After I randomly go through the diagnostic criteria for ADHD with parents, I show them how many their child met, based on their responses, on form I created. Oppositional and Defiance Disorder (ODD) is the column right next to the ADHD columns. Many parents will say, “He fits the ones you checked, but he really fits the ones in the ODD column!” I don’t even ask those questions because 95% of children in America, including my own, would fit that diagnostic category at least once in their life and probably more like 95% of kids at least 50% of the time! What looks like ODD is usually oppositional, bratty behavior that is best dealt with by using my two-part post about discipline.
When kids meet diagnostic criteria for both ADHD and ODD the majority of the time, they are often very verbally and physically aggressive and explosive. They go into fits of rage and it is very difficult for them to calm down. It often is at bedtime or after being told no about something they are hyper-focused about doing or getting. They literally come unglued!
Many psychiatrists will diagnose this type of kid with Bipolar Disorder. I respectfully disagree. ADHD has a huge emotional component to it in many kids. It is emotional impulsivity even in kids who are not physically impulsive. The term “Fly Off the Handle” also fits these kids. They are most often kids that would be described as “Old Souls.” In short, 55-year-old men or women trapped in children’s bodies.
Fifty-five year old men and women don’t like to be told what to do! They think they know better than anyone else. Little professors in some ways, raging, out-of-control children in others. The term “little professor” is often used to describe some kids on the Autistic Spectrum. Another crossover between ADHD and Autism. Some ADHD kids have to be right. Interestingly, many times they are because the are also smart.
One of my most significantly aggressive girls was only that way with her parents. She would spit at them, hit, kick, and become extremely verbally abusive at home and in public. They walked on eggshells around her. She was bossy in school but usually not physically aggressive. I had to call the school and ask someone to test her intelligence level. I had seen her since she was 3-years-old for toilet training resistance and she was then six or seven-years-old. The school would not test her. Her parent’s sought services elsewhere when she was in 2nd grade. It came back as higher than Einstein’s score of 160! Not only did she have ADHD and ODD, she was stuck with a bunch of other “typically developing” second graders. It was too much. She reacted impulsively like a cornered wildcat.
Medication for ADHD helped. What ultimately improved her quality of life significantly was the combination of stimulant medication and an all gifted classroom. She was finally among peers who thought similarly. More than likely if we would not have found an appropriate educational setting, she would have at some point, been evaluated for Asperger’s Disorder, an Autistic Spectrum Disorder, or Bipolar Disorder.
What works best with this type of child is to:
1. Play into their intelligence and not insult it. Parents often feel like they are constantly trying to stay one step ahead of them. When did we get the idea that it is okay to be disrespectful to our kids just because we are the parents or the adults? My way or the highway does not work at all with these kids. Getting their opinion and giving them choices, with age appropriate parameters, does.
2. Give them motivators that they are allowed to earn. Notice I did not say rewards! Go to my general ADHD post to see a description of my Carrot and Fire method of living. It is especially important with the combination of ADHD, ODD, and high intelligence. Working for motivators is how we work as adults. If these kids are 55-year-old people stuck in children’s bodies, it works great with them and they don’t feel like their intelligence has been insulted.
3. Understand that hyper-focus is probably the worst in this type of kid. When they get an idea in their head, even if it’s for the latest toy in their collection, they won’t let anyone in the house sleep until it’s accomplished. One of my kids at work who is like this, couldn’t sleep and in 3rd grade had taught herself how to sew. Her mother told me that when the family woke in the morning there were 24 little holiday stockings laid out on the girl’s floor. She had gotten up in the night and sewn them in order to give them to her classmates the next day! She was also very tired for days, which made her mood volatile and difficult to deal with. She was not Bipolar, she was tired!
4. Provide structure and continuity. This is good advice for all kids with ADHD, but particularly this type. Transition and change are times when this type of child behaves the worst. One of the best examples would be kids who don’t follow the rules. ADHD/ODD kids will lash out and try to make the offender follow the rules. Even older children may cry and throw tantrums when the rules aren’t followed. It’s the hyper-focus on the injustice, tied up with the 55-year-old man/woman.