Tag: defiance

Back to School: Tips for the Transition

Back to School: Tips for the Transition

Starting school after a summer vacation triggers behavioral problems in many troubled children and teens.  A rocky start can result in problem behavior for a couple of months.  Your child does poor academically during those months, and their behavior primes teachers to treat them differently.  This guest article by Eileen Devine, LCSW, breaks down the issues and offers solutions for parents.


Back to School: Tips for the Transition
Eileen Devine, LCSW

parent talks with teacherIt’s that time of year again—back-to-school sales at all the stores, school emails and supply lists, fresh questions about new teachers and new classrooms. The summer break is winding down, which for some brings relief at the idea of returning to more structured days (with some respite for parents and other caregivers).  For others,transition into school brings the dread and stress of educating a new teacher on our child’s unique way of being in the world, bracing for what seems to be inevitable challenges inherent in our child’s experience of school.

Wherever you fall on that spectrum between relief and dread, there are things you can do as a parent to begin building a new foundation of collaboration with your child’s teacher. Set up a goal for everyone that leads to a successful school year.

To Disclose or Not to Disclose

Many children with brain differences (trauma-induced, biologically based.) might appear to be “neurotypical” or normal, causing their brain-based disability and related challenges to go unnoticed.

Teachers often don’t recognize the symptoms of your child’s disability and interpret them as disrespect, defiance, lack of motivation or laziness.

art classParents with whom I routinely work will struggle with when to disclose that their child has a brain-based disability that makes seemingly simple tasks incredibly difficult.  Parents are worried about the impact this disclosure might have on their child, that the stigma accompanying various diagnoses will cause negative ramifications.  (See “Teachers and Stigma – Judging and Blaming Families“)  The stigma is real, and yet with this reality in mind, my challenge to a parent is always this:

What will the impact on your child be if you choose not to disclose?

How will you advocate for them?

If you don’t disclose, how will your child access the accommodations they so rightfully deserve, based on their brain-based disability?

If your child is not fully understood by those who interact with them each day, the ability for your child to having meaningful and positive relationships with school staff is greatly diminished. I always advise pro-active planning (early disclosure) vs. waiting for a problem to occur, which can force the disclosure under less-than-ideal circumstances.

Getting Clear on Brain Tasks

When was the last time you gave serious consideration to exactly which cognitive skills or brain tasks are especially difficult for your child? We often can pinpoint the situation or recall the event where it occurred, but what brain task was involved that sent your child into a meltdown or a fit of rage?

Does your child get “stuck?”  Does your child’s thinking limit his or her ability transition without substantial support? Do they get trapped in verbal or behavioral loops? Are they unable to initiate an appropriate activity independently, even one that you know they love?

Does your child only see black and white? Are they cognitively inflexible, and respond to everything as, now or never, right or wrong?

Do they have difficulty processing sensory input? If so, what types of sensory input are especially challenging (noise, bright lights, crowded spaces, smells)?

Does your child struggle with social and emotional skills? Do they act younger than they are, and are they still learning what it means to think of others, empathize, share, and compromise?

Is their verbal communicating “off?” What do you know about the limits their brain has turning thoughts into speech?  How would you describe their memory and recall challenges?

Teachers and other school staff need specific answers so they can appropriately treat your child.

As parents who daily students fightingexperience challenging situations with our child, we usually have no difficulty articulating what event or situation “set our child off” or caused them distress. But if we can take a step back and link it with brain function, we gain an essential piece of the puzzle in terms of how to understand our child in all environments and situations.

Taking the step back, making the list of brain tasks and then translating them for others—teachers, para-educators, administrators, bus drivers— is essential for these professionals and their ability to be pro-active in their approach with your child.

I clearly remember my own first steps up the steep learning curve of trying to understand an individual with brain differences from a neurobehavioral perspective. It was challenging. I needed reminders and re-teaching. I needed to be gentle with myself when I failed to parent differently, and needed support in doing it better the next time around.

Teachers are on their own steep learning curve with this approach. It’s often not taught in education classes or offered in professional development sessions, leaving educators unprepared or ill-equipped to see children from this lens. There are ways we can help bring the information together for teachers in a concise, but comprehensive way, to help them understand what it means for our child to struggle with those identified brain tasks.

Write a succinct summary of what brain tasks your child has the most trouble with and translate what this looks like in the classroom. Then explain what works to help.

For example, for a 9-year-old child who is experiencing “dysmaturity” (a gap between the developmental age and the chronological age) might be emotionally closer to age 4.  One might observe:

boy with ADD

Johnny’s social behavior is frequently younger than his chronological age (as much as 4-5 years younger). Because of this social and emotional developmental gap, he can sometimes be seen as irresponsible or ‘acting like a baby;’ this is what it looks like when he is much younger developmentally. Remembering that he’ll benefit (and be safest) when understood as being a younger age than he appears, will help prevent development of frustration, personalization and anxiety for Johnny.

