Why I don’t Diagnose Oppositional Defiant Disorder (Part 4 of 4)

by James Wiley, MD, FAAP -- @adddoc As we wrap up this series on why oppositional defiant disorder is often misdiagnosed, let's talk about depression.  "She doesn’t care about anything." "He’s lazy! Every day instead of doing homework or studying he goes straight to bed." "She is so grumpy and cries at the drop of a hat." "She won’t even try in school.  When pushed she gets very angry and says the meanest things." "He skips school or falls asleep in class half the time." "Every time I ask her to do something she argues or tells me she is too tired." "She can’t make up her mind about anything until we ask her to do something and then she won’t do it." Does any of this sound like common rhetoric in your household? Depressed kids seem apathetic and don’t see… Read More »

Get A Head Start On Valentine’s Day!

Does your ADHD constantly keep you in the doghouse for forgetting anniversaries and birthdays? It’s ok, we know you don’t forget on purpose but there are some easy things you can do to help you remember the next big holiday, Valentine's Day. Valentine's Day is in just a few weeks and we’re here to help you avoid the doghouse. Here are four tips to help you stay ahead of the game and surprise your special someone! 1. Make plans now: Don’t put it off or you will forget. Start now making dinner reservations and buying gifts. *Do this right after you read this blog, you'll thank us later. 2. Set reminders in your phone: Our smartphones do amazing things these days, one feature that can help you is setting alert reminders to send flowers to her office or buy him… Read More »

Why I don’t Diagnose Oppositional Defiant Disorder (Part 3 of 4)

by James Wiley, MD, FAAP -- @adddoc As we continue our series on symptoms and disorders that resemble ODD, another factor that can affect a child's behavior is having a learning disability of any kind.  Dyslexia, dysgraphia and dyscalculia all make school days long and arduous for kids.  Few schools are equipped with the expertise and resources to meet the needs of kids with learning differences, much less those with learning disabilities. Kids who have trouble with receptive or expressive language often have trouble asking for help!  Kids with LD often feel different and unfortunately often even think of themselves as "stupid".  Some of these kids will withdraw or shut down, resulting them in getting labeled as "lazy".  Some will become class clowns and be labeled "disruptive" (and therefore ADHD, whether they have ADHD or not) and some will get angry… Read More »

Why I Don’t Diagnose Oppositional Defiant Disorder (Part 2 of 4)

by James Wiley, MD, FAAP - @adddoc In this series we are talking about how co-morbid conditions can mask themselves as oppositional-type behaviors. In part one we discussed the importance of starting ADHD treatment and introduced anxiety as a common co-morbid cause behind this type of behavior. The next disorders we will discuss are obsessive-compulsive disorder and Tourette's disorder.  I don’t think a parent has ever come in and said, “I think he has OCD”.  Here are some clues that help expose OCD as the cause of a kid’s irritable, angry, or oppositional behavior. “He’s very particular.” “He hates tags, he can’t stand socks with seams, and he only wears one kind of underwear!” “He will refuse to put on a pair that looks just like the favorite pair.” “She’s a perfectionist, but only on certain things. She will cry… Read More »

Why I Don’t Diagnose Oppositional Defiant Disorder (Part 1 of 4)

by James Wiley, MD, FAAP  - @adddoc Okay, I have diagnosed it. On occasion, I still might diagnose a young person with it. However, every time I think ODD, I ask myself “What is making this kid so angry and defiant?”  And if I do diagnose ODD I consider it my failure to answer that question. Almost all of the DSM 5 diagnoses, including ODD, have the same final criterion; the symptoms are not better explained by something else. I think ODD behaviors almost always arise from other diagnoses or social situations. Failure to consider this criterion leads to significant over diagnosis of ODD, which is too often cited as the most common co-occurring condition along side ADHD. This week I’d like to further discuss some common conditions and situations that replace the diagnosis of ODD in my practice. In this… Read More »