Hang in there Jim! I know it can be hard to have people throw questions at you but remember, we are just a bunch of parents who have kids who do (many of us anyway) OUTRAGEOUS things...we have lived lives of people criticizing us for not being strict enough, picking the right consequences, not following through with behavior plans, not getting them ON medications ...for putting them ON medications and not getting them OFF medications, etc. SO each one of us can only speak to our own experiences and then as you give us more and more information, finally someone who has been in some similar shoes to you will ring a bell. No one is trying to convince you to do anything you are not comfortable with, we just are sharing our experiences and if it fits for you then you can try and if not move on to the next post. I have been here long enough now to know that people who take the time to post to you are doing it out of care and concern. Why??? Because we LIVE this life with you. We know the frustration of constantly beating our heads against the walls and having many good leads turn into a no-go for our kids.
Many of us come here especially for the first time, on days of total frustration.
when we discuss medications, I promise you, most of us have very, very mixed feelings. You are right that some medications can cause terrible side effects and they are not worth the risk. My son had such a terrible reaction to a medication recently he ended up in the hospital, then a new medication caused his seizures to get worse... sigh. But he is on some medications that without them, he would jump off a roof, NO LIE...HE actually has tried these kinds of things! So, having found medications that work, when they
really do, you can end up with a person who has a chance to realize their potential. There are many kids who self medicate to try to relieve things when appropriate medications are not found. medications, for SOME (not saying this will be for you) can end up allowing a person to not have a life behind bars, in a residential program/group home for years, or at the very least...not having every single day people mad at you which leads to a self concept of being "bad" and not good enough and in the end.....many of our kids do just live up to what people are now expecting of them--what they are used to themselves. But as parents we know what is under that. For most of our kids we have seen the real child under the behaviors and while it can be hard to remember on days when you get a bunch of phone calls about awful things they did or have the police involved....(sigh) we do try to hang in there, as it is clear you are doing too... to see if there is SOME kind of way we can help them.
I think it is an excellent idea to start reading The Explosive Child. There is another book of his called Lost in School which I am finding really helpful too. Next on my reading list is What your Explosive Child is trying to tell you by Doug Riley (or Reiley??? you can search here and you will see posts from him as he was a guest here several times).These books offer real ideas to try and it is not just a bunch of sticker charts and positive rewards or taking away every privilege which as you say at some point loses all effectiveness anyway. If kids do not have the skills to do better than a consequence or reward to just tell them to do the right thing is not going to work. They need to learn some skills which are often so subtle that it is hard to puzzle thru what to teach...or are so HUGE that it is hard to know HOW to teach those skills. Most psychologists and behavioral people will tell you to do the traditional parenting approaches though, and then we often feel life failures because our kids are actually wired differently. as you mentioned...from BIRTH. There is a ton of research on this now so we are not just giving you a line here...it really is true. (many of us work in related fields...social workers, teachers, therapists, etc... and we really do know how to run a behavior plan...and if it works, great...but for our kids, in general things just tank)
As others have said, when we look at a diagnosis of a child there are some that are more "umbrella" diagnoses which can be associated with symptoms that themselves can have an independent diagnosis (like ODD or CD) but which really "just" describe behaviors and do not offer much in the way of treatment. Many kids...even kids with neurological conditions like Autism can qualify for the ODD diagnosis. But clearly treatment for Autism would be with a different slant than treatment for a child with bi-polar disorder. both legitimate physical conditions, both resulting in ODD for many kids, but needing specific therapies. That is why it is hard for us to offer ideas without asking you a bunch of seemingly annoying questions, sorry...
So, you say he was like this since he was a baby... how did that look? Did he cry more than typical babies? Did he have any medical conditions? Did he attach well. Was he a kid who cuddled, made eye contact, hurt animals at a young age??? Did he ever (from birth through early childhood) have to be separated from you--his parents-- for an extended time due to his or parental illness?? How did he do with his milestone--was he exceptionally early with talking/reading etc.. or delayed?? Or just average..same for walking etc... (it may seem odd to go this far back but if we know then we can share what over time and CURRENTLY is helping our kids who have brains that are wired similar to how your son started out).