For LaQuisha, the 11-year-old in fifth grade:

LaQuisha is a very good listener, but she listens slowly (think: ten-second-child in a one-second world). She will often say “I don’t know,” or “What?” because she cannot maintain or track the typical flow of classroom conversation. Slowing down and giving her space between sentences works for her. Giving her prompting questions or other visual cues before the instruction or classroom discussion begins will allow her to participate more fully in what is being discussed.

For Miranda, who is 13 and in middle school:

Miranda struggles with memory and recall, which makes changing classrooms throughout the day— each with its own teacher and differing set of rules and expectations— overwhelming for her to manage. She will benefit from visual cues and reminders from each teacher about those rules or expectations, which she can keep at the front of each section in her binder for that particular class.

For Omar, who is a 16-year-old in high school:

Omar has significant challenges related to executive functioning as a result of his brain-based disability. One of the ways you will see this in the classroom is when he is unable to initiate a task on his own (freezes up or gets stuck) and he may need additional prompting and support to get into the assignment at hand. He also experiences difficulty forming links, such as hearing instructions and then transitioning into doing the expected task (hearing into doing), seeing instructions for a writing assignment on the board and then translating that into writing on a paper (seeing into writing), formulating his thoughts and then verbalizing them (thinking into talking). He will experience success in your classroom if it is understood he needs more time and support in this area.

Always describe your child’s strengths too, not just their limitations.  Suggest how a teacher can help your child be successful by building on things they are naturally good at and enjoy.

From the Flipside – Tips from a Teacher

frustrated teacherMany of these ideas are formulated from the perspective of a parent preparing for a child to return to school, but what about the teacher’s perspective? What suggestions would a thoughtful, experienced special educator have for parents and children about to shift into back-to-school mode?

Kelly Rulon is a teacher I’ve come to know through her work with our daughter. She’s been teaching special education for seven years, working across multiple schools and districts. She’s a strong believer in research-based systems and instruction. In her experience, with those in place, every child can be educated in their neighborhood school, without restrictive placements.

Here’s what she had to say, from a teacher’s perspective:

I know that transitioning back to school can be a time of great anxiety, both for parents and kids. A little preparation can go a long way. Here are a few things that can help your student get emotionally ready to return to the routine of school:

  1. Set aside time for an intentional conversation about the return to school. Ask your child what they are excited about for the year, as well as what might be causing feelings of nervousness. It’s a wonderful opportunity for you to connect with them. As a teacher, I love hearing about these things too! It really gives everyone the chance to begin the year with a strengths-based approach, as well as an idea of potential struggles. Knowing about these feelings early on helps to get folks on the same page, and to get some proactive strategies in place.
  2. The looser, less-structured routines and schedules of summer can be fun, but moving abruptly from that to school day schedules can be hard. Help your child gradually get back into the school routine ahead of the first day of school, be it bedtime or wake-up time or meal time. This will help with that exhausting transition back to school. (I know I’m asleep before my head hits the pillow those first few weeks back!)
  3. I always invite my students to come for a short visit to the school during the week of in-service, before school begins. It’s a busy time for teachers as we’re prepping away for Day 1, but a short, informal visit helps me establish positive, low-stakes contact with challenging students and families. This may not be the case for all teachers— and I have many colleagues who have wonderful family relationships without this meeting— but it’s worth an ask if you think your child could benefit from a preview.


A book I like is by Diane Malbin
, “Trying Differently Rather Than Harder.” It is an easy-to-read resource on the neurobehavioral approach. Although specific to FASD (Fetal Alcohol Spectrum Disorder), the information applies to other neurobehavioral challenges. Buying your teacher a copy of the book and highlighting sections that are particularly reflective of your child is a wonderful way to expand understanding of your child.


classroomAs Kelly suggests above, before school begins, but when teachers have returned to prepare their classrooms, contact the school and request a 30-minute introductory meeting with the teacher(s). Use this as an opportunity to set the stage for collaboration and provide the teacher(s) with the concise-but-comprehensive write-up you’ve thoughtfully prepared. This is not the meeting to go into your child’s extensive history or to detail their previous challenges in school. Keep it short and positive, making it clear that you’re there to be a source of support in how to work with your child. If you know your child has a “honeymoon” stage at the beginning of the year, be upfront about that, so the teacher is not blindsided by it. If you know your child typically has a rough transition back, but then settles into the routine after a certain amount of time, let the teacher(s) know this, too, and suggest ways you can work together to support your child through the anticipated rough patch.

