HELP FOR PARENTS WITH STRONG-WILLED, OUT-OF-CONTROL CHILDREN AND ADOLESCENTS

Education and Counseling for Individuals Affected by Oppositional Defiant Disorder and ADHD

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Dealing with Oppositional Defiant Behavior (ODD)

ODD is a pattern of disobedient, hostile, and defiant behavior toward authority figures. This disorder is more common in males than in females. Some studies have shown that it affects 20% of school-age kids. However, most experts believe this figure is high due to changing definitions of normal childhood behavior, and possible racial, cultural, and gender biases. This behavior typically starts by age 8, but it may start as early as the preschool years. This disorder is thought to be caused by a combination of biological, psychological, and social factors.

Symptoms include:

• Touchy or easily annoyed
• Spiteful or seeks revenge
• Loses temper
• Is in constant trouble in school
• Has few or no friends or has lost friends
• Blames others for own mistakes
• Argues with adults
• Angry and resentful of others
• Actively does not follow adults' requests

To fit this diagnosis, the pattern must last for at least 6 months and must be more than normal childhood misbehavior. The pattern of behaviors must be different from those of other kids around the same age and developmental level. The behavior must lead to significant problems in school or social activities.

Kids with symptoms of this disorder should be evaluated by a psychiatrist or psychologist. In kids and teens, the following conditions can cause similar behavior problems and should be considered as possibilities:

• Substance abuse disorders
• Learning disorders
• Depression
• Bipolar disorder
• Attention-deficit /hyperactivity disorder (ADHD)
• Anxiety disorders

The best treatment for the youngster is to talk with a mental health professional in individual and possibly family therapy. Moms and dads should also learn how to manage the youngster's behavior. Medications may also be helpful, especially if the behaviors occur as part of another condition (e.g., depression, childhood psychosis, ADHD). Some kids respond well to treatment, while others do not. In many cases, kids with ODD grow up to have conduct disorder as teens or adults. In some cases kids may grow up to have antisocial personality disorder.

Call your health care provider if you have concerns about your youngster's development or behavior. Be consistent about rules and consequences at home. Don't make punishments too harsh or inconsistent. Model the right behaviors for your youngster. Abuse and neglect increase the chances that this condition will occur.

My Out-of-Control Child: Parenting Children with Oppositional Defiance

How To Stop Your Teen From Sneaking Out At Night

"Our 14 year old keeps sneaking out in the middle of the night. We've screwed the windows shut, called police. She says she sorry...but she can't be that sorry if she keeps doing it. What is the best way to handle this? We've told her it is a safety issue more than anything else."

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==> My Out-of-Control Teen: Help for Parents

Teens Who Refuse To Get Out Of Bed In The Morning

"What is done in a case where my teenage son (16 years old) will not get out of bed for either school or work without a huge fight everyday?"

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==> My Out-of-Control Teen: Help for Parents

Home Drug-Testing Your Teenager

"What are your thoughts on testing a teen suspected of using drugs through the use of a home drug-testing kit that can be purchased online?"

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==> My Out-of-Control Teen: Help for Parents

How can I get her to get up in the mornings...

Hi Mark,

I continue to have struggles with my 17 year old. She has not gone to school for this past semester as she was supposed to be taking her classes by correspondence. Unless I stood over and watched her do the courses, she wouldn't do them. I wasn't about to do that as she needs to learn to be responsible. So, needless to say, she is now behind 3 classes in order to graduate next year. She is going to register for regular school for September as this other method does not work for her. She is not motivated at all.

My one big problem with her is that she will not get out of bed in the morning. She has a part-time job that she is supposed to be at 3 days a week. She maybe goes to it 2 times a week if lucky because she just won't get out of bed. She calls in sick so she can sleep in. She will end up losing this job soon. I know she will be exactly the same way once school starts again. She refuses to get out of bed. Then when she does, she thinks she can just go out and hang out with her boyfriend in the evening. Even if we say no, she will leave and go anyways. I am so upset and frustrated by all of this as it has me so stressed out all the time. I dread mornings as I know the hassles we will have. I know that there are "natural consequences" of her actions and she has to be the one that has to live them but we are all living them. Plus, I don't want her to be a high school drop-out and still living at home once she turns 18.

How can I get her to get up in the mornings and to understand that she needs to be more responsible and motivated or she will get nowhere in life?

Thanks,

P.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Adolescents are notorious for staying up late at night and being hard to awaken in the morning. Your adolescent is probably no exception, but it's not necessarily because he or she is lazy or contrary. This behavior pattern actually has a physical cause — and there are ways to help mesh your adolescent's sleep schedule with that of the rest of the world.

