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

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What the Future Holds for Teens Diagnosed with ODD

Hello again Mark,

Things are going significantly better... We have been trying your 3-part mantra: poker face, repeat the rule/plan/consequence, no emotion. Not always successfully, but better every day. I'm still very much grieving the child I will never have and would welcome ideas about how to move through this.

But, my bigger question for today is, what is the outlook for teens with Oppositional Defiant Disorder as they move into adulthood? I'm especially concerned that my son is in for a life of turbulent and broken relationships and will likely have trouble holding a job.

I guess I do have another question. Upon receiving his grade card today for the end of his sophomore year, our son declared that he is not a good match for public school and that he will not be going to school in the fall (reminder that his IQ is in the 140s, he scored 32 on the ACT as a sophomore but also has ADD and dysgraphia). Could it be that in his case he really isn't ever going to "succeed" in the system we call public school? And, what is an appropriate response when our child says he wants to quit school? As always, thank you.


Re: What is the outlook for teens with ODD as they move into adulthood?

There are three main paths that an ODD child will take:

First, there will be some lucky children who outgrow this. About half of children who have ODD as preschoolers will have no psychiatric problems at all by age 8.

Second, ODD may turn into something else. About 5-10 % of preschoolers with ODD will eventually end up with ADHD and no signs of ODD at all. Other times ODD turns into conduct disorder (CD). This usually happens fairly early. That is, after a 3-4 years of ODD, if it hasn't turned into CD, it won't ever.

Third, the child may continue to have ODD without anything else. However, by the time preschoolers with ODD are 8 years old, only 5% have ODD and nothing else.

Fourth, they continue to have ODD but add on comorbid anxiety disorders, comorbid ADHD, or comorbid Depressive Disorders. By the time these children are in the end of elementary school, about 25% will have mood or anxiety problems which are disabling. That means that it is very important to watch for signs of mood disorder and anxiety as children with ODD grow older.

Re: Could it be that in his case he really isn't ever going to "succeed" in the system we call public school?

Yes, definitely. I would strongly recommend that you begin thinking about – and planning for – an alternative school setting for your son. Given his IQ, it's possible that he's simply bored with the standard schoolwork and needs to be in a class in which he's a bit more challenged academically.

Re: What is an appropriate response when our child says he wants to quit school?

In many states, once a teenager turns sixteen years old, he or she can drop out of school. By the time a teenager reaches the age of sixteen, half of the battle may already be lost. If the child is struggling with a particular subject or subjects, he may need extra tutoring. As a parent, you can encourage your child by spending time working with him in the evening. If you don’t feel knowledgeable enough to tutor your child, you can arrange for help from someone else.

Many schools now have afternoon tutoring available to help students who are falling behind. Some schools also have “last chance” programs. These programs are typically given at night or on the weekends. They offer students a chance to take a subject or subjects that they have failed, so that they might still be able to graduate on time.

As a parent, you should realize that there may be more serious causes behind your teenager’s lack of ambition. Drug abuse is a real problem among teenagers in today’s society. If you feel that your child is exhibiting signs of drug abuse, you should have him tested immediately. If he tests positive, you will need to decide on a direct course of action.

Never give up on your child. There may be times when both he and you are discouraged about his academic success. Try to hide your discouragement as much as possible, and, instead, let your child see that you believe in him and have high expectations that he will succeed.

Bottom line: Your son will excel at whatever he puts his mind to.

Mark Hutten, M.A.

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

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