Bringing it all Together

Transitions are hard, and from my experience working with parents who have children with brain-based differences, the back-to-school transition is often one of the hardest. My final suggestion is for you, as the parent, to make your own plan for self-care.  Focus the plan on what you will do to take care of yourself as you gear up to support your child through this potentially intense period. Rally the troops you have around you to help buffer some of the stress. Be clear with those closest to you about what you need during this period to make it through without burning out.

If you have a thoughtful, well-considered plan in place for you and your child, if you’re positive, clear, supportive and realistic with your child’s teacher(s), and if you’re able to place your child and their needs at the center of the conversation, the transition back to school doesn’t have to be simply a rewind of previously challenging transitions.


Eileen Devine, LCSW, works in Portland, OR as a therapist supporting parents of children with special needs. She is also a consultant for families impacted by FASD (Fetal Alcohol Spectrum Disorders) and other neurobehavioral conditions through her private practice, FASD Northwest, working with families nationally and internationally. She lives with her husband and two amazing kids, one of whom happens to live with FAS (Fetal Alcohol Syndrome). For more information, visit FASD Northwest.

 

The Silent Suffering of Parent Abuse When Children Abuse Parents

The Silent Suffering of Parent Abuse When Children Abuse Parents

Parent abuse is real and serious.

This [edited] article is by Alicia Bradley, LCPC, who lives in the United Kingdom.  It is excellent and covers a serious and hidden subject that’s rarely addressed.  “How many people have heard of parent abuse? especially at the hands of teenage children with serious social and violence issues? Google it. You won’t find much, except on a few support sites.  Parent abuse is a form of domestic violence that results in physical harm, damage to property, job loss, PTSD, and family breakdown.”


What Is Parent Abuse?

We have all heard of child abuse and how children are damaged by this terrible behavior, and you only have to Google “child abuse” to find page after page of information, support groups, and advice on this subject, but, how many people have heard of parent abuse? especially at the hands of teenage children with serious social interaction and violence issues? Google it. You won’t find much, except on a few support sites.

screaming teenager

Parent abuse occurs when the child commits an act or acts against the parent through manipulation, control, and intimidation in order to exert control and have power over the parent. Parent abuse can take different forms, from physical, emotional, verbal, to financial abuse.  According to Barbara Cottrell in the book When Teens Abuse Their Parents, parent abuse can be defined as “any harmful act of a teenage child intended to gain power and control over a parent.” (It should be noted that children of any age (pre-teen or adult) can commit parent abuse, not just teenagers.)

For parents and families who share their home with abusive young people, there is virtually no support or protection. In both the UK and the US, the law is on the side of the child, not the parent.  Parents seeking help will instead get inappropriate advice or blame.  The parent is always under suspicion so they keep it secret.  “Domestic violence feeds on silence.”

Signs of Parent Abuse by a Teenager

crying motherParent abuse is a form of domestic violence that results in physical harm, damage to property, job loss, PTSD, and family breakdown. It is usually perpetrated by a child in their teens who displays the following behaviors towards parent(s) and members of their family.  Signs include:

  • Threats of and/or physical violence including hitting, punching, kicking, pushing, slapping, biting, hair pulling with or without weapons or objects.
  • Screaming, swearing, and name calling
  • Intimidation
  • A constant refusal to do what has been asked (going to bed, coming home, asking friends to leave, cleaning up after themselves, not attending school/college/work), or contribute to the household, or participate in normal family activities.
  • Bullying by text or phone
  • Stealing money or property or misuse of parents credit cards/phones/computers
  • Deliberate damaging of property
  • Threats of or actual violence to pets or other children of the household as a way of intimidation
  • Emotional blackmail, such as threatening to accuse the parents of abusing them, or actually doing so
  • Drug/alcohol abuse in the home
  • Belittling parents in front of friends/other family members/public.
  • Willful drug abuse in front of family/friends
  • Other illegal activity

This abuse often occurs at school too, where students abuse their teachers and other students.  It occurs in other relationships too, when a teen abuses or bullies another adult or acquaintance.

beaten mother

Those suffering from parent abuse have experienced physical harm resulting in medical or mental health treatment or even  death; there’s damage to property, theft, or bullying other family members.  Quite often, the child who is abusing the parent does it willfully and for enjoyment.  The ability for empathy and compassion may be not well-developed they impacted by  mental disorders or psychological disturbances.