Everyone has an internal clock that influences body temperature, sleep cycles, appetite and hormonal changes. The biological and psychological processes that follow the cycle of this 24-hour internal clock are called circadian rhythms. Before adolescence, these circadian rhythms direct most children to naturally fall asleep around 8 or 9 p.m. But puberty changes an adolescent's internal clock, delaying the time he or she starts feeling sleepy — often until 11 p.m. or later. Staying up late to study or socialize can disrupt an teen's internal clock even more.

Most adolescents need about nine hours of sleep a night — and sometimes more — to maintain optimal daytime alertness. But few adolescents actually get that much sleep regularly, thanks to part-time jobs, homework, extracurricular activities, social demands and early-morning classes. More than 90 percent of adolescents in a recent study reported sleeping less than the recommended nine hours a night. In the same study, 10 percent of adolescents reported sleeping less than six hours a night.

Big deal? Yes. Irritability aside, sleep deprivation can have serious consequences. Daytime sleepiness makes it difficult to concentrate and learn, or even stay awake in class. Too little sleep may contribute to mood swings and behavioral problems. And sleepy adolescents who get behind the wheel may cause serious — even deadly — accidents.

Catching up on sleep during the weekends seems like a logical solution to adolescent sleep problems, but it doesn't help much. In fact, sleeping in can confuse your adolescent's internal clock even more. A forced early bedtime may backfire, too. If your adolescent goes to bed too early, he or she may only lie awake for hours.

So what can you do? Don't assume that your adolescent is at the mercy of his or her internal clock. Take action tonight!

• Stick to a schedule. Tough as it may be, encourage your adolescent to go to bed and get up at the same time every day — even on weekends. Prioritize extracurricular activities and curb late-night social time as needed. If your adolescent has a job, limit working hours to no more than 16 to 20 hours a week.

• Nix long naps. If your adolescent is drowsy during the day, a 30-minute nap after school may be refreshing. But too much daytime shut-eye may only make it harder to fall asleep at night.

• Keep it calm. Encourage your adolescent to wind down at night with a warm shower, a book or other relaxing activities — and avoid vigorous exercise, loud music, video games, text messaging, Web surfing and other stimulating activities shortly before bedtime. Take the TV out of your adolescent's room, or keep it off at night. The same goes for your adolescent's cell phone and computer.

• Curb the caffeine. A jolt of caffeine may help your adolescent stay awake during class, but the effects are fleeting. And too much caffeine can interfere with a good night's sleep.

• Adjust the lighting. As bedtime approaches, dim the lights. Turn the lights off during sleep. In the morning, expose your adolescent to bright light. These simple cues can help signal when it's time to sleep and when it's time to wake up.

Sleeping pills and other medications generally aren't recommended for adolescents.

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My child is aggressive. How can I prevent this type of behavior?

RE: "My child is aggressive. How can I prevent this type of behavior?"

The best way to prevent aggressive behavior is to give your youngster a stable, secure home life with firm, loving discipline and full-time supervision during the toddler and preschool years. Everyone who cares for your youngster should be a good role model and agree on the rules he’s expected to observe as well as the response to use if he disobeys. Whenever he breaks an important rule, he should be reprimanded immediately so that he understands exactly what he’s done wrong.

Kids don’t know the rules of the house until they’re taught them, so that is one of your important parenting responsibilities. Toddlers are normally interested in touching and exploring, so if there are valuables you don’t want them to handle, hide or remove them. Consider setting up a separate portion of your home where he can play with books and toys.

For discipline to be most effective, it should take place on an ongoing basis, not just when your youngster misbehaves. In fact, it begins with moms and dads smiling at their smiling baby, and it continues with praise and genuine affection for all positive and appropriate behaviors. Over time, if your youngster feels encouraged and respected, rather than demeaned and embarrassed, he is more likely to listen, learn, and change when necessary. It is always more effective to positively reinforce desired behaviors and to teach kids alternative behaviors rather than just say, “Stop it or else.”

While teaching him other ways to respond, there’s also nothing wrong with distracting him at times, or trying another approach. As long as you’re not “bribing” him to behave differently by offering him sweet snacks, for example, there’s nothing wrong with intentionally changing his focus.

Remember, your youngster has little natural self-control. He needs you to teach him not to kick, hit, or bite when he is angry, but instead to express his feelings through words. It’s important for him to learn the difference between real and imagined insults and between appropriately standing up for his rights and attacking out of anger. The best way to teach these lessons is to supervise your youngster carefully when he’s involved in disputes with his playmates. As long as a disagreement is minor, you can keep your distance and let the kids solve it on their own. However, you must intervene when kids get into a physical fight that continues even after they’re told to stop, or when one youngster seems to be in an uncontrollable rage and is assaulting or biting the other. Pull the kids apart and keep them separate until they have calmed down. If the fight is extremely violent, you may have to end the play session. Make it clear that it doesn’t matter who “started it.” There is no excuse for trying to hurt each other.

