Aggression in a 4 Year Old

I don't believe in the "Boys will be Boys" theory. I think that's an excuse.

In your case, it sounds like there are issues that need to be medically or psychologically addressed. Even rotten kids know not to kick a baby in the head, so I'm leaning more towards something that needs diagnosis and treatment.
Now that other people (such as your baby) are being affected, I'd call the counselor back and let them know the situation has become more serious and see if you can get in more quickly. If not, I'd ask your pediatrician for another referral and not give-up until you have some quicker resolution.

Good luck! I hope they're able to diagnose this issue quickly and prepare an effective treatment so you can have your child back well.

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I'm not a medical expert, but if I were in your shoes, I'd consider getting psychological testing done for disorders like ODD, ADHD, ADD, maybe Aspbergers, bipolar disorder, or schizophrenia (on the extreme end). Some of these disorders share some characteristics of "violent/aggressive" behaviors.

There are many books on the topic of "Spectrum" disorders. Maybe check them out, and see if any of the information seems fitting for your experiences.

You can have a private evaluation. However, some school districts will provide an evaluation too.

http://www.amazon.com/Defiant-Child-Parents-Oppositional-...

http://www.amazon.com/Kids-Syndrome-Aspergers-Tourettes-B...

http://www.amazon.com/Autism-Spectrum-Disorders-Understan...

http://www.amazon.com/Autism-Aspergers-Diane-Drake-Burns/...

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If you have a very aggresive 4 year old child, I would suggest either a child psychiatrist or a Developmental Pediatrican first. A counselor, therapy, or psycholgist are good treatment options once you know what is going on, but start with a medical professional.

I would suggest a child psychiatrist who is not on any insurance plans (if you have out of network bennefits) because you will get in quickly and it sounds like that is something you need right away. You may pay more, but it will be worth it if you do not have to wait the usual 6 to 8 weeks for the first available appointment.

I feel your pain, when lay people hear about children with behavioral issues, they first try to blame the parenting style or suggest what worked for them with a nureologicaly typical developing child has never been tried. It is not that simple when something has gone wrong with the way that a child processes information or percieves the world. Brains are organic, flesh and blood organ systems, and sometimes, they have issues that need intervention before trypical dicipline will work. A child who has a kidney ailment that interferes with continence is not going to benefit from potty training until the physical issue is resolved either. It is human nature to under estimate how difficult parenting is when a child's brain development is off kilter, traditional dicipline does not work, and that child needs help that has nothing to do with what the parent is or is not doing.

Stay strong, keep the counselors appointment, but explore medical options that will get you help next week if possible. He is probably more miserable than you are.

God bless,
M.

With the examples that you added, I would suggest both a psyciatric evaluation ASAP and an appointment with a Developmental Pediatrician, which will likely be farther off. You need help now, but he needs a full evaluation that will incoperate all the professionals that he needs and will miss nothing. Call both in the morning, you can find developmental Pediatricians at children's hospitals, and if you call NAMI in your area, they may be able to find you a child psychiatrist in your area that can see you right away. NAMI will have a lot of resources that will help you. Good luck.

One more note! Schools will evaluate, but you need to own the evaluation that contains your son's diagnosis. For behavioral issues to this degree, you are better off going with private providers and not bringing the school into the pictures just yet. Even though you certainly could, it could cause more harm than good until you know yourself what he needs and you can protect him from the very people you might be entrusting him with. Unless you are sure that there are educational delays, speech delays, sensory needs, etc that need school based instruction, you are better off to stay private until you have a handle on the behaviors. You don't want to turn him over to the schools where restraint and isloation are often used as the easy way out for behavior that needs theraputic intervention.

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Hi A.

My daughter will be 3 in Sept she is doing the same mostly to me. Just last night she pulled my lip so hard it bled and then tore out some of my hair for no reason..... but I know exactly what you are going thru she broke windows toilets I could go on but I get the same thing from people "oh it's just a phase" ..... I just hate it when people say that because they have no idea........... I have taken my daughter to sevarl doctors and we are still trying to figure out what makes her so angry the worst part is she is not talking all that well so daily life is so hard right now. I just want to let you know you are not alone I wish you all the best

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I don't have any advice. I just wanted to wish you luck and support during this trying time. It's hard enough being a mom on an average day....not to mention when you are thrown a curve ball.

