Aggressive 3 Yr. Old

Possibly a milder form of autism???

Hi S., I know he seems young but he could be having sleep apnea due to enlarged adnoids and or tonsils. I would suggest she see a ENT. Hope this helps.

Why dont you suggest the parent take him to an Ear Nose and Throat doctor just to make sure he doesnt have some problems.

Have you thought about possible autism? he could be on the autism spectrum - esp. the dev. late and isolates self....

2 things come to mind off the bat when I read this,

1- could be Sleep Apnea causing the behavior symptoms and weight trouble and fatigue.

2- Possible Aspergers but Kind of early to tell...

I would reccommend a sleep study to your friend. Havve him go see Dr. Mehendle the ENT and you can request a sleep study through the pediactric sleep study center in Plano...

A great place for evaluations is Our childrens house Baylor. I would go to the Allen one because I don't think the Frisco one files with insurance but I am not sure of that.

Hope that helps.
A. J

You are a great friend to help them out. Your friends are so blessed to have you.

Sometimes it is difficult for a parent to really describe to the pediatrician the magnitude of behavioral problems so they are often overlooked until a child begins school. From what you described it almost sounds like a form of depression, but I'm definitely no MD. With my experience in child development, however I have seen that usually if a child is immature or developmentally delayed in language skills, he may use aggression because that is how he communicates to get his wants/needs met. It is important to encourage him to "use your words" This will need to be repeated over and over. Give him examples of what he could have said/done differently. But be sure to praise him when he does use his words to reinforce the positive behavior. Reading to him and singing to him is a wonderful way to encourage development of language skills. Also there needs to be consistency with discipline and logical consequences for inappropriate behavior. If he doesn't know what the boundaries are, he will not feel secure and will not transition easily. I would encourage the parents to lay it all out to the pediatrician. They can also go to www.loveandlogic.com for practical parenting and discipline strategies.

S.,
How are his speaking skills? Example: Can he speak in sentences, or effectively communicate what he wants? It could be a speech problem, and he gets frustrated when he is not understood. However, with the symptoms you described, I would suggest the mom have him tested for autism. Moms don't like to hear that though. My brother had many of the same symptoms: he isolated, did better in a comfortable environment, slept a lot (still does), deep sleeper, sleeps at random times, and he was diagnosed as autistic 8 years ago. I have also worked with autistic children that had many of the same signs. It could very possibly be something else, I am by no means an expert. If it is though, the earlier the intervention, the better it is for the child. You're an awesome friend to be concerned, and I hope this mom can appreciate your efforts! Good luck!

I strongly suggest you research sensory dysfunction. My youngest son has this issue. While other people would just classify him as a discipline issue, I knew in my heart there was something else going on because his behavior didn't match up with his character. In short, with SD the sensory data that comes in via eyes, ears, touch, etc. is not deciphered correctly in the brain and produces an inappropriate response. Often the kids end up in a fright/flight reaction, such as when you are walking through the yard and sudden walk through a spider web and you instantly start ducking your head and moving your arms. This is how I saw aggression in J in social settings or really any time the pressure was on (i.e., in the doctor's office). On the outside J looks like any other boy his age and intellectually he's right on, but he is also about a year behind in social development, motor skills, and motor planning (the ability to subconsciously mentally sequence your steps to produce the desired result). If you think this might be a fit, check out The Out of Sync Child. Also, we did therapy with Excel Pediatric Therapy in Rockwall and within months he improved. If you want to discuss this more I'm sure I have more to say that space will permit and you can email me directly.

More thoughts after reading the other responses.
1. I have read Dr. Bock's book on The New Childhood Epidemics...Good book and good information. Dr. Rao in Plano is a very similar kind of doctor and worth look with him.
2. IF it were sensory dysfunction, your friend will have a hard time with most pediatricians. They just don't recognize the symptoms so easily.
3. Public school. HA. I ended up withdrawing J from public school in 1st grade because his teacher wanted him to "conform to the classroom" when we had tried everything together and separately to make him "behave". I homeschooled him for a year while we figured out what was going on. The next year he want back to a DIFFERENT public school and did great. Sad to say, I lost a lot of faith in the school actually wanting to help a child that didn't fit the mold. AND they don't offer services for kids with sensory dysfunction unless there is some other classifying reason.
4. Other parents. Lots of judgment. It's a sad fact that parents are often the worst at judging other people based on their own experiences with their own children.
5. As a mom, the most difficult thing to do was to admit that there may be something wrong with my child. Felt like I would betray him. My #2 is also on the autism spectrum (very highly functioning at this point). Help her understand that if her son was diabetic she wouldn't withhold getting him treatment or insulin if he needed it and by checking this out she is his #1 advocate.