To avoid or minimize “high-risk” situations, teach your youngster ways to deal with his anger without resorting to aggressive behavior. Teach him to say “no” in a firm tone of voice, to turn his back, or to find compromises instead of fighting with his body. Through example, teach him that settling differences with words is more effective—and more civilized—than with physical violence. Praise him on his appropriate behavior and help explain to him how “grown-up” he is acting whenever he uses these tactics instead of hitting, kicking, or biting. And always reinforce and praise his behavior when he is demonstrating kindness and gentleness.

There’s also nothing wrong with using a time-out when his behavior is inappropriate, and it can be used in kids as young as one year old. These time-outs should be a last resort, however. Have him sit in a chair or go to a “boring” place where there are no distractions; in essence, you’re separating him from his misbehavior, and giving him time to cool off. Briefly explain to your youngster what you’re doing and why—but no long lectures. Initially, when kids are young, time-out is over as soon as they have calmed down and are “quiet and still.” Ending time-out once they are quiet and still reinforces this behavior, so your youngster learns that time out means “quiet and still.” Once they have learned to calm themselves (to be quiet and still), a good rule of thumb is one minute of a timeout for each year in your youngster’s age—thus, a three-year-old should have a three-minute time-out. When the time-out is over, there needs to be a time-in, while giving him plenty of positive attention when doing the right thing.

Always watch your own behavior around your youngster. One of the best ways to teach him appropriate behavior is to control your own temper. If you express your anger in quiet, peaceful ways, he probably will follow your example. If you must discipline him, do not feel guilty about it and certainly don’t apologize. If he senses your mixed feelings, he may convince himself that he was in the right all along and you are the “bad” one. Although disciplining your youngster is never pleasant, it is a necessary part of parenthood, and there is no reason to feel guilty about it. Your youngster needs to understand when he is in the wrong so that he will take responsibility for his actions and be willing to accept the consequences.

When to seek medical help—

If your youngster seems to be unusually aggressive for longer than a few weeks, and you cannot cope with his behavior on your own, consult your doctor. Other warning signs include:
  • Attacks on you or other adults
  • Being sent home or barred from play by neighbors or school
  • Physical injury to himself or others (teeth marks, bruises, head injuries)
  • Your own fear for the safety of those around him

The most important warning sign is the frequency of outbursts. Sometimes kids with conduct disorders will go for several days or a week or two without incident, and may even act quite charming during this time, but few can go an entire month without getting into trouble at least once.

Your doctor can suggest ways to discipline your youngster and will help you determine if he has a true conduct disorder. If this is the problem, you probably will not be able to resolve it on your own, and your doctor will advise appropriate mental health intervention.

The doctor or other mental health specialist will interview both you and your youngster and may observe your youngster in different situations (home, preschool, with adults and other kids). A behavior-management program will be outlined. Not all methods work on all kids, so there will be a certain amount of trial and reassessment.

Once several effective ways are found to reward good behavior and discourage bad, they can be used in establishing an approach that works both at home and away. The progress may be slow, but such programs usually are successful if started when the disorder is just beginning to develop.

There is no way of taking away this privilege without a physical conflict...

We are into week 2 of what is supposed to have been a 3 day grounding with my 16 year old. He is still skipping school regularly and although he is generally pleasant enough when he is home, he is non-compliant with his grounding. We have taken away his cell phone, i-pod, computer time and tv. He just simply goes out whenever he wants and stays out as late as he wants to. The only thing that he currently does as a privilege is when he gets home he takes food to his room to eat. He is 6'3" and there is no way of taking away this privilege without a physical conflict, so we don't know what else to do except to try and wait out his defiance until he complies with grounding. If you have a specific suggestion in this regard it would be appreciated. It seems to us that the point of your program is to decrease the intensity of the interactions with him, so again, we are searching for ways to reduce this privilege without a physical interaction.

Also, on June 22 he is going to his Dad's for 1 month. If he hasn't complied with his grounding with us before that date, does he go away for a month without his phone and i-pod? If so, when he gets back do we try and start the 3 day grounding again or wait until he makes a mistake?

We certainly appreciate that you are a very busy man, however, we really need some expert personal input from you, beyond what we have seen in the e-book and reference material. We take parenting extremely seriously and have searched again, and again through the material but cannot find answers to our particular questions.


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