Sue Scheff: ADHD ODD - Parenting the Defiant Teen

As a mom of an ADHD son, I remember the adolescent years - they were not always the easiest. ADDitude Magazine has some great parenting tips, ideas and answers to help parents today. Years ago I don’t recall as much information was available to us.

Source: ADDitude Magazine

ADHD behavior issues often partner with oppositional defiant disorder (ODD) — making discipline a challenge. Try these strategies for parents of ADD kids.
Every parent of a child with attention deficit disorder knows what it’s like to deal with ADHD behavior problems — sometimes a child lashes out or refuses to comply with even the most benign request. But about half of all parents who have children with live with severe behavior problems and discipline challenges on an almost daily basis.

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

How bad can it get? Consider these real-life children diagnosed with both ADHD and ODD:
A 4-year-old who gleefully annoys her parents by blasting the TV at top volume as soon she wakes up.

A 7-year-old who shouts “No” to every request and who showers his parents with verbal abuse.
An 11-year-old who punches a hole in the wall and then physically assaults his mother.

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

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

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

Looking for links

No one knows why so many kids with ADHD exhibit oppositional behavior. In many cases, however, oppositional behavior seems to be a manifestation of ADHD-related impulsivity.
“Many ADHD kids who are diagnosed with ODD are really showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.”
Another view is that oppositional behavior is simply a way for kids to cope with the frustration and emotional pain associated with having ADHD.

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

Riley agrees. “Children with ADHD know from a young age that they’re different from other kids,” he says. “They see themselves as getting in more trouble, and in some cases may have more difficulty mastering academic work — often despite an above-average intellect. So instead of feeling stupid, their defense is to feel cool. They hone their oppositional attitude.”
About half of all preschoolers diagnosed with ODD outgrow the problem by age 8. Older kids with ODD are less likely to outgrow it. And left untreated, oppositional behavior can evolve into conduct disorder, an even more serious behavioral problem marked by physical violence, stealing, running away from home, fire-setting, and other highly destructive and often illegal behaviors.

Getting treatment

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

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

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

Sue Scheff: Feingold Program

Many learning and behavior problems begin in your grocery cart!

Did you know that the brand of ice cream, cookie, and potato chip you select could have a direct effect on the behavior, health, and ability to learn for you or your children?


Numerous studies show that certain synthetic food additives can have serious learning, behavior, and/or health effects for sensitive people.

The Feingold Program (also known as the Feingold Diet) is a test to determine if certain foods or food additives are triggering particular symptoms. It is basically the way people used to eat before "hyperactivity" and "ADHD" became household words, and before asthma and chronic ear infections became so very common.

ADHD (Attention Deficit Hyperactivity Disorder) is the term currently used to describe a cluster of symptoms typical of the child (or adult) who has excessive activity or difficulty focusing. Some of the names that have been used in the past include: Minimal Brain Damage, Minimal Brain Dysfunction (MBD), Hyperkinesis, Learning Disability, H-LD (Hyperkinesis/Learning Disability), Hyperactivity, Attention Deficit Disorder, ADD With or Without Hyperactivity.

In addition to ADHD, many children and adults also exhibit one or more other problems which may include: OCD (Obsessive Compulsive Disorder), ODD (Oppositional Defiant Disorder), Bi-polar Disorder, Depression, Tourette Syndrome (TS), and Developmental Delays. These people often have food or environmental allergies. Many have a history of one or more of these physical problems: ear infections, asthma, sinus problems, bedwetting, bowel disorders, headaches/migraines, stomachaches, skin disorders, sensory deficits (extreme sensitivity to noise, lights, touch), vision deficits (the left and right eyes do not work well together, sometimes nystagmus).

While all the above symptoms might be helped by the Feingold Program, generally the characteristic that responds most readily is behavior. Although the symptoms differ from one person to another, the one characteristic that seems to apply to all chemically-sensitive people is that they get upset too easily. Whether the person is 3-years-old or 33, they have a short fuse.

Dr. Feingold began his work on linking diet with behavior back in the 1960's. He soon saw that the conventional wisdom about this condition was not accurate. At that time most doctors believed that children outgrew hyperactivity, that only one child in a family would be hyperactive, and that girls were seldom affected. Parents using the Feingold Diet also saw that these beliefs were not accurate. Years later, the medical community revised their beliefs, as well.

Another change in the medical community has been the increased use of medicine to address ADHD. In the 1960's and 1970's medicine was used with restraint, generally discontinued after a few years, and never prescribed to very young children. If there was a history of tics or other neurological disorders in a family member, a child would not be give stimulant drugs. The Feingold Association does not oppose the use of medicine, but believes that practitioners should first look for the cause(s) of the problems, rather than only address the symptoms. For example, ADHD can be the result of exposure to lead or other heavy metals; in such a case, the logical treatment would be to remove the lead, arsenic, etc.

The Feingold Association believes that patients have a right to be given complete, accurate information on all of the options available in the treatment of ADHD as well as other conditions. Sometimes, the best results come from a combination of treatments. This might include using the Feingold Diet plus allergy treatments, or plus nutritional supplements, or plus a gluten-free/casein-free diet, or even Feingold + ADHD medicine. We believe that it's useful to start with the Feingold Diet since it is fairly easy to use, not expensive, and because removing certain synthetic additives is a good idea for anyone.



Read entire article: http://www.feingold.org/pg-overview.html

Sue Scheff: Parenting ADHD Children - Advice from Moms

By ADDitude Magazine

Moms' advice for parenting ADHD children, creating an ADD-friendly household and smoothing out daily rough spots

It’s the stuff attention deficit disorder (ADD ADHD) days are made of: You’re trying to get your daughter to finish her homework, but she insists on doing cartwheels across the living room. Or you’ve already had two big dustups with your son — and it’s only 9 a.m.

