ADHD and ODD
Some studies suggest that over 80% of people with ADHD will also meet criteria for another common childhood disorder - oppositional defiant disorder (ODD). 80%!
In the 5 grade classroom, a big majority of the students simply “get it,” they understand that getting along well in the classroom means balancing my own needs against the rules of the classroom, or the preferences of the teacher. In friendships, they also “get it,” meaning I have to balance my wants and wishes against the wishes of my partner or friend. I may experience uncomfortable feelings like boredom and irritation which I will need to tolerate and manage.
There are essentially two types of movies: one in which cars blow up, and another in which people kiss on bridges. You probably have a preference for which type of movie you would rather see on a Saturday night. But your friend or partner might have a preference for the other type of movie. How do you manage that? If you are an adult, or even a teenager, you don’t fold your hands across your chest, stick out your lower lip, and pout. You negotiate, you cooperate, you even (wait for it…) compromise. And most people even in the elementary classroom grasp that.
What About Kids that Do Not Get It?
But what’s up with this (sizeable) minority of children who don’t? They don’t understand that the rules of the classroom, even the “dumb rules,” apply to all of us. They don’t understand that when the teacher is talking, and I'm reminded of something fascinating I saw on television last night, it is not okay to blurt that observation out right then and there. They don’t seem to “get it” - that although hitting a peer who has made me mad might briefly “feel good,” in a longer lasting sense and in a more meaningful sense, it wouldn’t. It will severe the relationship, get me in trouble, and disrupt the whole classroom experience. They don't seem to understand that we all have yucky feelings sometimes, and we need to manage those for at least brief periods.
What is different about this (again, not tiny) minority of students who simply don’t get these concepts of balancing my needs against your needs? And before you answer, I have to say right off the top that I can’t accept answers like “they’re bad,” or “they’re lazy.” I want to be more curious than that. If you have someone in your home living with one of these conditions, I know you want to be more curious than that. We scratch our heads together and ask why would this bright, adorable (usually), curious and motivated kid not grasp these basic concepts, concepts that most of their peers have grasped?
ODD as a Learning Disorder?
Again, if you remember that 80% of young people with ADD/ADHD also meet criteria for ODD, you may be on your way to forming a hypothesis already. About 50 years ago, if Brenda didn’t read, we simply put her in the back of the classroom and said something like “Brenda doesn’t read.” These days, we have three or four different ways of understanding dyslexia, of understanding students’ different ways of grasping the grapheme-phoneme concept (looking at the print word, and understanding the sounds, as well as the meaning or intention). Reading disorder or dyslexia is a way of processing the written word differently. We think about students differently when we say “she has a reading disorder” than when we say “Brenda doesn’t read.”
Likewise, if we can begin to conceptualize oppositional and defiant behaviors as “learning disorders,” or points of performance and skill development, we begin to develop an attitude of curiosity rather than frustration.
What all of us want is that this young child will be be - eventually - a healthy and well adjusted 26-year-old. What skills does he need to master between now and then to be a healthy, well adjusted young adult? He has years ahead of him between now and then, but it is important that we not lose time. There are important skills that can wait (driving, negotiating a mortgage, voting) and other skills (flushing the toilet, waiting until mom is off the phone before interrupting her) that probably need to be developed right now.
Quarterly Quality Improvement Meetings
Parents, sometimes in consultation with professionals, might sit down monthly or quarterly and ask “What particular skills do we want to develop (and this means I will turn off the TV and give time to this task) to make sure that he is on target towards the goal of being a healthy, well adjusted 26-year-old?”
What's Different When You Look at It LIke This?
So what do you think? Can you see oppositionality and defiance as evidence of learning disability? And what's different when you think about it that way?