I have a 10 year old son with adhd and oppositional defiance. He is wonderful child underneath, but we are at our wits end with the behaviors and how to deal with them effectively. The first major problem is that he has 0 tolerance for his little brother who is 6. He can't even be in the same room as him without either being mean, or screaming about any tiny sound that he makes. He spends most of his time in his room, including eating there, etc. He refuses to eat at the dinner table, even with headphones on. It's as if he's not part of the family. Sounds don't bother him from other people, only his little brother. Sometimes his little brother is literally just speaking to me and he reacts negatively. Car rides are awful with constant anger and mean words such as, "stupid, dummy, shut up" etc. Some days this literally goes on ALL DAY with no break. He also urinates in the corners of his room but denies doing anything. We make him clean and shampoo it, but it doesn't seem to deter the behavior. This behavior has been happening on and off for years. Every time we think it's done, he starts again. We lived in an apartment previously for 6 months and he didn't do it at all. I have never been able to get to the bottom of this behavior, and why he is doing this. He can also be very defiant in general when asked to do something. He DOES NOT behave this way in school, with the exception of a few random incidents. We started with Parent Child Interaction Therapy before the pandemic, It seemed to help somewhat but that was 3 years ago, and it wasn't practical for us. There were a lot of life changes over the last 3 years. Then we tried a collaborative and proactive solutions course, but the course was incomplete and really left everyone in the group unsure of how to implement the system. Most recently we tried a more general therapy, but it was useless. Someone mentioned that ABA therapy might be helpful. Any advice is appreciated. Thank you.
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Thanks for joining the group, we are excited you are here and have a place to share the journey with us.
Most children with ADHD benefit from the following: therapy, medication, physical activity and an educational plan ( IEP or 504 plan).
We found that when taking the proper type, dose and timing of medication he was then able to deal with the pressures of life. We were told that medication when it is correct can help control 60% of unwanted behaviors.
Many things in life challenge our kids and make if hard from them to control themselves. Once the medication was dialed in then with therapy we were able to work on ways to teach him how to control himself.
Over time our son has been able to take on many things- school, sports, tutoring and chores at home.
I hope you find some tools to support him and then he will be easier to live with. I will say that maturity has also helped our son to stop the unwanted behaviors.
There are stimulants and non stimulant medications. Both help a lot and do not change their personality. In fact if you ask our son, he doesn't really know if he has taken them. Stimulants help to decrease impulsive behaviors, decrease talkativeness, etc. Some examples are: Ritalin, Concerta, etc
Non-stimulants help with mood (decrease explosive behavior, help with mood, etc) and increase focus. An example Guanfacine..
Our son has tried a number of medications to fine tune his behavior.
There are also medications like Welbutrin ( not controled) which are also very supportive and help a lot.
If your child has not see a psychiatrist, I highly recommend them being part of his team to help him. They specialize in identifying the proper type of medication what dose is needed ( this will change as he grows) and more importantly when it is best to take.
While it sounds complicated once you find what works best for him it is life changing. I say that becuase medication is not right for some children, for our son it has truly changed how he lives his life.
Our son has come so far and I know there are many families that say " I wish I would have given my child medication sooner".
Best of luck with providing tools that work for your child.
I'm not OP either but I'm wondering what sort of therapy you have found useful? We were offered monthly (remote) parent meetings with our son's psychologist but did not find them very useful and stopped scheduling them.
We have Kaiser and we went in together ( he was not alone) to work on a number ofnthings but mostly strategies on how better to manage his behavior. But we also worked on accepting his ADHD.
My son has had very similar behaviors, in fact the parallels are striking. PCIT helped but medication made the largest difference by far. In our case he is on guanfacine (extended release) and atomoxetine after a lot of trial and error with a child psychiatrist. Interestingly, stimulant medications didn't help.
Things are not perfect by any means but are much improved and we are finally able to really appreciate all the good qualities he has. It feels like the medications just give him a few extra seconds to consider his behavior, and help slightly with his mood.
I have a son in 2nd grade that was diagnosed in Kindergarten with ADHD. He also has a lot of jealousy towards his younger brother who does not have ADHD. He feels like we love the younger brother more because he doesn’t get reprimanded as much. It has been a journey.
We started out with PCIT and that seemed to help a bit but was short lived. We decided to start meds due issues he was having at school. He showed his privates to a mixed group of classmates not once but twice. Two weeks in a row. Talk about embarrassment. His pediatrician started him on a low dose of Vyvanse. It was like a miracle pill…for the first year. Not perfect but a good improvement. We regretted not starting him sooner. From diagnosis to meds it was about 3.5 months. We also started him with a weekly therapist, who he absolutely loves, and looks forward to seeing her every Monday.