The law is almost always on the child’s side, but there is little to protect parents from children who abuse their parents. In the UK and US, you as a parent are legally responsible for that child.  There aren’t social services or legal protections for parents unless the child has a long history of repeated offenses of violence involving the police that has been reported and documented.  Schools often expel teenagers with behavioral issues, but for the parent… now what?  Expulsion protects the public but the parent is still very much at risk.

teen bullyParent abuse is not restricted to certain social groups; it can affect single and two-parent families equally. It is usually the mother or the primary caregiver who is targeted, but other children in the family and fathers suffer too.

What Causes Teens to Abuse Their Parents?

It is difficult for parents to recognize they are being abused, or admit they are being abused.  Most blame themselves and are therefore reluctant to seek help.  Yet many people (most?) consider parent abuse to be the result of bad parenting, neglect, or the child suffering abuse themselves. However, many teen abusers have had a normal upbringing and have not suffered from these issues.  Other factors contribute to children abusing their parents, such as undiagnosed mental illness.  Additionally, if the child sees domestic abuse happen in the household, they will be more likely to continue such behaviors.  Parent victims of domestic violence are often re-victimized by their own children.

Psychological Effects of Parent Abuse

girl hittingParents who are exposed to abuse from their child are affected in many ways, with many psychological issues as a result of the abuse. They can lose their ability to control the household and protect everyone else—all family members are victimized just like in any situation with domestic violence between adults.  They develop PTSD, depression, and suffer from lack of sleep and constant fear anxiety.

Giving into the child’s demands and abusive tactics can,
paradoxically, be easier to handle than the severe backlash
they’ll face by standing up for themselves.

10 Steps for Dealing With an Abusive Child

Do not allow yourself to suffer in silence; confront this problem for everyone’s sake, including your abusive teen.  You have little choice but to take back control!  Do not give your power away any more; you really can put a stop to abuse.

  1. If you are suffering from parent abuse, you must recognize that you are not at fault and do not deserve this, as with any form of abuse. Speak to a friend, or contact a domestic violence support group. Seek professional help.
  2. Calmly confront the child about their behavior and tell them you will not tolerate it anymore. Explain that what they are doing is abuse (and brace yourself ahead of time because their backlash could be fierce). You will have to communicate this many times so that they will eventually hear you.  It doesn’t mean they’ll have any intention of stopping, but it prepares them to expect what you’re about to do next.
  3. Remove all privileges, rights to cell phones, computers, video games, money, etc. and refuse to be a taxi service. Set boundaries and punishments and enforce them.  Be careful, if the child makes homicidal threats don’t hesitate to call the police and get them to an emergency room for a psychiatric evaluation!  Remember the definition of a mental health emergency: the person is “a danger to themselves or others.”
  4. If your teen runs, report them to the police immediately, and report anyone who is harboring your runaway. (Anyone who protects runaways from parents is guilty of the crime of custodial interference.)  Sometimes police intervention is enough of a wake-up call for your teenager and reduces the severity of abuse or leads to stopping it.
  5. abusive son in courtIf you feel that you can still communicate with your child, seek mediation with a counselor or other professional, and explain that you will not tolerate this behavior in the session. You want someone else to hear this.  Lay down some ground rules.  Take a hard stance and tell your child that if you are hit again, you will call the police and have them arrested. Don’t call their bluff, do it. They need to see that you mean business. If your child physically harms you, steals from you, or damages property, involve the police immediately and PRESS CHARGES!  Sometimes getting law enforcement and the juvenile justice system involved is the only way to get professional help for abusive teenagers.
  6. Try not to retaliate by hitting back unless in absolute self-defense, and disarm them if they come at you with a weapon. Abusive teens have called the police themselves, or other sympathetic adults, to report you have hit or abused them, and the law will come down on their side first. You can be prosecuted for hitting your child, and your child can be removed from your care as can any other children in your household. Don’t be reluctant and call the police immediately (!), get it on record.
  7. Get help and support from other parents who understand and will support you without judgment.
    a—In the UK contact Parentline Plus, an organization dedicated to helping parents. They can be reached at 0808 800 2222. Visit their website and look on the message boards for help and support groups in your area. They often run groups which offer practical support and tips for parenting difficult teens.
    b—In the US you can call the National Domestic Abuse Hotline at 1-800-799-SAFE (7233).  Also look for a StandUp Parenting support group in your area.  Their website is standupparenting.org/.
  8. Approach your child’s school and have your child referred to children’s mental health services, or refer them yourself, informing them that you are suffering parent abuse.
  9. Keep a journal of events, with dates, times, etc., or a video diary, and film your child when they are abusing you (you can use your mobile phone or digital camera). Often, when faced with media of their own behavior, it can shock them into accepting help from professionals.  (I’ve personally seen videos work very, very well –Margaret)
  10. You cannot do this alone!  Involve others who will help you.  Seek help from extended family and friends to see if they can offer to give you respite by taking the child from you for a few days.  Get therapy for yourself and your family.  You are all paralyzed by suffering–it’s serious and can affect all of you for years.