Do everything you can to get in to see a doctor earlier. If you can't, sit tight and do the best you can.

Also, take care of yourself. It's so easy to get wrapped up in family and lose yourself.

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Mom,
I would call the clinic where you have the appt and ask to be called asap if there are any cancellations to get your child in sooner. Also ask yourself has something changed at home or preschool recently like a move, separation, divorce, job loss or loss of a friend or family member, cange in daycare arrangement? Your child he needs to be seen asap for this agressive rage and violent behavior. Do you have a pastor who you can meet with you and your son that he would talk to and maybe get to the cause of the anger and make suggestions for you and your son until the appt. I would for sure call the Pediatrician bk today and let them know the 1st counselor you found has you on a 2 mo. wait list and this is not going to work. Also I am concerned for your safety of your baby and any other siblings at the house and would definitley not leave the baby or your child in a room unsupervised until the appt. In this cae you must be your child's advocate and get pushy if you need to in order to get the care he needs. If you have med. insurance call the provider customer service no. on the card and see what other child psychologists are in your area to see that are covered by your ins. There has to be more than one to see I would hope.
Hang in there mom.

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I was just wondering, did these episodes where he would calm down just start one day? Had anything changed in his life? Did he start a new day care/school? Was anyone new introduced into his life? I know that adding a family member can be a stressor to an older sibling, but you are right in saying that his behavior goes beyond the norm. I guess the first thing I might do is think back to when all of this started and just see if you can identify any particular change. I was abused as a child and I would fly into huge fits of rage bc i didn't know how handle the emotions of what had happened. Therapy did help, I still look back with really warm feelings toward the therapist I went to. The thing that helped the most though was my mom's prayers. She literally pulled me up in her lap one time after I had actually left a note about wanting to die and she prayed for me. God really touched me and I was a really different kid after that. She didn't know what to do, she was getting me help and it was good, but it couldn't reach into the depths of my heart in the way God can. So never underestimate a mamas prayers:) So if you noticed this come on suddenly and you can remember about when you may want to ask your son questions about that time. Like, "remember when you started _____ school?" "Boy that teacher Ms. _____ is so funny" and then just see what he has to say about it. He may have a physiological thing to work through, but if I saw rage in my kid, the first thing I would do is lovingly snoop around to make sure something traumatic had not happened to them as this can easily be overlooked due to the focus on the outward raging. Just wanted to throw that out, not saying anything happened or wanting to freak you out, just wanting to help. I am doing great today and all the help my mom gave me and got for me is a big reason why and it sounds like you are doing a really good job to try and help your son sort through whatever is going on with him. Hang in there!!:)

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Could food allergies be a factor? My son was out of control until I figured out what he was reacting to. It took me 5 years and lots of doctor appointments until I finally figured out that gluten was the offending allergen. Once I cut that out, he was a totally different child.

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This sounds like it could be PANDAS to me. My daughter has this. It has components of OCD, ADD and aggression, but is not caused by a chemical imbalance like those things can be. It is caused by a common strep infection (or sometimes a virus.) Before you stop reading and say, oh but he has not had a sore throat, please read on...

It is an autoimmune disease that often has NO symptoms other than the psychiatric ones. Often the child will not have a sore throat or any indication that they are sick- this is because the body is not recognizing the strep in a "normal" way and is instead attacking ITSELF, causing the brain stem to swell and the behaviors to flourish.

Since it is an issue with brain swelling, you see it manifest in a variety of ways, but here are some common themes:

-OCD which is different in children than in adults. It can be anything from the child getting upset because you don't do something EXACTLY the right way, to asking you to repeat a word a million times over, to having to have ONLY the blue toothbrush, etc. This can range from mild to VERY extreme.

-Bed and day-wetting problems, or issues with not wiping or wiping too much. More common in girls (and obviously you would see the regression in a child who is potty trained, not one still in diapers, etc.)

-Regression in other areas- babytalk or made up languages, drawing or handwriting is changed, slanted strangely compared to usual, crowded in margins, or has regressed (stick figures versus more elaborate drawings, etc.)

