ODD-CD part 11

Behavior Modification doesn't work for everyone.  Sometimes you have to keep changing it all the time.  It works best when you find the perfect reinforcers, positive or negative.  A lot of people just do not have anything they are willing to try that hard for.  Also, some people are so severely impaired they just can not benefit from this.

3. Decide what you are going to ignore
Most children and adolescents with ODD are doing too many things you dislike to include every one of them in a behavior management plan.  The key caregivers have to decide ahead of time what sort of thing will just be ignored.

4. Try very hard not to show any emotion when reacting to the behaviors of children and adolescents with ODD.
The worst thing to do with a kid with ODD is to react strongly and emotionally.  This will just make the child push you that same way again.  You do not want the child to figure out what really bugs you.  You want to try to remain as cool as possible while the child is trying to drive you over the edge.  This is not easy.  Once you know what you are going to ignore and what will be addressed through Behavior Modification, it should be far easier not to let your feelings get the best of you.  If these interventions work, then hopefully the dialog can proceed like this:

Ann comes in and says, as she watches you folding the wash, "I need my red sweater washed and dried by 7:30 tonight"

You do not reply but think a moment.  This was the sort of thing you and your husband decided to ignore.  You respond, "Are you hungry?"

Ann comes in and says, as she sees you folding the wash, "Aren't you done with that yet?  I need that sweater right NOW!"  Ann throws her books on the floor and knocks over a glass of milk.

You respond, "let's see, that sure sounds like being disrespectful to me.  I guess "the plan" says that means no TV tonight."

Ann comes in and says, as she sees you folding the wash, "Aren't you done with that yet?  I need that sweater right NOW!"  Ann throws her books on the floor and knocks over a glass of milk.

Mom throws the clothes down, glares at Ann, and replies the way she really feels, "Why you inconsiderate #$%*!  Take this sweater and wash it yourself!  (Throws sweater at Ann) and these socks!  (throws socks at Ann) and these pants!" (throws them, too).

Dad comes home later and Ann tells him that Mom "lost it" when she just asked about how the wash was coming!

Make sure that you are as healthy and strong as you can be Children and adolescents with ODD will find the weakness in the family system and exploit it.  Is there tension between father and mother?  They will aim to worsen this.  Trouble with the in-laws?  These children and adolescents will try to exploit this.  Are you out of shape and exhausted after work?  That's when they will be most trying.  Are you worried or depressed about something?  They will try to figure it out and torment you.
Dealing with a child with ODD is very exhausting and trying.  It will take about 1/3 to ¼ of all your emotional, mental, and physical resources.  If you knew that you would be chopping wood for four hours every day, You would make sure you got enough rest, a good diet, and had plenty of time to relax.  The same holds double for dealing with ODD in the long term.  You have to take care of yourself in ways you would not have to if your child did not have ODD.  This includes things like:

• Find a baby-sitter and go out weekly away from this child and your home with your spouse or significant other.
• Make sure you have plenty of time to piss and moan about the difficulty of this to your spouse or friends.
• Get adequate exercise.  There is nothing better to blow off steam than exercise that is fun.
• Get enough sleep
• Eat well and don't try to go on a big diet.
• Don't try to do too much.  Remember, caring for a kid with ODD is a big job!
• Get help if your marriage is in trouble
• Do everything you can to stop drinking if you or your spouse has a drinking problem
• Make sure you have some hobby you enjoy and can do when things get rough.

Television is a major force in our lives.  Study after study have shown that Television is filled with violence, drug and alcohol use, and sexuality.  The average child spends at least 2-3 hours a day watching this stuff.  Many children spend 4-6 hours a day watching this.  It should not be any wonder then that children who watch a lot of TV are more violent, are more likely to do drugs, and are preoccupied with sex.  In a child with a problem like ADHD or ODD, this is clearly something that needs to be done.  The American academy of Pediatrics recommends the following:

Limit all media use to no more than 1 to 2 hours per day.  Monitor their children's use of the media.  Coview television with their children.

It also goes without saying that it is impossible to limit children's viewing if the parents are watching Television or playing video games all day and night.  Turning off the TV is the most effective but radical solution to a host of child psychiatric problems.  My advice is to be radical and do it!

Anyone who has ever seen a child play nintendo can see that there is a very potent force at work here.  Unfortunately, the vast majority of computer and video games are violent and are becoming more graphic, not less, in their depiction of violence.  As mentioned above, large amounts of television viewing can cause increased psychiatric problems for children.  Although there is a less research on games, the same trend is there.

About 33% of children play computer or video games.  As anyone who has a child knows, these games can be very addictive.  One out of five children from grades 5-8 are as addicted to computer games as an alcoholic is to alcohol.  The earlier children start playing these games, the more likely they are to get addicted.  Children who play lots of video and computer games aren't as nice to others. Children who play violent games are more physically aggressive and are not as intelligent.  Unfortunately, the question remains whether or not children who are aggressive and have problems are attracted to these games or whether the games make them that way.  With TV, the evidence suggests that violence on TV makes more violent kids.  Given that video and computer games are a much more powerful medium than TV, I think it is quite safe to assume that they are having a detrimental effect on children.