If you’re a victim of abuse by your child, take Ms. Bradley’s advice and take action.  –Margaret

Resolving Parent Abuse

furious boyHopefully, you found some strategies in this article to help you deal with abuse from your children. There is a light at the end of the tunnel, and there are solutions that can stop the violence from continuing. Stay strong and be vigilant and plan ahead for self-protection. If you love your child, love yourself. They need you to be OK.

Be strong.  Be courageous.  You can do this.

Note from blog owner:  I made edits for length or clarification, and added additional information.  This is a link to the original published article by Alicia Bradley LCPC.
—Margaret


Do you have a story of abuse?  Do you have questions or need support from others?  Add your comments.  Other parents out there know what it’s like, and they care.

Managing defiance: tips and advice

Managing defiance: tips and advice

If you raise a defiant child or teen, this is a most important piece of advice:  take care of yourself, your primary relationships, and the rest of your family. You have a life, and your other children need nurturing.  Schedule regular times for you and the others to relieve tension and do something that takes you out of the home and brings you joy.  The time or expense is worth every bit as much as psychotherapy.

These are typical traits of defiant children.

  • They act younger than they are. Don’t expect them to mature quickly.
  • They live in the here and now, and can’t think about the past or future.  They don’t see how their actions result in a series of consequences.  They can learn sometimes, but only if it is pointed out immediately after an incident.
  • They don’t notice their effect on others.  Sometimes you can ask one of the others how they feel immediately after an incident, or you can gently report how it makes you feel.
  • Their brain is easily overloaded, and they have a hard time with changes.  And yet, you can use this overloading problem to your advantage (more below).
  • They cannot follow your reasoning, so don’t try.
  • Defiance may be a strength in their future. With mature skills, they’ll better resist negative things they’ll face in life.

 

One of the most effective things you can do is control your tone of voice.

Managing defiant children is a balancing act.  If you go too far asserting authority you can draw more resistance, especially if you become emotional.  Your defiant child is very sensitive to a tone of voice that sounds (even a tiny bit) defiant or impatient or angry.

Practice ahead of time

Before you make a request or set a boundary on your child, practice what you will say in advance.  Play the dialogue out in your head—imagine their reaction to your request or rule, and practice that neutral tone of voice.  Remind yourself that you are the authority, and that you are more resolved and persistent than they are.  Your message doesn’t have to be rational or justified.  You may get away with things like, “Because I’m the mommy (or daddy) and I say so”.

Approaches that work

Be a benevolent dictator

Since your home is not a democracy and your child does not run the household, they are not entitled to have all their needs fulfilled or opinions considered.  When they make a demand, thank them for letting you know their opinion, and explain how you will weigh their needs with those of everyone else.  Your child will find your decision completely unfair, but remind yourself that “fair” is not “equal.”   (It’s not desirable to treat everyone and every situation equally.)  Say it’s the best you can do for now.  As their accusations fly, dial back your interest, get busy with something else, and become distracted

Allow some aggression

When it’s appropriate and safe, ask your child to do more of what they’re already doing so that they turn it around and defy you by stopping the behavior. Example: your child refuses to take a direction and throws a book on the floor in anger.

Parent:  “There’s only one book on the floor. Here is another one, now throw this on the floor.”  (Child throws book down.)

“Here’s another one. Throw this down too.”  (Child throws book down.)

“And here’s another book, throw this one down, too.”  (Child becomes frustrated and angry, but stops throwing books in defiance.)

Be a marshmallow

Show no resistance, instead, listen and respond to how they feel, not what they say.  Show them you are open to genuine talk later when the stress dies down.

Teen:  “I hate you, you f- -king b- -ch!”

Parent:  “Sounds like you’re really angry.”

Teen:  “Shut up you stupid wh- -e!  You c – -t!”

Parent:  “Can you tell why me you’re angry so I can do something about it?”

Teen:  “Leave me alone f- -k face!  Stop patronizing me!”

Parent:  “OK, I hear you don’t want me to patronize you, so I won’t.  I feel this is stressful for both of us, so I’d like to take a break and maybe talk about it later.”

Call their bluff

Child:  “I’m going to run away!”

Parent:  “OK, if you do, find a way to call me, and I’ll bring you your stuff and maybe a snack.”  Then walk away.  If they do run and call you, you’ll know where they are.

Reverse psychology

Parent:  “Oh my God, I can’t believe what you’ve done to your hair, that’s horrible!  What are people going to think?  That’s worse than tattoos.  You have to stop this nonsense!”

(One mother used this technique to get her daughter to stop her plans to make a homemade tattoo on her face.  After all, hair grows out, but facial tattoos can be forever.)

