Overall, I think it is a hopeful article. Focuses on what might cause these symptoms, important factors to assess and then what to focus on for treatment. It does give opinions about when medication may be called for (for the neurobiological co-morbid issues, for underlying issues, for resulting depression/anxiety/aggression issues).
I of course read it with a bend toward our home situation (adoption, neurological trauma, autism) so the things that jumped out at me will be different than others but here are some of the things I found interesting:
They discuss whether ADHD and ODD have a common pathway or are separate issues and discuss some of the ideas that support both ideas. They say the benefit of identifying ODD early is what we all know now, that early appropriate intervention is better than waiting. One way it is described evloving is when a 2 yr old goes through the normal oppositional stage, it continues without their developing the ability to self regulate whether due to internal factors, environmental factors and/or adhd.
As I read some of this I agreed certainly, but thought of my son's frequent-at times nearly constant- negative interactions from adults in his life and thought it should say parents AND teachers. I know he wears them down and that is why even when I am frustrated with them for being so grumpy with him, then expecting him to cooperate, I stay their cheerleader and remind them that they have the opportunity to make a life long difference in this kid if they can just hang in there.
This is huge for my difficult child and I hate it (the process that is) It is so hard to establish a new rule or routine in our house but once it is established, even if he hates it, he always does so much better. I am sure that is just common sense for neuro-typical households, but for me I have to consciously think about it because the process of establishing limits can be so physically demanding that it is tempting to just let things slide. I always pay for it if I do that though, so it is really rare I change a pattern once established.
