Oppositional Defiant Disorder

I finally have a “diagnosis” for Karen’s behavior. No doctor or psychologist has yet tagged her with it, but that is most likely because her therapist doesn’t want to treat a disorder, she wants to treat Karen – and our family, by extension. Our therapist did mention the phrase to me once, in passing, and I have since scoured the Internet for more information.

I have another parent meeting with K’s psychologist next week, and I’ve found more to add to the soup. Interesting how dealing with one child’s issues, overlaps and helps resolve things with the other.

Matan is getting occupational therapy to help him overcome some of his delays. Overall, he seems to function at about the age of a 20 month old. She gave us a questionnaire to complete in order to determine if he is suffering from sensory integration issues, ie, suffers from sensory overload. She recommended the “brushing treatment”, which we will begin next week. It consists of spending about 20 minutes, six times a day, to brush large portions of his skin and then put squeeze with moderate pressure on his major joints. This is supposed to help him moderate his responses to sensory overload.

After completing the questionnaire for our son, DH and I realized that when Karen was at his age, she had much more extreme responses to over stimulation than does Matan. After reading a lot of material, both online and in real books, I’ve come to the conclusion that much of Karen’s acting out may be attributable to Sensory Integration Disorder.

Topics to discuss with our therapist next week are whether Karen can also benefit from treatment for sensory integration disorder, such as the brushing we’ll be doing with her brother. I also want to know if there may be other solutions more appropriate for her age. My guess is that working with this therapist, and having the therapist guide is in parenting, will have the most influence, but it will take a long time. I like the brushing idea because I think she’ll enjoy the closeness of having me focus on her like that.

It seems that most institutionalized children suffer from sensory integration issues because they were exposed to so little in terms of their senses. Sure, they may have had music, but they had no physical closeness to a caring adult on a consistent basis. They formed no attachments. They had never seen tv, a movie, or even a car. They spent about 14 hours a day in bed, and the remainder, in a cold environment with few toys, and certainly nothing stimulating and exciting. Suddenly they find themselves in a loud and colorful world, full of motion, new creatures and people speaking a strange language. It sounds like science fiction, but when we first brought them home, both children were like aliens in a new world.

Every child responds differently. Karen went into shock after her first day out in a park full of people, dogs, bicycles, skateboarders and noisiness. She spent the next 48 hours staring listlessly, lying on the cold floor tiles and refused to eat or drink. We managed to help her pull out of it, but she continued reacting to loud events and new people and places. Now she’s a big girl, and thinks she can deal with anything. I wish she could, but she isn’t, and can’t.

A plethora of diagnoses, but few real ways to treat, except to follow a long road to creating a safe and calm situation for both children.

4 responses to “Oppositional Defiant Disorder

  1. Whether or not the brushing will help Karen I think your sense that she would like the closeness and close attention is key. Can you do something else with just her that will be physically close?
    I hope you get some answers and a good plan to work with.

  2. I am very practically minded so I always say clarity is better than no clarity even if the initial response to a diagnosis is shock and/or sadness. It’s so hard when our kids have problems that is for sure. To be sure, you are right that nothing will be solved overnight. It is a distance race, not a sprint.

    I think Karen’s therapist is right in treating Karen like a child rather than a disorder. It’s good to know that a disorder exists and read about it but in the end Karen is a child. I know from my own experience how easy it is to get lost in the diagnosis, the cause, the effect, the research, etc. And while, at least in my own experience, all this has helped me to gain a greater understanding of how my daughter sees the world and where the world is with understanding and treatment, it has been important to me to balance my child against “the written word” regarding her condition. I always try to keep firmly in mind that no matter what Maya has or is, she is much more than her autism. So what I am saying is that I think your therapists approach is good.

    I am interested in the brushing. I’ve not read much about it. Maya also has sensory integration issues. I will Google it but if you have information that you find sound, I would love to have a link.

    Lita, you are doing well. You are getting answers and while it is of course so very hard to see your child having problems, both of those kids are lucky to have a mom like you, who is fighting for them and doing everything she can to help them. They will be all the better for that.

    Take care!

  3. Sorry, no time to really comment properly, but I totally agree that clarity is better than no clarity because you can start to see how your child sees the world. Alex has an SPD evaluation on Tuesday. I am hoping they find sensory processing problems so that we can start to help him with it. Otherwise, I’m out of questions and out of answers. But yes, treating the whole child is critical because our kiddos from orphanages do not just have one issue, they have overlapping institutional effects (delays, SPD, attachment, etc) that make it harder to get results from treating a single disorder.

    Lita, I’m glad you’ve found the right people to help you help your beautiful kiddos.

  4. Michelle, for sure, the closeness is important. I like to help her put on body lotion because she has dry skin in the summer. She likes it, but often wants to take over and show me she can do it on her own. She’s almost six, so it’s hard to argue with her. But she does like to snuggle, it’s just that with Matan around, she doesn’t get pure 1 on 1 snuggle time.

    Dana, you are always so encouraging. I have read more about the brushing, and it seems to be sort of like an immunization or desensitization. That said, from everything I’ve read, it is used clinically, although there is no hard scientific evidence. But a lot of these things are evolving, and it does seems to be popular among a wide range of therapists.

    I think a lot of children who exhibit a wide range of problems also probably have sensory integration issues. When you don’t experience the world as others do, then you are more likely to be easily overwhelmed by over stimulation.

    Thanks Tam, I know you understand. Sometimes there are no clear cut answers. You just need to go with whatever comes along. But I am sure that things do improve with our orphanage children. The changes in Karen are amazing. Other parents of children her age are sometimes shocked at her independence. I usually let her run with it because holding her back, unless it’s something really dangerous, is pointless. She’ll just find another way.

    It’s interesting that even with the oppositional behavior, Karen can also be very warm and caring. She won’t kiss or hug grandparents, but is very physically affectionate with all of us at home.

    Oh, we had to cancel the therapist today since both kids are sick and I’ve been home with one or both of them for 3 days. Karen may have strep. Just no energy left to make a 9 pm appointment.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s