Overload their brain circuits

Give your child or teen multiple instructions quickly, and include things they do and don’t want to do.  It becomes too much work for them to sort out what to defy.

Parent:  “Keep up the yelling and close the door on your way out.  And be sure to get louder out there so all the neighbors can hear.  Dinner is at 5:30.”

(What happens?  The door is slammed maybe, but your child is home at 5:30 for dinner.)

Actively ignore

This works best with children 2 through 12.  They try to get a reaction by annoying you or threatening to do something you don’t want them to do.  Stay in the vicinity but don’t respond, look away, and act like you can’t hear them.  Go into another room or outside, for example, and the annoying child will follow you to continue to get your attention with annoying behavior.  If they flip the lights on and off, or ring the doorbell repeatedly, or turn up the volume too loud, maybe you can switch a circuit breaker off and walk away… or if driving, you can pull over, stop the car, and get out and wait.  This article can help with other ideas.  Defying ODD: What it is and ways to manage.

Mix it up

  • Be unpredictable.  Give a reward sometimes but not all the time, and your child will keep trying the good behavior to get the reward.
  • Instead of a consequence, occasionally use bribes to stop a behavior.
  • Allow them to do something they like to do, but within limits of boundaries.
  •  Choose your battles; let your child win unimportant disagreements.
  • Be sneaky on occasion if  (or frankly manipulative) if nothing is working.  For example: suggest you’re considering a very serious consequence that you don’t intend to follow through on.

Have realistic expectations

It’s easy to get stuck in rut—it happens to everyone—but your child is stuck too.  Remember,  it’s not the child’s fault and it’s not your fault.  Your child may not go through life the same as others and may always have problems, but your job is to help them learn from their mistakes the best you can.  This may not happen for many years.  If your child’s condition is serious, they may face serious problems because of their disability, but you’ll know you’ll have honored them, lived your values, and loved unconditionally.

It is heroic to stick it out with your defiant child or teen when you don’t see progress.

Hope

  • They have the ability to do better.
  • With treatment, children improve (e.g. therapy, exercise, medication…).
  • Things usually work out.
  • Help is out there.

–Margaret

How am I doing? Please comment or rate this article.

Defying ODD: what it is, and ways to manage.

Defying ODD: what it is, and ways to manage.

ODD is caused by abnormal electrical activity in the brain, it is not in the character or ‘soul’ of your child or teen, and not something they can control.  If your child could do better on their own, they would.  You are the one who can make the most difference.

If you think your child or teen’s defiance is oppositional defiant disorder, there are practical ways to manage your child’s exasperating condition.  This information comes from psychiatric, psychological, and child behavior resources and can help you work effectively with mental health providers or teachers.  You’ll need to ask them focused questions to learn everything they know about ODD.  Professionals pay better attention to knowledgeable parents (which shouldn’t be the case, all parents deserve attention).  Go in armed with knowledge.

anterior cingulate gyrusThis is what ODD looks like.  The pinkish curving region in the center of the 3-D brain image below represents hyper-charged electrical activity in a 13-year-old boy with severe oppositional defiant disorder.  This feature is typical of ODD, but also typical in individuals with obsessive compulsive disorder (OCD), “Road Rage,” pathological gambling, chronic pain, and severe PMS.

The name of this region is anterior cingulate gyrus (ACG), and scientists believe this area is responsible for enabling a person to shift attention and think flexibly, traits which are deficient in ODD kids.  It is also the brain region known to regulate emotions.  Children with a hyper-charged ACG have “a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which 4 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.” 

–From the “Diagnostic and Statistical Manual of Mental Disorders, 4th Edition,” published by the American Psychiatric Association, 2000.

There are two different medication approaches to ODD:

  • Treat it as a form of attention deficit disorder;
  • Treat it as form of depression and obsessive-compulsive disorder.

The attention deficit approach may use Straterra (chemical name is atomoxetine), Ritalin (methylphenidate), Risperdal or risperidone (for patients with low IQ), and Depakote or divalproex (a mood stabilizer).  This is not a complete list because new compounds may come into the market.

The depression & obsessive-compulsive approach may use serotonin-based antidepressants such as Prozac (fluoxetine), and Anafranil or clomipramine (used to treat OCD).  Again, this is not a complete list.