These are symptoms of autism which is a spectrum. Autistic/ADHD/Allergic kids tend to have bowel problems and many allergies. Dr. Bock's book Healing the New Childhood Epidemics:Autism,Asthma, ADHD and Allergies is a good book on the subject. Chronic strep is common in these kids. Have the doctor run ASO and DNASE titers (blood test). Also no more booster shots. You can run titers to determine if he is already immune. Doctor can also run IgE tests for food allergies. She could try elimating casein and gluten (milk and wheat products) to see if his behavior improves.

Hi, S.. This sounds like a tough case.

Is the child on any meds that might have aggressive side effects? We pulled our daughter off an asthma medication a few years ago because of something very similar.

Does the pediatrician seem concerned about his behavior?
I have a friend who has a child with almost identical symptoms, and her pediatrician referred them to a child psychologist for testing. He was eventually diagnosed with Sensory Integration Dysfunction, and a few months of therapy have been amazing for this little boy.

I hope this helps a little.

My daughter was like that and she is a very fine, high functioning, friendly 6 year old. Things will change with time I believe. She was so afraid of everything so much that we stopped going certain places.
Every child has different needs and right now mom and Dad are it.
There will be plenty of time to socialize. I will suggest that mom joins a play group for a few ours a day. But do not live him alone at a daycare or some other day orphanage.

AD/HD is one place to start researching. I'm not saying it is the issue just possible. Impulsive side of the AD/HD. Also, sensory intergration issues may be something else to consider. Aspergers (high end of Autism) would be another thing to research. These things seem similar to my son's situation when he was 3/4 years old. We finally came to the conclusion with tests etc. that our son had ad/hd impulsive issues. He is on meds but very low, and I mean very low dosage in conjunction with play therapy and a low carb diet. He is now almost 7 and doing absolutely wonderful with a few flare-ups once in a while. As you know as an early childhood educator it is best to figure these things out early on so that they don't suffer in grade school.

I also suggest investigating nutrition/allergies. And seeing a homeopathic medical doctor (we like Alex Bekker, MD in Dallas) who can work with the child's constituiton to strengthen his systems and address underlying issues affecting his behavior. I am a firm believer in investigating nutrition/homeopathy as a critical first step.

Have his parents tried a nutritionist? So many issues are food related. The first thing I would try is a nutritionist and then an allergist.The noises in his sleep are troubling. If he is not getting true, deep sleep, this can lead to all sorts of issues, none of which he would be able to communicate at his age. I think an ENT specialist should be involved,not just a pediatrician.

It seems fairly common to be jealous of a new sibling, mom and dad have a split focus now, and it is not centered on him but hopefully that will go away when the younger sibling can actually play with him. I think your instincts are correct. This child is not feeling well physically and his behavioral issues no doubt stem from that. Imagine how we feel when we don't get a good nights sleep. You are a terrific friend and I hope the parents take the advice you give them to heart.
K

I would investigate the possibility of Asperger's. I have 2 friends that raised boys with Asperger's. One is age 20 and one is 18 now. Examples of things that I have witnessed in the boys not being able to process sensory input properly: 1) not being able to touch school notebook paper, 2) not being able to wear socks or touch velvet, 3) not being able to go into movie theatres due to loud volume, 4) not having "appropriate" behavior in school or playgroups. I like Nicole's advice of NO MORE vaccinations and using an elimination diet to find out what foods he may be allergic to.

Please take the child to be evaluated for Autism Spectrum disorders. The public school will do it and it is imperative to get early intervention. It is not to early to tell if the child is Asperberger.
He is showing some classic signs as far as socialization.

Tell the Mom to remove all wheat and gluten from his diet for four weeks and see if she sees some improvement.

Get a second opinion and beg your friends to seek an expert opinion these signs are not normal although they don't have to be anything major but I believe they should be looked at. Good luck I think autistic when I here his behavior he could be highly functioning.Yet on the spectrum.