-Randomly not knowing how to do something they have always done. This can be anything from tying shoes and suddenly one day not knowing how (and frustration ensues) to being almost catatonic and not understanding how a doorknob or shirt works. This will look like deliberate, willful disobedience or the child ignoring you.

-Enlarged pupils and a "wild" look- like a switch was flipped suddenly. Pupils will often remain enlarged for days, weeks.... The wild look can come seconds before a rage attack on a thing or person, and then often it fades just as quickly as it came on.

-Not remembering the aggression, or apologizing for it and begging for help. We have personally run the gamut from her going limp afterward because she is totally physically spent, to apologizing and begging us for help, to her not even knowing anything happened. We suspected seizures but have had numerous EEGs to rule those out. It is creepy when it happens!

-Sensory issues. This can range from problems sitting still, to being overly loud, to being sensitive to sunlight and mildly loud noises, to not being able to have seams in socks. A lot of kids will SEEK sensory input and rock, spin, run around, hit things, have to touch something rough or smooth, roll on the floor, like to swing, etc.

-Tics or Tourette's Syndrome. Some kids will have something as simple as a repeated sniff that looks like allergies, or eye-blink and some will have big motor tics like shoulder shrugging. Some have none, but it's a common factor. Onset of this seems to be more around 7 yrs old, however.

If any of this sounds familiar, then I would suggest posting to the PANDAS support forum and trying to get an appointment with Dr Kovacevic (in Oak Park) who is the best (and maybe only) PANDAS dr in our area. In the mean-time, get to a pediatrician and ask for a throat culture (a quick strep swab AND demand a 72 hour culture as well.) This will give you info for Dr K but not necessarily prove anything. There is NO definitive diagnostic (blood) test at this time. The preventative for the autoimmune malfunctions and the rages are antibiotics or in some cases, IVIG (a blood-product infusion given by IV.) IF he does test positive on the throat swabs, you can go ahead and get him on antibiotics quickly to help his body calm down in the meantime until you can get in with Dr K.

If you have ANY questions, please don't hesitate to ask me or ask on the PANDAS board. For some reason, ages 3-4 seem to be the time these particular kids go from quirky to really starting to rage- maybe the brain swelling has just gotten to be too much by that point. This is NOT a fatal disease, but it can involve the heart (with Kawasaki disease) if left untreated, so it's best to rule it out.

Here are some sites for you.

The PANDAS
http://www.latitudes.org/forums/index.php?s=a7bf0ccd1dc89...

Dr K's website:
www.webpediatrics.com

And more information and case histories:
www.pandasnetwork.com

My blog with some of our story is here:
www.chickiepea.wordpress.com

-Manda

I'm afraid I need more detail. What is it that you are dealing with? What are the behaviors the child is exhibiting? Have you discussed this with your pediatrician?

Okay, after reading your examples I have to ask: What do you do when he does these things? What techniques have you tried to stop it? Do you do the same thing consistently?

It sounds to me like he is raging because he does not know how to deal with his anger appropriately. All you can do is remove him from the situation. Do not attempt to talk to him, reason with him or negotiate with him. When he has these episodes, I suggest that you immediately remove him to a completely empty, safe location. If you have to empty his room of toys and turn to doorknob around so the lock is on your side, do it. He's probably too big to put into a crib, so his room is likely what you'll have to use. If he DOES find something to break in there, make sure that you take it out to the big trash can and sadly throw it away. Do not attempt to fix it, since he broke it in his rage he should deal with the loss of that item.

Hitting and kicking is unacceptable and he should not remain in a location where he can do it again nor should he return until he has calmed down.

If he is having tantrums let me know, I have a previous post which will stop those immediately but need to go find it to cut and paste it for you.

Luck!

I thought my 3 year old was bad, but wow I can not imagine....so sorry you are going through this. While you are waiting I would try to contact John Rosemond on www.rosemond.com (you have to become a member for him to answer your questions in the "membership area" on the left) I am reading his book "Parenting by the book" and it sounds like he has seen it all in his career. Would not hurt.

What kind of aggression and problems exactly?