Oppositional defiant disorder often includes symptoms from other disorders, so you may be coping with more than defiance.  Below are common disorders that combine with ODD:

  • 50-65% of these children also have ADD or ADHD
  • 35% of these children develop some form of depressive disorder
  • 20% have some form of mood disorder, such as bipolar disorder or anxiety
  • 15% develop some form of personality disorder
  • Many of these children have learning disorders

Anthony Kane, MD 

Other medical conditions that can cause disruptive behavior like ODD:

  1. Neurological disorders from brain injuries, left temporal lobe seizures (these do not cause convulsions, no one can tell these are happening), tumors, and vascular abnormalities
  2. Endocrine system problems such as a hyperactive thyroid
  3. Infections such as encephalitis and post-encephalitis syndromes
  4. Inability to regulate sugar, rapid increases and decreases of blood sugar
  5. Systemic lupus erythematosus, Wilson’s disease
  6. Side-effects of prescription medications:  Corticosteroids (anti-inflammatory and arthritis drugs such as Prednisone);  Beta-agonists (asthma drugs such as Advair and Symbicort)

–From Peters and Josephson.  Psychiatric Times, 2009.

ODD is a disability.  It isn’t easy to manage, but you can do it.  Your child may need multiple medications and a large variety of approaches to therapy and behavior modification.  You will need patience as his or her teachers, doctors, or specialists try different approaches until they discover one that improves your child’s behavior, so hang in there!

Some good news, if your child has these traits, it will be easier to improve or overcome ODD behaviors:

  • A normal IQ
  • A first-born child
  • An affectionate temperament
  • Positive interactions with friends their age
  • Nurturing parents who can consistently set clear behavioral limits**

–From the Journal of American Academic Child and Adolescent Psychiatry, 2002.  Author J.D. Burke.

** Let’s face it, consistently enforcing and reinforcing limits, over and over to exhaustion, isn’t possible 24/7.  You are only human.  Take a break; let some things go.  Forgive yourself for not being perfect.

People’s natural instincts of parenting do not work with an ODD kid.  They need completely different techniques than normal children. 

How to reduce ODD behaviors

Shield yourself.

First get a shield, then prepare yourself for the intensity of parenting a defiant kid because you are about to run a marathon.  Get enough sleep, maintain your other important relationships (spouse or partner, children, friends), schedule breaks or getaways, and guard your physical and emotional health.  Don’t expect quick results with these techniques; it may take weeks or months… years.

Tips from professionals that may work for you:

Parent Management Training – PMT refers to intensive educational programs that are “evidenced based,” proven to help parents gain the skills they need for extremely difficult children, especially those with ODD.  These programs are intensive, but substantiated interventions in child mental health.  PMTs help parents assert consistency and predictability, and promote pro-social behavior in their child.  A good explanation can be found at the Encyclopedia of Mental Disorders.  Examples include:  the Total Transformation and the Incredible Years.

Find something positive to do together.  Your child has normal needs for closeness and appreciation and joy.  Ask your child about their interests, and if their ideas don’t work for you, try new activities until one brings about a good chemistry between you and your child.

Praise is a powerful tools for managing disruptive behavior.  Make an effort to inject positive energy into your relationship with your child or teen.  It’s likely that this relationship has been close to 100% negative, yes?   Caution: don’t expect thanks or joy from your child once they’re praised; it’s not about you.

Set limits – “Consistent limit setting and predictable responses from parents help give children a sense of stability and security.  Children and teens who feel a sense of security regarding the limits of their environment have less need to constantly test it.”
–Webster-Stratton and Hancock, Handbook for Parent Training, 1998

ignore childActive ignoring – This works for best with children between the ages of 2 and 12.  It involves purposefully withdrawing your attention away from your child when they are misbehaving, such as in a temper tantrum, or when whining or sulking, or when making continuous demands or loud complaints, etc.  Pretend you don’t care and even turn your back if possible.  Give attention only after the behavior is over.

Make the behavior uncomfortable for the child/teen.

  • Example:  If your kid swears, test them, “C’mon, you can do better than that, be creative, I’ve heard all those things before.”  They can get frustrated when they aren’t getting the reaction they want from you, and give up.
  • Another example:  Your teen refuses to get out of bed for school.  Don’t nag or repeat, repeat, repeat.  Remove the bed covers and set them far enough away that your child has to get out of bed to retrieve them.  (“Managing Resistance,” John W. Maag, jmaag1@unl.edu)

Give multiple instructions at once, where at least one of the instructions is what they want to do, and one is what you want them to do.  “Close the door while you’re yelling at your sister and don’t forget the light.”  Your child will be overloaded as they try to figure out which thing they’re supposed to defy.  Kids tend to get flustered by the mental effort and comply without knowing they’re doing it. (from “Managing Resistance,” see above)

Reverse psychology:  Yes, this works, and it’s OK when important.  Example:  your child is bouncing on the furniture.  You turn on music and say “hey, try this, see if you can bounce to the beat, it’s harder to do on the floor.”  This is a good kind of manipulation.

