Both are extremely hard to parent but I'd take ODD over RAD any day.It seems that a lot of kids with RAD also have a diagnosis of ODD
I have a RAD child and she is attached to us. There are two forms of RAD. Since RAD seems to run on a spectrum I find that it varies so greatly. Our Twin B is affectionate, calm (tantrums less than Twin A who doesn't have the diagnoses). They both have difficulty following instructions. The RAD child doesn't want to do it. The ODD child can't do it.
I believe that by definition ODD can have multiple causes but is likely genetic, but the R in RAD means reactive(?) and therefore must be in reaction to something that happened (neglect, medical etc.), not genetic.
This is a great way to think about it. The two go hand in hard and often seen together. RAD is about attachment and relationships. ODD is more of a PTSD reaction. So the difference is in the root cause, not so much the behaviors. A RAD child will fight because they are scared of relationships. They don't want anyone to be in control of them. An ODD child fights because something triggers the "fight or flight" response in them. Again, it may be about control in that you ask them to do something and it triggers in them that when someone else is in control, it is harmful. So they fight.It is hard to tell them apart. And they are very entwined. The biggest thing - is it in response to a relationship? If so, its RAD based. This is why RAD kids are so much worse at home. They are reacting to a relationship. In school, there is no real relationship expectation. If its ODD, it will come out everywhere.Does that make any sense? I kind of rambled....
The RAD child doesn't want to do it. The ODD child can't do it.
i have one of each. the ODD kid was tough--he needed limited choices, some control of his environment, and a calm demeanor when the ODD went spiraling out of control. he had all that compounded by ADHD and bipolar. he would be defiant unless he felt he had some control. he was and is totally attached, has the ability to be loving and affectionate in a genuine way, and has made a good marriage, is a dad to 2 older kids who were an extra-good bonus with his lovely wife, and they're now expecting a daughter in September. it hasn't been easy for him--he still struggles with the idea of authority over him, has had a bunch of growing up to do, and has bounced around a bit with employment due to his issues. he's chosen to be a diesel mechanic--his inclination is to work with his hands in a physically demanding job so that he expends much of his energy. he's learned to adapt. the one with RAD is on the mild end of the spectrum. he was very interesting at 4 when he came. he hugged random strangers but was evil to me. i was the mom and he already had one to whom he was attached in his own way. but he didn't trust her--she didn't meet his needs, refused to take care of him, had drug and alcohol issues, and eventually lost him. RAD comes with crazy lying and defiance (like ODD) but is more calculated in its response. this child did not trust that i would be able to take care of him. he didn't believe he was safe. he did all of the lovely behaviors involving bodily fluids and excretions. he hoarded and gorged. he was unkind to everyone including the animals. he bit and kicked and scratched and only once acted out sexually. over time, with consistant treatment, plenty of food and security, and love, love, love, this child has been able to learn that we are trustworthy. he needed almost no control in the beginning--we chose everything for him like we would a baby. over time, as he's improved in his responses, we've lightened up. we're 6 years in with this kiddo and it's looking much more normal--he eats like a regular kid, hasn't peed on stuff in over a year, gives hugs only to the family and good, good friends, and runs to me when he's hurt or scared. let me say that this is all his doing--he was able to heal himself. some can't. some are also lots worse than he ever was--and he was a ring-tailed tooter! the ODD kid wanted to be good, to do the right thing, but was chemically unable to do so. treating his ADHD and bipolar gave his brain a fighting chance to make choices, but i tell you that this was his issue almost from birth. the RAD kid was hardwired to fight me for his survival by his experiences. he had no reason to believe that i was safe until he saw it for almost a year. the older one trusted that i would care for him. the younger one had to learn it. they both fought me, though! which would i choose? NEITHER. they both suck. and while i birthed the boy with ODD, i chose the one with RAD! i wouldn't change a thing.
