and with our son's school. She also is practical and a straight shooter, and genuinely cares about our son. He still sees her at age 10,and we feel extremely lucky to have her in his life.

Diane is usually booked up, but if you're flexible you could get lucky. Her number is 547-4147.


Other advice: If you need a psychologist (vs. a child therapist) I know of two places which do psychological assessments and treatment planning:

As they work specifically with children, I am assuming they will assess and treat preschool aged children.

If, after the assessment, you are in need of an experienced play therapist who enjoys working with preschoolers, I'd be happy to talk with you. I wish you much luck in finding help for your child and family.


If you're suspecting Oppositional Defiant Disorder in a preschool age son, then you must be experiencing some very troubling behavior -- I'm sorry. I assume his behavior is pretty unusual, and I think you're right to be careful about confirming the diagnosis and planning interventions.

It's hard for me to be specific without knowing more, but in general I have to say that I can't think of a child psychologist to recommend. We've had experiences with several psychologists, because we have two children who needed diagnosis and treatment as preschoolers. Networking with other parents of high-needs kids, I've also heard of other therapists. The psychologists we went to looked at the problems psychologically and tried to find explanations in the child's past experiences, family dynamics, etc. The solutions they proposed were a kind of good, conventional wisdom -- which is fine if you have a conventional child. In our case(s), there were biological factors that the psychologists were not prepared to diagnose accurately, and the conventional wisdom failed because the children's neurological makeup did not allow them to respond conventionally. In fact, the conventional wisdom was counter-productive and the failure to diagnose correctly meant that we did not get effective help for the children in the early years when interventions are most effective.

My recommendation is to seek a neuropsychological assessment. A neuropsychologist will take a thorough look at psychological and biological factors. Often behavior issues are rooted in or complicated by biologically-based conditions, as with our child's aggression and oppositionality. A good place to start is the department of Neuropsychology Assessment at Children's Hospital Oakland. There are other recommendations on the website.

How has your pediatrician responded? I had to reveal a lot of embarrassing detail to get our pediatrician's attention, but once I did she saw the seriousness of the issue and was very helpful with referrals and explaining the process. A neuropsych assessment is more expensive than a few visits to a psychologist, but our insurance covered most of it with the doctor's referral. Most important, an assessment is cheaper than years of unhelpful psychotherapy and can lead to great progress. A sympathetic mom