She should try a dairy free (and maybe even gluten free) diet for the kiddo. Even a week without dairy might make all the difference, and it certianly couldnt hurt.

My son is 5 now and has always slightly troubled me b/c of his behavior and attitudes. Like your friend, he is somewhat fearful of things: hurricanes, tornadoes, strangers, someone breaking in...none of which have ever even come close to him. After my 2nd son was born (3.5 years apart), my son really plummeted to new lows in behavior. I would truly say he is just now (18 months later) BEGINNING to show more of his sweetness. I do think some of his issue is sibling attention. I have worked very hard lately to laugh, joke, play, encourage and generally pay more attention to him and literally make my other son wait...truly, the 18 month old will not remember but I know my older one will harbor resentment the longer we 'seem' to be giving little one more...in whatever way he sees.

Also, like your friend, my son is well behaved with myself, but once the brother enters, or truly anyone else!, he turns into a little monster at times. He truly wants all of my attention but ends up getting sent to his room or time out when he misbehaves. He does not like to socialize much, but when put in situations, will prefer to play with girls over boys b/c they play nicer, he says ;). He's all boy, though. He climbs, wrestles, plays sports...

So, all that to say, I think there are some behavioral similarities and I would absolutely encourage her to create a behavior plan with him based on rewards of TIME with mom and dad. We start off each day with 4 balls (fuzzy pom poms...could use whatever) displayed openly for him to be reminded. I put them in a little jar on the table. Each time he behaves poorly, he gets a ball taken away and a chore or a ball taken away and time out. When dad comes home, if he has any balls left, Dad reads him an extra story at bedtime. If he misbehaves after dad comes home, I don't take any more balls away...he just gets less cuddle time (and it truly goes sometimes close to an hour). At the end of the week, we add up the balls and he gets a big reward. So, a small reward each day (extra books and time to cuddle) and a big reward every 7. A treat for 1-10 balls...mom or dad spend the night with him for 11-19 balls...and a special day with just him and us for 20-28 balls. IT'S WORKED MIRACLES AND IS SHOWING CHANGES FOR SURE! That, and being consistent in smiling and remembering he's ONLY 5. They can't articulate, so you have to put yourself in their shoes. What a ramble...hope that helps. :-) Feel free to email me back if you want to connect more.
K.

S.,
Some of these symptoms sounds like autism......the not wanting peer contact.....being alone.....upset by change....different noises.....leaving the room can be his way of de-stressing. I have a 12 year autistic son and he displayed the same symptoms although he has never been agressive in any way. The agression can come from frustration though. There can be so many reasons.....this might be tough to figure out on your own. You're a good friend cor your concern.

Take care

Also, I have heard that you can take a toddler to the local elementary school and tell them what you suspect. Since they will be getting the child in Kindergarten, sometimes they will give you support or at least some clues, to help correct the problems early on.

Also, get a grandparent to take the baby regularly and make a predictable one-on-one routine for him. That eased our transition when twins arrived and de-throned our little prince. ;-)

My friend's son had several of these symptoms. He kept getting expelled from school. I didn't even know you could get expelled that young! He even stabbed a kid in the hand with a pencil! When he was 8 she found a doctor who tested him for allergies. They put him on twice weekly allergy shots and his behavior completely changed. He became a straight A student and never got in trouble again. Now he's 16 and he's been just fine. The doctor said it's like having an itch under your skin and not being able to scratch it. He was too young to really be able to explain to anyone how he felt and he had felt that way for so long he didn't even realize it wasn't right. Before someone diagnoses him as autistic, I would check it out.

I am an aide in a special education classroom. A lot of the behavior you described resemble children with Autism or PDD. There are different levels. It seems like early intervention is the key. There has been great strides in research recently. These type of children are not bad. They are just trapped in their body and can not relate to others worlds very well. Best of luck to you and your friend!

I would definitely recommend a sleep test. Our son was having some of the same issues, and our ENT recommended a sleep test. He has mild sleep apnea. I think it is worth digging deeper even if you rule something out.

I think it sounds like something that a pediatrician needs told about, but also I wonder even if she is a stay at home mom, if she ever pays attention to him, reads to him , explains things, and tells him about playing with others and what the proper behavior is, and how much fun it may be etc. Some people do act out when in fear, and she may not comfort him in new situations, if she just thinks he is (spoiled), if she isn't sinsitive, and I'm not say she is or isn't, but if she doesn't it will just make him worse it sounds to me like.

