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Current Issue of BDINews
Caring for the High Maintenance Child
By Kate Andersen.

Child Talking Back/Marital Conflict, March, 2017.
Dear Kate:
We took our 'high maintenance' eight-year old son to a child psychiatrist last week because we were so worried ....
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 B-DI News
A Newsletter About Caring for the High Maintenance Child

by Kate Andersen, M.Ed.
Issue Theme: Child Talking Back/Marital Conflict
Volume 19, Issue 7, March, 2017.

Letter to Kate
by Kate Andersen, M.Ed.

Dear Kate,

We took our 'high maintenance' eight-year old son to a child psychiatrist last week because we were so worried about his deep-seated resentment about being adopted. A social worker told us that our son had "adopted child syndrome". We've been reading your newsletter for over a year and find that our son really fits your definition of a 'high maintenance child'. The psychiatrist said that our son had Oppositional Defiant Disorder. He said that 'high maintenance temperament' was a load of rubbish and so was the adopted child syndrome.

We are relieved in some ways, concerned in other ways. Can you help us sort out high maintenance temperament, adopted child syndrome and oppositional defiant disorder?



Kate's Answer

Dear Overwhelmed:

First of all, here's what Oppositional Defiant Disorder is, according to the American Academy of Child and Adolescent Psychiatry:

"All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child's social, family, and academic life."

They state that when children display "an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster's day to day" they may be diagnosed with Oppositional Defiant Disorder (ODD).

Symptoms of ODD include:

* frequent temper tantrums

* excessive arguing with adults

* active defiance and refusal to comply with adult requests and rules

* deliberate attempts to annoy or upset people

* blaming others for his or her mistakes or misbehavior

* often being touchy or easily annoyed by others

* frequent anger and resentment

* mean and hateful talking when upset

* seeking revenge

Other Points About ODD

* symptoms are usually seen in multiple settings

* may be more noticeable at home or at school.

The causes of ODD are unknown. The Academy states that many parents report that their child with ODD was more rigid and demanding than the child's siblings from an early age, suggesting a role for temperament and well as environmental factors.

The Academy states:

"A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention-deficit hyperactive disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop a more serious conduct disorder."

I asked Dr. Sean McDevitt, Editorial Consultant, to answer your questions about high maintenance temperament, ODD, and adopted child syndrome. He stated:

"Oppositional behavior often arises when the youngster has had too many instances of negative feedback and then refuses to try to obtain approval from adults. Often the oppositional behavior appears more intense or more negative due to the child's temperament. Trying to "catch the child being good" and giving positive reinforcement for other behaviors will lead to a decrease in oppositional behavior. Parents and other caregivers need to learn to avoid the power struggles set up by oppositional behavior.

With regard to adopted child syndrome, there is no one set of behaviors associated with being adopted. Adoption and the factors that sometimes lead to taking a child from one family to another are many and complex. It would be more productive to focus on the child's temperamental characteristics, a facet of behavior that is well established in research."

I hope this is helpful to you.


Best of luck!


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