Underlying causes of grandson’s conduct require attention

Published 11:59 am Saturday, March 8, 2014

Question: My grandson Jack, age 7, was recently diagnosed with ADHD, Attention Deficit Hyperactivity Disorder. His teachers always complain of him interrupting his classmates, kicking his desk and refusing to sit still. His grades are well-below average. At home his mother, my daughter, has a hard time getting him to listen or do any chores. Medication was suggested for Jack at the time of his diagnosis, but my daughter refuses to put him on it because she thinks Jack is just being a kid. I think his actions go beyond that and should be treated with medicine. What is your opinion?

Answer: Ten years ago Marcus was a nationally ranked college freshman basketball player whose deep-down desire was to be a lawyer. Unfortunately, none of the top ranked NCAA men’s basketball schools that offered Marcus a full scholarship also had a strong undergraduate law program. This financial incentive, in combination with insurmountable pressure from his family, convinced Marcus to accept a scholarship. The strength of his basketball ability forced into hiding, overrode and preempted his desire to be a lawyer. Over time, Marcus’s spirit increasingly suffered.

It appears this same concept is happening to your grandson. The strength of his ADHD symptoms could be forcing into hiding, overriding and preempting consideration of other equally strong, but lesser known causes of his behavioral issues such as Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD). Until a children’s therapist who specializes in behavior has conducted a thorough assessment of him, any decision with regard to Jack’s currently prescribed medicine should temporarily be placed on hold. His pediatrician will be able to provide you with a list of and a referral for this type of therapist. Consider the following information about ODD and CD in relation to Jack and you will better understand why a more thorough investigation of his condition is suggested.

ODD is characterized by the following: losing temper; arguing with adults; actively defying or refusing to comply with adults’ requests or rules; deliberately annoying people; blaming others for his or her mistakes or misbehaviors; being touchy or easily annoyed by others; being angry and resentful; and having a tendency to be spiteful or vindictive. The child’s behavior often disrupts normal daily activities, including those within the family and at school. Children with ODD who also suffer from another behavior problem such as ADHD, anxiety disorder, or depression, are more likely to develop a more serious behavior disorder call CD.

Symptoms of CD include: aggression toward people and animals; destruction of property; deceitfulness, lying, or stealing; and serious violations of rules including running away from home. It is not uncommon for children and teens to have behavior-related problems at some time during their development. The behavior is considered to be a conduct disorder, however, when it is long-lasting, violates the rights of others, goes against accepted norms of behavior, and disrupts the child’s or family’s everyday life.

Although the exact cause of ODD and CD is not known, the REACH Institute attributes it to a combination of genetic vulnerability and environmental triggers such as parental inconsistency and mood disorders. Treatment involves the help and intervention of a behavior therapist working with the parents, child, teachers, and all other caregivers to replace unintentionally reinforced ODD/CD behaviors with healthy behaviors. This treatment often employs the use of positive reinforcement, consistency, and persistence.

It is now important to take note of where Marcus is today. He is stuck in a dead-end office job due to a very unexpected basketball career-ending injury. Family and financial responsibilities keep him from making any major career change or from pursuing his desire to be a lawyer. Marcus’s spirit continues to suffer.

Although the method of diagnosis and treatment chosen for your grandson is ultimately his mother’s decision, you are not powerless with regard to the situation. Show respect for your daughter’s position by lovingly communicating your concerns about Jack’s behavior to her. Present her with facts, not opinions, and remain calm yet assertive.

If Marcus had a grandmother like you to testify on his behalf, he would not be an office worker behind a desk. He would be a lawyer in front of a judge. Persistently testify on behalf of Jack and his health so they do not suffer at the hands of injustice as do Marcus and his spirit.

ABBIE LONG is a Franklin native and advice columnist for The Tidewater News. Submit your questions to askabbie@tidewaternews.com