Those symptoms could be several different things. First and foremost it sounds like he's bi-polar. A completely treatable condition. But until bi-polar children are on meds, they are completely miserable and so is everyone around them. It is very important to get it diagnosed and treated BEFORE he starts school.

HE could also have ADHD....Autism, etc. I would recommend that she contact Scottish Rite Hospital in Dallas. They are a non-profit hospital that will do testing that he needs. They can Test for everything.

My little sister suffers from bi-polar disorder and she was miserable, and we were too. He hated school,life, everything. She was finally diagnosed in 2nd grade and it has made a world of difference.

I know several other repsonding with syaing possible Autism Specturn Disorder which is possible but I would he has some sensory processing issues that need to be addressed through a pyschology. My son has sensory processing issues - his are more with feeding and some with interacting with others. He sees a pyschology and speech therapist (for the feeding) and was seeing an OT for sensory and fine motor - has had great improvments. He goes to Our Children's House at Baylor.

Has he ever been tested for Asperger's Syndrome? Here is a bit about it:

Diagnostic Criteria For 299.80 Asperger's Disorder
A. Qualitative impairment in social interaction, as manifested by at least two of the following:

1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)
4. lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

You REALLY need to look into Autism. Or something in that spectrum, Pervasive Developmental Disorder, Asperger's Syndrome, Autism. They usually go hand in hand with Sensory Integration issues. These things would be resistance to change, and the need for the same environment at all times. The aggression towards others is simply a defense mechanism to touch or stimulation. He should be seen by a multi-disciplinary team. Such as a Child Development Specialist, Neurologist, Pediatrician (doesn't sound like his is doing the job, or mom is just not sharing the critical information with him) Occupational Therapist, and so forth. The EARLIER that he has a diagnosis the better. That way he can get the therapies and classes that he needs before all of those precious nuerons have finished making those synapses in the brain. I cannot stress enough how important it is to be diagnosed early and get all the treatments early. Good luck and I hope that she will be accepting that there may be an issue with her son that NEEDS to be addressed.

I think there is a possibilility it could be mild Aspergers, but I would try some sensory integration excercises with him before going to doctors and specialists and trying to get a diagnosis.

We all learn through our senses, and sometimes kids are overly sensitive to certain stimuli and it hinders their learning. I think especially spirited children have issues with sensory integration. My daughter has these same tendencies that you describe in this little boy, but I have been doing sensory activities with her since about 18 months, and it really seems to help her. We have just recently been able to get her to sit in bath water. She also plays in the sand, and eats a wide variety of foods. I am trying to find a tunnel that she can crawl through, since she doesn't like to be "under" anything. We have recently been able to get her to sit in a little pop-up tent, but she still won't go under the table to get a toy. Everytime we conquer one of these little fears, I see improvement in her sleep patterns and her speech.

This is the website that I often use as a resource http://www.sensory-processing-disorder.com/sensory-diet.html . Some children do have SPD, I don't believe my daughter does, but the exercises help her especially with her irrational fears. Maybe some of these exercises can help this little boy, too.

A.
www.greenbabydiaperservice.com

He sound like there could be more than one issue going on, One sounds very much like a high functioning austism, and also sleep problems I would find a good peds or get him refered to Scottish Rites.

Those are some very serious issues. He is too young for that but it sounds like he could have ADHD but I am not a doctor but it wouls be wise to have him checked out. He is 3 and he should be very social at this age and not agressive towards others, and if the mother condones this and is always leaving a outing for him then this will continue its best to get him checked out now while he is young. Good Luck

recommend nutrition response testing to pull the meatals out. So he can behave normal. I do it here at my clinic in Irving. ###-###-####.
Dr. J.

I actually do recognize most of these issues. My son was just like that, really, it's almost eerie. We did all kinds of tests and everything, however, it wasn't until he was 7 yrs old that we found out that he had autism. Pervasive Developmental Disorder, which is a fairly mild form. The reason it took so long to diagnos was because it was so mild. Once we took the proper steps to help him, it was amazing. He still has his problems of course, but he is a much happier boy, he is now 15. It just may be worth looking into for her. When my son was 3 his doctor told us that he was "absolutely not autistic", but later, after 3 opinions, we found out differently. Good luck!