Unexpected rewards – Occasionally reward appropriate behavior with something they like.  They are more likely to do a desired behavior if they expect something they want and aren’t sure when it will be offered.

“Why should I have to do this when it’s my kid’s responsibility to behave?”

It’s your responsibility as a parent to do what you can to help your child be successful.  ODD is a genuine disability that negatively affects their life and future.  I’ve seen highly intelligent ODD kids experience academic failure or enough suspensions and expulsions to hold them back a grade.  This is a can’t-win-for-losing path sucks, doesn’t it?  Just do what you can the best that you can.

Warning, once you notice some success with enforcement, things get worse at first – Defiant behavior will increase once your parenting changes.  This as a good sign—you are regaining your authority!  Your child’s backlash is a common human psychological response, and it’s called an “extinction burst,”  see diagram below.  As parents change their approach to handling inappropriate behavior, the child becomes more defiant to test their resolve.  View this as predictable and plan ahead.  It won’t last, and they will eventually comply with this one rule.  They then find another rule to defy and ramp up their defiance.  As you enforce it, they back off again, and the pattern continues until it’s just not worth it to defy these particular rules anymore.

extinction burst

 

–From “Behavioral Interventions for Children with ADHD,” by Daniel T. Moore, Ph.D., © 2001, http://www.yourfamilyclinic.com/shareware/addbehavior.html .  The author requests a $2 donation through PayPal to distribute his article or receive printed copies.


Tips for effective parenting of an ODD child through adulthood

Don’t treat your home like a democracy, where everything must be fair and equal.  You must be the supreme ruler, the benevolent dictator.  Your child does not have an equal say in how things are done.  Parents must keep their authority and rightful power in the household, tell your ODD child that you make the important decisions, and your decisions may not always seem fair. Tell them you’ll listen to what they have to say but make no promises. Once you’ve made a decision, avoid explaining your reasons when they challenge you. This helps you keep your power and limits endless arguments and accusations that drag you down. As your child ages into adulthood, you must still hang on to your power. The adult child will continue to require limits, and limits will still need enforcement. To a parent, it will feel as if you’re treating your adult offspring as a child. YOU ARE and you should be, and this is the interesting part: they won’t notice.

Don’t blame or belittle your child-–this goes for all children–but a difficult child can bring out the worst in an exhausted parent. It’s easy to think they’re being bad on purpose because they’ll act like it, and show amusement when they’re bad or belittle you. Keep in mind that ODD is no one’s fault, and your child would not choose to have ODD if they understood what it meant.

Don’t ignore your child’s unique challenges that have nothing to do with ODD.  They may face bullying at school, lack of sleep, stress from a chaotic home, or other challenges… like any other child.

teenage mouseAlways enforce rule breaking as immediately after the fact as possible.  Why:  If enforcement comes later or only occasionally, the child does not connect the broken rule with the punishment. They really don’t, even when you describe it clearly.  Or, they believe they can still get away with breaking a rule and then talk their way out of consequences later.

Don’t let your stress turn into anger directed at your child.

  • They can use this against you by teasing or baiting to get you angry again!
  • You’ll be modeling that anger is an OK response to stress.

Take care of your emotional wellbeing. Check in with yourself if you feel you are losing control. All parents with troubled children need to work extra hard at maintaining a level head. It’s a good skill to have anyway.

Avoid justifying your rules or offering explanations. Children with ODD are not able to reason when they turn defiant. They will only resist harder and use your words to argue more with you. Even if they can understanding your reasoning in a calm moment, this will vanish once they become defiant again.  (What’s interesting is I’ve observed parents trying to reason with young children (4 or 5), too young to be reasonable in the first place, or with young adults (early 20’s) who have a long track record of being unreasonable.

Don’t interpret everything as ODD-defiance.  Some rebelliousness is normal for children, especially if parents are over-controlling (and why wouldn’t you be–who wants another battle).

Don’t keep trying the same things that still don’t work.  Like making excuses; like yelling.  (Don’t be embarrassed; we’ve all done this.)

Don’t jump to conclusions that demonize the child.  It hurts you as much as it hurts them. I often hear parents say:  “Why does he keep doing this?, or, “Why doesn’t she stop after I’ve told her not to, over and over again.”  Then they answer their own questions:  “It’s because he always wants his way,” or, “She’s doing this to get back at me.”  As they tell their story, I hear them taking things personally:  “He does this just to make me mad;” “She manipulates the situation because she wants more (something) and I won’t give it to her.”  Is this really what you want?

Find the energy and doggedness to be consistent, and the compassion and forgiveness to be nurturing.

 


If you would like to get ongoing updates on the latest news and research in child & adolescent mental health, follow my Facebook Page.