Letter to Kate
by Kate Andersen, M.Ed.
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?
First of all, here's what Oppositional Defiant Disorder
is, according to the American Academy of Child and Adolescent
"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
* 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
I hope this is helpful to you.
Best of luck!