Sound familiar? Parents of ADHD children have a lot on their plates. And while doctors, therapists, and ADD coaches can offer helpful guidance, much of the best, most practical advice on parenting ADD children comes from those who have been there, done that. In other words, from other ADHD parents.

For this article, ADDitude asked members of support groups across the country (both live and online) for their tried-and-true parenting skill tips for monitoring behavior problems, disciplining and smoothing out the daily rough spots. Here’s what they said.

The morning routine
In many families, the friction starts soon after the alarm clocks sound. It’s not easy to coax a spacey, unmotivated child out of bed and into his clothes; the strategizing required to get the entire family fed and out the door on time would test the mettle of General Patton.

Getting off to a slower start can make all the difference, say parents. “We wake our son up a half-hour early,” says Toya J., of Brooklyn, New York, mother of eight-year-old Jamal. “We give him his medication, and then let him lie in our bed for a while. If we rush him, he gets overwhelmed — and so do we. Once the meds kick in, it’s much easier to get him going.”

Some parents aren’t above a little bribery. “In our house, it’s all about rewards,” says Jenny S., of New York City, mother of Jeremy, age seven. “Every time we have a good morning, I put a marble in the jar. For every five marbles, he wins a small reward.”

Amy B., of Los Angeles, mother of Jared, age seven, is another believer in reward systems. “If the TV is on, it’s impossible to get him moving. Now the TV stays off until absolutely everything is done and he’s ready to go. He moves quickly because he wants to watch that television.”

Another way to keep your morning structured and problem-free is to divide it into a series of simple, one-step tasks. “I’m the list queen,” says Debbie G., of Phoenix, mother of Zach, 10. “I put a list on his bedroom door that tells him step-by-step what he needs to do. I break his morning routine down into simple steps, like ‘BRUSH TEETH,’ ‘MAKE BED,’ ‘GET DRESSED,’ and ‘COME DOWNSTAIRS FOR BREAKFAST.’ The key is to make it easy to follow.”

What about kids who simply cannot, or will not, do what’s asked of them? When 10-year-old Liam refuses to comply, his mom, Dina A., of New York City, shifts into “if-you-can’t-beat-’em,-join-’em” mode. “I can’t believe I’m admitting this,” she says, “but I wake him up and bring him cereal in bed. Once he’s gotten something to eat, he’s not as crabby.”

Behavior patterns
At first glance, a child’s misadventures may seem random. But spend a week or two playing detective, and you may see a pattern. Pay attention to the specific situations that lead to trouble and — even more important — to the times of day when trouble usually occurs.

“You may find that tantrums come at certain times of the day,” says Laura K., of San Francisco, mother of Jack, eight. “With my son, we found that it was right after the medication wore off. So we asked the doctor for a small booster dose to get us through. It’s worked wonders for cutting down on the bad behavior.”

Sometimes children simply fail to see the connection between how they behave and how they’re treated. In such cases, behavior charts are a godsend. The idea is to post a chart, specifying the behaviors you expect and the rewards the child will earn for toeing the line.

Renee L., of Northbrook, Illinois, mother of Justin, nine, explains: “Once children see that good behavior gets them privileges and bad behavior gets them nothing, they’re more likely to comply.” It helps to focus on only a few behaviors at a time.

Sue Scheff: ADHD Teens - Room to Bloom

By ADDitude Magazine

10 ways for protective parents to step back and allow their ADHD Teens to Grow..

I saw Donny for an evaluation shortly after his eleventh birthday. Like many parents, his mother, Christine, reacted to his diagnosis with mixed feelings: sadness that her son was not "perfect" and that the attention deficit disorder (ADD ADHD) wouldn't go away - and concern about the implications for his future. She hoped that the treatment plan we devised - a combination of academic accommodations, therapy, and medication - would improve their day-to-day lives. Mostly, she was determined to do whatever was necessary to help her son.

Christine became the boy's champion, protector, and advocate. She coordinated with Donny's teachers, school counselors, soccer coaches, piano teachers, and the parents of his friends to make sure that they understood his needs and treated him fairly. She attended IEP meetings and helped shape his academic plan. Morning, homework, and bedtime routines were established to structure life at home. The bottom line? Donny thrived.

Read entire article here: http://www.additudemag.com/adhd/article/720.html

Parents Universal Resource Experts (Sue Scheff) Behavior Therapy for Children with ADHD

By ADDitude Magazine

Seven parenting strategies guaranteed to improve the behavior of your child with attention deficit disorder (ADD ADHD).

The fundamentals of behavior therapy are easy to understand and implement, even without the help of a therapist. Have you ever given your child a time-out for talking back — or a “heads-up” before taking him someplace that is likely to challenge his self-control? Then you already have a sense of how behavior therapy works.

“A lot of behavior modification is just common-sense parenting,” says William Pelham, Jr., Ph.D., director of the Center for Children and Families at the State University of New York at Buffalo. “The problem is that none of us were trained how to be good parents, and none of us expected to have children who needed parents with great parenting skills and patience.”

The basic idea is to set specific rules governing your child’s behavior (nothing vague or too broad), and to enforce your rules consistently, with positive consequences for following them and negative consequences for infractions. Dr. Pelham suggests these seven strategies:1. Make sure your child understands the rules.

Telling a child to “do this” or to “avoid doing that” is not enough. To ensure that your child knows the rules cold, create lists and post them around the house. For example, you might draw up a list detailing the specific things your child must do to get ready for school.Make sure the rules are worded clearly. Go over the rules to make sure he understands, and review them as necessary. Stick with the routines until your child has them down.

Click here for more: http://www.additudemag.com/adhd/article/1563.html