Friday, May 21, 2010

If You Have FASD Can You Also Be ODD? Are You Sure?

Three of my kids are diagnosed with FASD and also with ODD (Oppositional Defiant Disorder) but as they get older and I learn more clearly how their FASD thinking works, I wonder if that is really an accurate pairing for them.

Most of the ODD definitions and therapies I read about point toward an ongoing pattern of uncooperative, defiant and hostile resistance to authority. Which is exactly what my kids with FASD seem to be like until you get to know them. These kids wear their hearts on their sleeves in a way that most of us find unnerving and very uncomfortable. There is no guessing how they feel about what's happening in their life ...they let you know and it's often directed at the authority figures in their life. So it's ODD.... maybe?

If they want soup with their takeout and you refuse, they might rage and trash the house, being told that it's time for bed might cause WW3 and, if you tell them they can not wear their swimsuit to church there just might be a major screaming fit. It does look like classic ODD - except that this is the way my kids tend to operate for any disappointment, any 'no' in their life regardless of where it comes from. It might be a little brother, the weather, a parent, a coach or the choices of anonymous TV programmers. Anything and anyone can make them mad, really mad.

FASD causes them to have extreme immaturity and the inability to normally regulate their emotions. They are often like a 40 week pregnant woman being told her due date is wrong and she is in fact only 38 weeks.....borderline hysterical and utterly unreasonable in the face of facts. They are also totally predictable.

Does this mean that they truly ODD or is their behavior simply FASD being acted out in daily life? The more I watch, the more I wonder if it's possible for FASD to be paired with ODD.


Stephanie S said...

I know what you mean. I'm wondering if it would take an additional diagnosis of something like Attachment Disorder (not Reactive Attachment Disorder, but AD, which is worse) in order to really have ODD as well as FASD.
I don't know; just my musings.

Kari said...

We've collected several mental health diagnoses throughout the years and I question them as well. Take, for instance, my son's diagnosis of Disruptive Behavior Disorder. Would he actually have that diagnosis had he not been prenatally exposed to alcohol? Aren't we just labeling a behavior that is a result of his FASD?

We know that many mental health problems are genetically linked and that some families battling generations of substance use have also battled generations of mental illness. It's hard to weed out what is what, but treatment for many of the mental health disorders is not effective for someone with brain impairment of FASD so we need to ask those questions.

My son's last eval included a mention of ODD. I know that his oppositional behaviors are almost always related to anxiety, frustration, or being overwhelmed (stemming from his FASD) so I don't consider it to be a true co-occurring diagnosis.

Interesting post, intriguing question.