I have tried lots of things with my 10-year-old daughter. I have done a parenting course, but she is still causing disruption and is very violent towards me and her 2 sisters, K____ 15, and L___ 9.

Today my 10-yr-old daughter has smacked me, kicked me, tried to smash the patio door with the fruit bowl, then grabbed the kettle and has started throwing hot water around. This is not just putting us at danger, but herself. I am now wondering what on earth I can do next as I have tried time out sanctions, reward charts, praising, etc. Please give me some advice, as I don’t know where to turn.

Thanks, C.
___________

Hi C.,

At the risk of throwing labels around, you have described behavior in line with Oppositional Defiant Disorder (ODD).

ODD defined:

A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

1. often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful and vindictive

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

All of the criteria above include the word "often". Studies have shown that these behaviors occur to a varying degree in all children. Researchers have found that the "often" is best solved by the following criteria.

Has occurred at all during the last three months-
  • is spiteful and vindictive
  • blames others for his or her mistakes or misbehavior
Occurs at least twice a week-
  • is touchy or easily annoyed by others
  • loses temper
  • argues with adults
  • actively defies or refuses to comply with adults' requests or rules
Occurs at least four times per week-
  • is angry and resentful
  • deliberately annoys people

Here is an example of how ODD looks for a 10-year-old:

Kaylee is 10. Her day usually starts out with arguing about (a) getting up on time for school, (b) having to share space with her siblings, (c) what she can and can not bring to school, etc.

Kaylee does not take the bus to school. She has been forbidden to ride the bus due to numerous incidents in which she was verbally and physically disruptive. Since it is impossible to supervise bus rides adequately, the school gave up and now mom has to drive her to school. It is still hard to get her there on time. As the time to leave approaches, she gets slower and slower.

Once at school, she usually gets into some verbal battles with peers in those few minutes between her mother's supervision and the teacher's. When she is not allowed to go to the bathroom, she flips her desk. When she is told to stop tapping her pencil, she swears at the teacher. When she is sent to the office, she tells the vice-principal how badly she is being mistreated by the teacher and how unfair things are in the classroom.

Recess is a hard time as well. Kaylee tells everyone that she has lots of friends, but if you watch what goes on in the lunchroom or on the playground, it is hard to figure out who they are. Some peers avoid her, but most would give her a chance if he wasn't so bossy.

After school is the time that makes her mom seriously consider foster care. Kaylee refuses to do any homework and is making poor grades. Each day she complains that mom doesn't do anything for her. She gets upset with her siblings, slams doors, goes in the other room and usually turns the TV on very loud.

Mom tells her to turn it down. She doesn't and is sent to her room. After supper Kaylee ends up in a screaming match with mom over her unwillingness to help with the dishes. In fact, Kaylee refuses to do any chores and gets very angry when mom asks her to help out around the house.

Kaylee’s siblings are afraid of her – so is mom.

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Traditional parenting strategies such as time-outs, reward charts, etc., do not work with ODD kids – in fact, they tend to make a bad problem worse. We’ll look at what does work in “My Out-of-Control Teen eBook.” It will take some time and a specific combination of strategies to get the problems turned around. There are no short cuts, and the longer the parent waits to implement these strategies, the more things deteriorate. 

Is our teenage son really suicidal?

"Our son recently lost his girlfriend in a very bad car accident. She and two of her female friends were killed instantly when the driver veered off the road and hit a tree head on. My question is he has been very depressed since the accident and is now talking about wishing he were dead. No amount of talking to him is making a difference. Should we be concerned that he really might follow through with a suicide attempt?"

Suicide is the 3rd leading cause of death among those 15 to 25 years of age, and it is the 6th leading cause of death among those 5 to 14 years of age. It is estimated that 500,000 teenagers try to kill themselves every year, and about 5,000 succeed. Furthermore, teenage suicide is on the rise. Some of the reasons for this increase:

  • Easier access to lethal means, such as guns and drugs
  • A more violent youth culture, fueled by video games, music, television and movies
  • A lack of family stability; divorce, abuse
  • Reduced impulse control due to technology and the rapid pace of modern life
  • A romantic misconception about the finality of death
  • Peer pressure and a feeling of powerlessness
  • Limited access to mental health services

Studies show that clear warning signs have preceded 4 out of 5 teen suicide attempts. Warning signs include:

  • Loses interest in favorite extracurricular activities
  • Has problems at work and loses interest in a job
  • Abuses substances, including alcohol and drug (illegal and legal drugs)
  • Begins to experience behavioral problems
  • Withdraws from family and friends
  • Experiences sleep changes
  • Experiences changes in eating habits
  • Begins to neglect hygiene and other matters of personal appearance
  • Experiences emotional distress which brings on physical complaints (aches, fatigues, migraines)
  • Has a hard time concentrating and paying attention
  • Begins to receive failing grades at school
  • Loses interest in schoolwork
  • Engages in risk taking behaviors
  • Complains more frequently of boredom
  • Does not respond as before to praise and encouragement
  • Actually says, “I’m thinking of committing suicide” or “I want to kill myself” or “I wish I could die”
  • Begins giving away favorite belongings, or promising them to friends and family members
  • Throws away important possessions
  • Shows signs of extreme cheerfulness following periods of depression
  • Creates suicide notes
  • Expresses bizarre or unsettling thoughts on occasion

Here’s some of the things you can do:

Ask your teen if he is thinking about suicide. Listen openly and without judging. Believe what he says, and take all threats seriously. Share responsibility by getting others involved. Reassure him that help is available, and support and encourage him to reach out to sources of help in the community. Act immediately if you feel he is at imminent risk for suicide by involving others who can help. If necessary, make contact with the police, emergency services, or a hospital to ensure the person's safety.

Talk, ask questions, and be willing to really listen. Don't dismiss your teen's problems as unimportant. Parents and other influential adults should never make fun of or ignore an adolescent's concerns, especially if they matter a great deal to her and are making her unhappy.

Be honest. It you're worried about your teen, say so. You will not spark thoughts of suicide just by asking about it. Share your feelings. Let your teen know he's not alone. Everyone feels sad or depressed at times.

Get help for your teen and yourself. Talk to your pediatrician, teacher, counselor, clergy, or other trained professional. Don't wait for the problem to "go away." Although feelings of sadness and depression can disappear as quickly as they came, they can also build to the point that an adolescent thinks of suicide as the only way out. Be careful not to assume that your teen's problems have been so easily solved.

If your child seems depressed and withdrawn, it's a good idea to watch him or her carefully. If your child will not speak to you about how he or she is feeling, it's a good idea to suggest that your child talk to someone else who he or she feels comfortable confiding in. If your teen doesn't feel comfortable talking with you, you may want to suggest a more neutral person, such as another relative, a clergy member, a coach, a school counselor, or your child's doctor.

Some parents are reluctant to ask teens if they have been thinking about suicide or hurting themselves. Some parents fear that if they ask, they will plant the idea of suicide in their child's head.

It's always a good idea to ask. Asking a person if he or she is having thoughts about suicide can be difficult. Sometimes it helps to let the person know why you are asking. For instance, you might say: "I've noticed that you've been talking a lot about wanting to be dead. Have you been having thoughts about trying to kill yourself?"

Your child's doctor can refer you to a psychologist or psychiatrist, or your local hospital's department of psychiatry can provide a list of doctors in your area. Your local mental health association or county medical society can also provide references. In an emergency, you can call 1-800-273-8255.


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