I didn't read the responses so I'm sorry if I'm just repeating someone else. I'm an LPC, and I broke out my DSM for you :) These disorders are easily misdiagnosed and many clinicians are quick to slap an ODD label on a kid who may actually have more severe problems. ODD is less severe than RAD and typically does not include aggression towards people or animals, destruction of property, or a pattern of theft or deceit. To be diagnosed with ODD the child must have at least 4 of these behaviors: loses temper, argues with adults, actively defies or refuses to comply with adults, deliberately annoys people, blames others for own mistakes, touchy or easily annoyed, often angry or resentful, often spiteful or vindictive. In addition the child must also display a significant impairment in social, academic, or occupational functioning(not exclusively occurring during the course of a psychotic or mood disorder, not meeting the criteria for conduct disorder, or antisocial personality disorder). A child with ODD is at greater risk of developing antisocial personality disorder as an adult if the do not achieve stability. Also, ODD often further develop s into Conduct Disorder which is much like RAD but not necessarily stemming from attachment problems. Children with RAD have had a negative attachment(or many) experience. They will often initially present as peaceable and well behaved and won't exhibit behavior problems until they begin to feel safe and the honeymoon is over. They do not understand how to trust or how to love or be loved. These individuals are prone to anger outbursts including aggression to people and animals, destruction of property, and serious violations of rules. These individuals are also at a greater risk of developing antisocial personality disorder if they do not achieve stability. Kids with either diagnosis are not a lost cause. They can be helped! They can develop into normal, happy adults. It can take a long time, I would say a minimum of a year for progress, and there are often multiple times with regressing behaviors. Its a battle, a huge battle and you need tons of support and a great therapist and tons of prayer. Check out Karen Purvis, The Connected Child if you haven't already done so (but I'm guessing you have already done that, since you sound like you read a lot!). Generally, children want to attach to their caregiver and a child with RAD fights that desire tooth and nail. They 'know' that if they let their guard down they are done for and are going to only lose; they don't get it but they can. For your little one: Zephaniah 3:17 The Lord your God is with you, He is with you, He is might to save; He will rejoice over you with gladness; He will quiet you with His love.
Your responses have been incredibly helpful. Thank you. If I am to understand correctly, then, a child with extreme ODD should be defiant just about anytime someone tries to exercise authority over them, or at least exhibit such characteristics in more places than just at home, right? And a child with RAD would present similar behaviors to a child with ODD, but it would only present itself if their brain has caught on to the fact that someone is trying to attach to them, right? Does that mean that if you have a child that has outbursts to the extent that they break things, that they lie constantly, steal, and try to manipulate others, but only do it at home, that they are RAD? We have a case that is definitely not RAD, but maybe somewhere on the attachment spectrum, but we also have a therapist who has thrown around the label of ODD (not a therapist trained in attachment or trauma issues). It is so hard to tell right now, but we need help. We need to address the behaviors correctly, because after 2 years I feel like we are just spinning our wheels. I have, indeed, read The Connected Child. I love it. I am using it. Ok, I am TRYING to follow of Karyn's advice. It is difficult, and doesn't very often seem to get to the source. So....still kinda wondering if we are dealing with a child that just plain oppositional, or if we have a child that is really struggling with attachment.
not necessarily on the breaking/lying/manipulating. that's present in both sometimes. my oldest with ODD did all of those things. my youngest with RAD does them also. their reasons are different! i don't think i can explain it well, but Sonny did those things because he could, Bubba does it because he thinks it's a way to push me away. Sonny's aim was to show me that i could not control him coupled with his need to be oppositional. Bubba's goal is to break up with me before i break up with him. Sonny found a place of remorse for his actions once his amygdala let go of his actions. also, he sometimes was so completely hijacked that he had no memory of the things he did--and i really believe him. Bubba, no matter the level of his reaction, remembers it all and feels that it was something that we did to him. for him, it's a matter of survival to deny his responsibility for his actions. Sonny has learned how to deal with the impulse to fight. Bubba is learning--and attaching. i would also suggest an old book to you--The Explosive Child by Ross Green. it saved our lives with Sonny and is useful with Bubba.
Bless your family! That is a hard road and I bet you guys are simply exhausted. Some RAD kids only act that way at home but others will act that way at school etc as well, it can vary and depends on severity. If the therapist is not trained in attachment then they would probably stick with a diagnosis like adjustment disorder nos, odd, or conduct disorder. Not to say they don't know what they are talking about, because they might be great, but that is just likely to be what they are more comfortable with. Finding a good therapist can be hard, my father is a psychologist and knows all the clinicians in our area but his referral list is very short.We like the connected child for the most part, I agree it isn't a catch all but it does have some good ideas :) Good luck with your sweetie!ETA: if a child with ODD begins to display destructive, manipulative, or aggressive behaviors the diagnosis should be ruled out and a diagnosis of Conduct Disorder should be given instead as those behaviors are more severe. That is what should happen, but some therapist will just not bother changing the diagnosis and just keep ODD. However, according to the DSM those behaviors are not consistent with ODD but they are with CD.
While many of the behaviors may be same, these are two different disorders. RAD is basically about the child pushing away closeness. They may do that through aggression, manipulation, arguing, lying, stealing, etc. ODD is basically about rejection of authority. This may also be seen as aggression, manipulation, arguing, lying, stealing. Its the root cause that is different.GreenRobin brought up a good point. A child with RAD doesn't feel remorse, but a child with ODD does feel remorse. I have a child with each. They may both become agressive, but the RAD child doesn't see it as a problem. The ODD child can be genuinely sorry that it happened. My ODD child can feel love and can express that love.