5 year old diagnosed with ADHD, defiant and conduct disorder

My 5 year old nephew has been getting to the point of being uncontrollable. He doesn't listen to anyone and isn't remorseful for his actions. He's been suspended from school several times, he's also been suspended from the bus for inappropriate behavior. He's been hitting other children almost daily, and even went as far as cutting a child's shirt because the child didn't listen to him. He hits, bites, claws, throws things at teachers and defies all adult authority, especially when he doesn't get his way. He threatened to burn the house down and kill everyone in the house...this is coming from a 5 year old child.

The doctor received medical, daycare and school files since he was two, and said this just didn't start, it was already there since he was two. He's been to counselling in the past and has gotten special assessment for his behavior but never did anyone tell my sister he has ADHD and more so.
It's only gotten worse since then.

Out of the 3 the doctor is most concerned about the conduct Disorder because he said he is already in the end stage of conduct disorder. He recommended medication starting immediately, counselling and also will be put in a class for children with special needs.

Help me to understand what is happening here. How is a 5 year old even able to come up saying such violent things. Isn't it children learn what they are taught? My sister has been more than loving with this child. The child is part of a custody battle between her and the father. The father gets visitation and the boy would show exaggerated symptoms when he would return from these visitations but the doctor said that isn't the cause of why he has these conditions? The system made her hand the child over for 9 straight days a month when he was only a year old. The child would scream his head off when separated from his mom, so I disagree, the stress of being separated from his mom at such a early age I'm sure contributed to making his condition worse,.

Hi,

I sense your uncertainty about how to deal with this; and I think that I'd be freaking out if I was in your situation. There are some things that I think you shoulkd do to get help though. Firstly, talk candidly to the doctor and get assurance from him that the actions he's taking (medication and counselling) is the best option. I mean, it could be that he's just trying to pass you on and make your problems someone else's business. So, really grill him about this, and get him to explain the medication, what the side-effects are, if there are any past success stories, etc.

Also, I think that you should arrange to talk to the principle of the school that he was expelled from, to see what your options are there.

Finally, talk to the boy himself and ask him what he wants in life. This might be a long shot of an idea, but maybe part of what's happening here is that there's miscommunication between him and the world aroumnd him. People usually lash out when they dont understand things around them as it can make them feel 'edgy' and nervous; they also lash out when they dont feel loved/appreciated.

kevin

The principal is treating this very seriously as he is gone to the point of hurting his classmates. Counselling will also be a part of the recommended treatment, so hopefully something will help open him up so he can talk about it.


Can these disorders be misdiagnosed? Could all these problems have stemmed from the stress of being caught up in a custody battle?, or is the doctor right in saying it has nothing to do with it?

mothersdaughter wrote:The principal is treating this very seriously as he is gone to the point of hurting his classmates. Counselling will also be a part of the recommended treatment, so hopefully something will help open him up so he can talk about it.

If you are in the US, your son is eligible for services from the Committee on Pre-School SpEd in your district. Contact them to arrange for an evaluation. They are responsible for testing and providing an appropriate placement.

mothersdaughter wrote:Can these disorders be misdiagnosed? Could all these problems have stemmed from the stress of being caught up in a custody battle?, or is the doctor right in saying it has nothing to do with it?

Absolutely. You need a second opinion. Psychological issues can cause behavioral problems that can be dismissed or overlooked, particularly if the doctor isn't familiar with this type of problem.

Thanks, my sister and her son do not reside in the US. Luckily this child is now eligible for special needs classes in her area that will deal with her son's behavioral problem specifically.

The doctor who diagnosed him deals with child behavior problems, that's why there was a long waiting time to get in to see him. He isn't the only child with this problem which makes me wonder why ADHD etc is so prevelant these days. I often thought he had autism, and who knows maybe once they start treating him, and getting to know the child better, maybe they will add that to his diagnosis as well.

maybe he's just a psychopath.

insincerity wrote:maybe he's just a psychopath.

In the DSM-V and ICsomething-10 the word psychopath does not exist, you know. "psychopathy" only tells us what we already know.. "cold hearted evil bastard".

Personally, I certainly don't know everything, but I find it very hard to believe that a 5 year old could be this way without being either abused or witnessing seriously inappropriate / aggressive behavior from others.

I have known various kids that were significantly violent at that age, and yes expelled from school for hurting other children, extreme anger and defiance.

All of the kids I knew were abused and witness to domestic violence etc.

I mean how does a 5 year old understand about burning down housing and get the idea to use them as a threat? It is hard to believe, that he has had no examples of this type of bad behavior in front of him.

If this child has been abused or witnessed domestic violence/ threatening etc, I don't believe medicine is the right road.

If he has suffered no abuse at all, and not seen violence, then wow.

I have a eight year old with ADHD. The school has tried all methods of helping him and he still will not comply. I and his grandmother know what his problem is but his mother will not accept it. He hates them and loves his grandmother and me and wants to live with us, (we raised him from birth) and then decided to give him back to his mother and step dad who abused him. The school is putting him in a special class just floor him and the teachers.

It distress's me to see him self destruct at eight years old. Thoughts please. questioner 1

I personally believe that conduct disorder (when in conjunction with ADHD) is partially caused by environmental factors, such as inappropriate parenting techniques for a child with ADHD.

I had some symptoms of it when I was a child and teenager. I broke my mothers shin when I was 5 because I bashed her leg hard with a cricket bat, and I threw a chair at the school principle during my first year of school etc etc.

I have personal experience with kids with conduct disorder and opposition defiant disorder, although I am not a professional.

Its going to take a combination of medication, and intense family/parenting support to manage a kid like this.

Its also critical the diagnosis is correct.

Assuming the diagnosis is correct stimulants may help (probably will help) with the ADHD side, but often doctors prescribe atypical anti-psychotic medications to help with anger. I have read a LOT and I am not sure if I can post specific recommendations. If you are interested in further discussion (such as some questions to ask the doctor etc), your welcome to PM me.

Most of my life I have suffered from "stress induced" fits of rage and emotion. For example when I was 13 I flipped out and destroyed my fathers car and house (well I broke various windows and many big holes in the wall).

I personally take a low daily dose of a medication called Abilify, because it works for me, and if you search on pubmed there are quite a lot of studies indicating it is very good and probably superior to other such drugs for aggressive behavior. But such medications have risks, especially in children.

However I can tell you from my own personal problems with aggressive behavior that there are a lot of parenting and environmental things to take into account as well. You really want a holistic approach. What you really need is a very good medical expert.

Best wishes.