Fast forward to 1st grade. It was rough, he didn’t get along with the teacher very well. She seemed to not have a lot of experience with difficult kids. We ended up adding the non-stimulant Guanfacine thinking that that would help his mood. We ended up stopping that after about a month. My husband and I felt like it just wasn’t working with his mood. In fact, I felt like his mood was worse. When we had a conversation with his pediatrician, we discussed that instead of stopping it, we should have increased. So we tried going from 1 mg to 2 mg but that just made him extremely tired so then afternoon homework, and bedtime was a nightmare with major meltdowns. At this point, we decided he was a little bit too complicated for our pediatrician so we found him a psychiatric nurse practitioner to manage his meds. This was a game changer. She felt that he was being under medicated by his pediatrician so we upped his Vyvance to the recommended starting dose, but then the poor kid didn’t fall asleep until 11 PM at night and that was giving it at 6 AM. We took him off the Vyvance and started him on long acting Ritalin, his nurse practitioner thought the amphetamines were not a good fit for his body. The Ritalin has been good. I will say that it only lasts about eight hours for him so we did have to add a very low-dose (2.5 mg) of short acting Ritalin in the afternoon so he can get through homework. He’s never been diagnosed with ODD but it’s been questioned for sure. We were still having really big mood swings. The Ritalin helped with impulse issues, but his moods were crazy. 0 to 100 in 10 seconds and not recovering quickly when he would get angry. We discussed putting him on an SSRI but of course after reading side effects my husband and I were nervous to do that. I decided to ask for a genesight test and I am so happy that I did. Not only did it tell us which SSRI would be the best fit for his genotype, but it also tested for the MTHFR gene. Turns out he’s a double recessive, he does not process folic acid and has elevated homocysteine levels. Being deficient in folic acid can have a major impact on your mood. He has a methylation problem that we didn’t know about so we started him on methylated folic acid and B12 daily, and we did go ahead and start him on a very low dose of Prozac. What a difference! No more explosive behavior! He no longer picks at his body or fidgets with his lips, all of the anxious behaviors stopped. He will still get frustrated with his younger brother but he doesn’t lose it like he used to. He’s like a normal 7 1/2 year-old and now we have information from that genesight test that he can use for the rest of his life if he ends up changing or needing a different SSRI, he will know what medication works for his body.
Hopefully my long winded response helps in some way. Hugs to you Mama
Very similar story, we ended up doing Genomind test, found MTHFR mutation, and finally got our son on the right meds and supplements. Sam e, methyfolate in daily vitamin as well as a special zinc supplement made a big difference. XR formulations really helped even out mood swings and med “crash” and he’s on Focalin XR and guanfacine XR. He needed XR, not a higher dose. Karate has really helped him find a community. I just started reading the book “Raising Lions” that helps with handling defiance, and it has some good learnings so far. Basically about how defiant kids respond to power rather than pleasing, and how to reach those kinds of kiddos. Thought it was worth a mention! Sending you positive vibes 🙏
We had a similar situation and tried some of the same approaches but by far the biggest impact have been parent training strategies from the “ADHD dude” coursework. Ryan is also available to support specific questions and coach parents along in office hours. Also, identifying the best medication.
The sound sensitivity to his little brother seems to be of particular importance.
This could be sound sensitivity (misophonia) or broader sensory sensitivity.
It could be related to sibling rivalry. Older siblings can feel jealous of younger siblings for various reasons.
• e.g. My 11 year old son seems to bring up often that he thinks his 8 year old sister has it easier with school, because she's in an earlier grade. [They are 2½ years apart in age and 2 grades apart in school.] She also is more interested in school than he ever seemed to be. (Ironically, I think that her intense interest in school sprung from her watching him go to preschool, for 2 years before she got to start preschool herself.)
• My youngest daughter knows how to mind her behavior better than her older brother, but I know that she pushes back in the rivalry. They just assert themselves in very different ways.
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Your 10 year old's room might feel like the only place that is his own, where he has control. Again, this might be in part due to sensory issues. However, it might be a control issue.
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It's also possible that he feels that he can assert himself when it comes to his younger brother, but not when it comes to parents and others.
This might not be due to sibling rivalry, but rather about a power struggle. He might be trying to assert himself in some way within the household, and perhaps the ways that he can do so without direct confrontation are the behaviors you're observing.
I'm not a child psychologist, but I think that you'd need one to help you to figure out what's going on within your son, to know why he's acting this way and what you can do about it.
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Talk to him with patience and openness. Be genuinely curious about his thoughts and feelings. When he does anything that is positive in your eyes, make sure to say so to him.
It shows that you really care, because you're reaching out, looking for help and answers. Make sure that he knows that you care so much.
Welcome to the group - it’s proven to be a very helpful outlet for us when things were bad with my 9 (now 10) year old son.
You didn’t mention medication. We have taken a non-medication approach and have had a lot of success. I’d be happy to share our experience if you’re interested.
My son's biggest manifestations have been irritability and anger. The two supplements that made the biggest difference for him were (1) nutritional lithium orotate (1-2mg per day; KAL Liquid) and (2) a methylated folate multivitamin called EnLyte. He also takes high potency Omega-3s (a common deficiency in ADHD), magnesium, zinc & probiotics.
I used the book Finally Focused by James Greenblatt as my guide, which lead me to get my son's hair minerals tested and to supplement with lithium as well as zinc & magnesium. As for the methylated folate - we found through Genomind neuropsych genetic testing that my son has a mutation in the MTHFR gene. Mutations in MTHFR make it difficult for the body to methylate folate, which is required for it to be active in the body. I'll attach a figure from a paper by Jacque Duff that illustrates why amino acids and many vitamins & minerals including methylated folate (5-MTHF) are required for proper neurotransmitter production.
Duff, J. (2014). Nutrition for ADHD and Autism. Clinical Neurotherapy, 357-381.
Thank you so much for sharing. Finally Focused was my first stop when he self diagnosed and we've been on a light protocol for about 3 weeks (mag, p5p, omegas, zinc, vit D). I have the lithium for irritability and anger but haven't started it yet. MTHFR has been on my radar b/c I have it, so know it's possible for him. I don't know if you can correspond directly (I'm new on the forum) but would love to hear more about your experience. Either way I'll look up the full article above. Thanks again, glad to know someone else had success with this protocol!
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