With regards to the medical diagnosis - this is the back story, sorry it's a little long winded:

So our eldest was born with 2 holes in her heart. She is the one suffering ODD. She was a difficult baby from the very outset, she wouldn't feed and was in hospital for the first 3 months of her life with her mother living in with her and me providing relief outside of work so she could get some much needed rest so it was a round the clock affair for 3 months until she was released just in time for Christmas. Of course this took a toll on everyone involved. She went round after round of tests, had a feeding tube and had to be fed through this every 2 hours, after which she would guarantee to throw up and need changing and cry the entire time and need to be carried around the halls of the hospital to attempt to stem the constant crying. While my daughter won't be able to remember any of this, it would be remiss to assume there was no psychological trauma left.

Fast forward 4 years and she had to go in for open heart surgery. She was old enough to understand what was happening and while we were as gentle as we could be, we couldn't shield her from the truth and we kept up a positive strength with her to help bolster a confidence in her that we lacked ourselves. To say this was traumatic is an understatement and I think all of us share in that trauma - some of which remains to this day. The killer was when she asked how we could have abandoned her at the hospital to be cut open like that... if you ever want to feel like you were cut in two and had your beating heart ripped out of your chest - that was that moment. We were by her side throughout, but there is trauma that she most definitely needs help with. In fact, in many ways, I think there is trauma all round that we'd benefit from help with.

We resisted for ages going for medical diagnosis because we didn't want to be "those parents" - you know, the ones that medicate their kids because they just can't cope with kids being kids. We asked ourselves many times if this behaviour was just normal kids and that our perspective was just skewed. In the end we went in to the hospital after our eldest had a throw down tantrum where she was looking like she was going to cause serious physical damage that lasted for too long to ignore and we sat down with the psychiatrist and said to them - we're not looking for medication, we're not looking for her to get a psychiatrist, we want real honest to God unbiased, objective advice on her behaviour and if this is normal and our perspective is whacked or if she needs medical assistance.

We all did questionnaires, her school teachers did questionnaires - we were very forthright with the teachers and told them what was going on and what we were experiencing at home and asked them for their input and gave them our support.

One thing I learned from this is that most teachers won't raise their concerns with parents because more often than not, parents will come back with the attitude "that's your job, they're our problem at home, when they're at school they're your problem" or if the teacher raises the prospect of the fact that your child may have something that needs to be dealt with professionally, parents get defensive. Our going to the teachers I think was liberating for everyone involved - the teachers thanked us for our support and have been incredibly incredibly supportive with us in return.

Anyway, after a week under observation at the in-patient psychological wing of the hospital and having in-class support at school, it was determined that our first does indeed have at least ADHD and suspected ODD.

Is there stigma? Yes. Does it affect how she's treated at school, to an extent yes, but on the whole the staff have been amazing and collaborative with us. Building a relationship with them helps a huge amount. Frequently the problem kids that you hear about being ostracized and mistreated are because the teachers have little choice but to remove the problem from their class to spare the rest of their class and that they have absolutely no support from the parents. Knowing that they have our full support and that we have theirs has been very reassuring. I know they're both treated like gold at school and their teachers have nothing but positive things to say about them both which considering the difficulties we've gone through, I'd say I'm very thankful and incredibly grateful.

> Their reactions to negative behavior aren't enough to prevent him from doing it.

With regards to your point about societal norms - if the negative behaviour hasn't been enough to prevent him doing it, it doesn't matter to him enough right now to make him change his belief. Eventually he will either become self conscious enough to change this, or he'll find a sense of style he enjoys that will change this, or he won't care and if he doesn't care - does this really matter? Only he can really answer that.