ODD-CD part 3

Ryan is 10.  Ryan's day usually starts out with arguing about what he can and can not bring to school.  His mother and his teacher have now made out a written list of what these things are.  Ryan was bringing a calculator to school and telling his teacher that his mother said it was alright.  At first his teacher wondered about this, but Ryan seemed so believable.  Then Ryan brought a little (Ryan's words) knife.  That lead to a real understanding between the teacher and Ryan's mother.

Ryan does not go to school on the bus.  He gets teased and then retaliates immediately.  Since it is impossible to supervise bus rides adequately, his parents and the school gave up and they drive him to school.  It is still hard to get him there on time.  As the time to leave approaches, he gets slower and slower.  Now it is not quite as bad because for every minute he is late he loses a dime from his daily allowance.  Once at school, he usually gets into a little pushing with the other kids in those few minutes between his mother's eyes and the teacher's.  The class work does not go that badly now.  Between the daily allowance which is geared to behavior and his medicine, he manages alright.  This is good for everyone.  At the beginning of the school year he would flip desks, swear at the teacher, tear up his work and refuse to do most things.  Looking back, the reasons seem so trivial.  He was not allowed to go to the bathroom, so he flipped his desk.  He was told to stop tapping his pencil, so he swore at the teacher.

Recess is still the hardest time.  Ryan tells everyone that he has lots of friends, but if you watch what goes on in the lunch room or on the playground, it is hard to figure out who they are.  Some kids avoid him, but most would give him a chance if he wasn't so bossy.  The playground supervisor tries to get him involved in a field hockey game every day.  He isn't bad at it, but he will not pass the ball, so no one really wants him on his team.

After school was the time that made his mom seriously consider foster care.  The home work battle was horrible.  He would refuse to do work for an hour, then complain, break pencils and irritate her.  This dragged 30 minutes of work out to two hours.  So, now she hires a tutor.  He doesn't try all of this on the tutor, at least so far.  With no home work, he is easier to take.  But he is still wanting to do something with her every minute.  Each day he asks her to help him with a model or play a game at about 4:30.  Each day she tells him she can not right now as she is making supper.  Each day he screams out that she doesn't ever do anything with him, slams the door, and goes in the other room and usually turns the TV on very loud.  She comes up, tells him to turn it down three times, he doesn't, he is sent to his room.  She calculated that she had made about 1500 suppers since he was five years old.  Could it be that they have gone through this 1500 times?  She decides this is not a good thought to follow through.  After supper Ryan's dad takes over and they play some games together and usually it goes fine for about an hour.  Then it usually ended in screaming.  So Ryan's grandmother had the bright idea of inviting them over for desert at about 8:00 pm most nights.  But what about days when there is no school?  Ryan's parents try very hard not to think about that.

Tasha is 15.  She is in ninth grade and from her marks, you would say there is no big problem.  She is passing everything, but her teachers always comment that she is capable of much more if she tried.  If they gave marks for getting along with others, it would be a different story.  Tasha's best friend is currently doing a 6 month sentence for vandalism and shoplifting.  Tasha and Sylvie have been friends since fall, if you can call it that.  Since Tasha has almost no other friends, she will do anything to be Tasha's friend.  At least that is what her parents think.  Tasha thinks it is "cool" that Sylvie is at the Shelbourne Youth Centre.  One sign of this friendship was that Tasha almost always gave her lunch money to Sylvie.  Why?  Because Sylvie wanted it.  Tasha thought that Sylvie was her friend, but everyone could see that Sylvie was just using her.  What seemed saddest to Tasha's parents is that Tasha could not see this at all.  But this was nothing new. She would make a friend, smother them with attention, and that would be the end of it.  Or, the friend would not do exactly what Tasha wanted and there would be a big fight, and it would be over.  But mostly Tasha complained that everyone bugged her.  What seemed to save Tasha was the nursing home.  Somewhere along the way Tasha got involved working there.  To hear the staff there talk about her, you would never guess it was the same girl.  Helpful, kind, thoughtful - they couldn't say enough good about her.  In fact her parents joked that maybe if they all moved to the nursing home, it would stop the fighting at home.  They figured it out when another teenager volunteered to help one of the same afternoons as Tasha.  Unfortunately the "other" Tasha came out.  Tattling, annoying, disrespectful and hard to get along with.  Tasha could get along with any one, as long as they weren't her age, a teacher, or a relative!

These examples stress some of the common features of this comorbid combination.  Extremely major social problems with relatively little academic problemsare common.  Recent research suggests that all things being equal, girls with ODD plus ADHD have significantly worse social problems than boys with ODD plus ADHD.  Tasha in the above example illustrates this.