Did he have difficulty in school always? Kids who have ADHD and Executive Function Disorder can have extreme difficulty with the "breaks" in their brains. So, if something is wrong with the wiring that does not allow them to STOP and say... hey this could have X consequence that I dont want... or even if they can totally say what the consequence is but act as if "i dont care" then they DO need help to calm that impulse control problem. Research on this is very strong. Study after study shows that behavior methods alone or medications alone do not do the trick. The frustrating thing about medications is that if that IS a part of the answer, it is hardly ever easy to find the right medication. There are many less dangerous medications than Haldol and they are similar in class (risperdal, seroquel) and for my son they are awful. For many kids here they are the thing that is allowing them to live in a home, go to school, do social things, not be in a restrictive housing placement. There are some natural things too that really do help... Including diets that restrict certain foods/chemicals and vitamins or minerals that can help the brain to function better.
I am currently using audio visual entrainment for my son (AVE....feel free to google it) and have used and will start another session of bio feedback/neurofeedback to help him to calm himself and reduce impulse problems. We are also doing metronome therapy which has really good results for many..we have just started so unlike the other two I can't tell you yet that it is effective for us... but the first two really make a difference. My son has had a hard month. He recently started nto being able to sleep which of course causes more problems. the AVE unit for the last week has allowed him to fall asleep within 15 minutes of starting it. I am amazed...sounded like hocus pocus to me but I have tried it myself and I get it. (of course I have read the research too, if interested I can PM you to connect you to someone who has rental programs so you dont have to make a big financial investment). My son also uses an FM system to help him to focus on instructions from the teacher. Many teens would not want to wear a personal one (like hearing aids) but there are speaker systems and no one knows who the system is there for. This type of thing is showing promise with kids with adhd, and many other conditions.
So, here are some things for now...if these things fit:
1. See if you can get a complete neuropsychologist evaluation. These psychologists have extra training in the brain/neurology and are able to help connect the dots between behavior and how the brain works. They are able to give more options as to what might be driving things. Nothing is a miracle but this can really give you some direction.
2. Do a complete Occupational Therapy evaluation looking at motor skill development (many things are very subtle and the history of issues, even if resolved now can give a clue) as well as sensory integration issues....because if this issue is any part of what is going on (and is often associated with ADHD) then there are some concrete, non medication things that can be done to help with frustration tolerance, impulse control, and general regulation/neurological integration of the mind and body.
3. Consider a therapeutic boarding school or a residential treatment facility or shorter term treatment programs which are intensive like IOP-Intensive Out Patient programs, wilderness programs (not the scary boot camps you see on tv where kids are abused, actual regulated good programs working with kids on issues like your son has). I would not do a typical boarding school as kids there form groups and have behavior issues that go off the radar of staff just like in any school until there is trouble. In a therapeutic setting that is on the table to begin with. Their goal is to help develop better skills to make better choices in life.
There is still a lot of hope because at his age, his frontal lobes have not fully developed. And mostly there is hope because he clearly has a parent who is really concerned and supporting him. Until his mid twenties things in that sense are still changing and if you can find a team who can support his choice making and alter his self concept to one of wanting to do the right thing there is still a chance. Are we all successful?? NO. Sadly, some of our kids end up learning the hard way. Some of them dont learn even when faced with the hard way. But I hear in your posts that you are not at a point where you are willing to leave that to fate. (and for some of us, there are times we do have to let go after trying all we can...either in part or totally, until they want the help for themselves.) You sound like a really caring and desperate parent as we all here are.
(oh, I forgot, what you said about Paxil was interesting. I had been on Paxil years ago, and stopping it suddenly did make my depression symptoms terrible....but I dont think it was anything like heroine with-d would be though I would never doubt that there are individual cases and being in a profession where you see the worst of things, it is really hard (I know this myself-when you work in Special Education you see the ugliest of issues at times...very scary) very hard not to think the worst will happen to OUR kids....
What happened to me--a sudden stopping of Paxil for several days--when I forgot to get them from the pharmacy and it was a holiday and I had to wait a few days to order and get it filled, I experienced a lot of sadness and tears...no physical sweats or anything though, though I dont doubt everyone is individual and it could happen.---but when I really did stop I did it slowly and had no problems at all, and several relatives in my family have used antidepressants and they have all gone off without any severe symptoms..... being on it though saved three of them from killing themselves, I really believe that).
Well, if you have stuck with me through this, I hope it helped a little. If nothing else I hope you realize that there are people here who really do care and know the frustration of having a child who feels out of control. It is a really hard parenting road. Wishing you all the best....