A.S. asks from Portland, OR on June 13, 2010
Three Year Old: Rages with Aggression (Evaluate or Not)
This post is primarily directed toward parents of children who are intensely spirited who have considered or gone down the path of an evaluation. (Please note, we are not a family who will use any physical means of consequences/punishment. To date, we have not tried any token reinforcement systems such as a star chart, sticker chart, etc. though if need be, we are not opposed to it.)
I am trying to determine if I should take my three year old child in for an evaluation. This level of aggressive behavior has been present for about two months.
My son can go from zero to sixty over situations such as requests to wash his hands, use the bathroom, etc. Basically, non-preferred requests. His rages involve a great degree of physical aggression (directed mostly toward me or my husband) and, while the actions are not hard - that is, they do not really hurt - they are very directed. When he rages it looks like the following: Pre-warning of request is made: "In 5 minutes, it will be time to use the bathroom". Time reminders are delivered in a non-emotional voice at three and one minute's time. When the five minutes are up he is given the choice to walk by himself or with me/my husband. (Even if we have tried to assist the transition by helping him find "safe" places for his current project, talking about the next fun activity that will follow the non-preferred task the following scenario will still occur.) This is when he screams and comes at me/my husband - hitting, kicking and spitting. He is permitted to take a break should he not desire to engage in the request but once aggressions have occurred he is instructed to take a time-out in his room. He will usually go to his room (a positive) but will continue to rage (screaming, kicking furniture) for 15 minutes to an hour. No amount of talking helps at this point. He has demonstrated he needs the space to "rage" until he is done. At which point, me/my husband goes in a checks in with him. We talk about what happened, what a safer choice would have been and practice calming techniques. We always model the following language, "When you hurt someone, you can say 'I'm sorry.' or 'Are you okay?' He usually chooses one of the phrases but apologies are never required.
On a good day, he usually has two episodes and on a bad, closer to six. I taught in early intervention rooms prior to obtaining my teaching license and taught a primary (K-2) behavior classroom for years before having my own children. I have read many a book and think my approach is solid and grounded. (Not that I am perfect but I feel like the manner in which I am addressing his needs is not the heart of the issue.) I provide clear boundaries, an appropriate level of choice, positive redirection, lots of cuddle time, etc.
We have had no big changes that have triggered this behavior. HOWEVER he did stop napping consistently around the time of the increased rages but I have tried everything possible to make naps happen and it is not working or worth it. Any quiet time or nap time is now met with more raging - lasting one hour typically. He has very developed linguistic skills. His diet contains a very limited amount of sugar. For example, he is allowed three vegan fig newtons per day if he remembers to ask. :) We get outside a lot and spend the majority of the day outside if possible. He has always been an intensely spirited child who has gone through three other phases of aggression. This one is more intense (perhaps because he is three?) in the degree of aggressions - approximately 20-25 on a bad day - and the duration that the episodes last. When he did attend daycare for a short while he did display similar intense behaviors yet not the level of aggression as that was not at the time he was in an aggressive phase.
Although this has been a very long post, I know as a specialist I would still have many clarifying questions. Here is my question: What would you do? Would you seek an Early Intervention evaluation? Would you look at diet? Would you just wait it out and appreciate that this could just be an intense child learning where the boundaries lie? Please advise.
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J.C. answers from Chicago on June 13, 2010
I would look into Early Intervention. You are doing a great job, but sometimes you need someone who can look from an objective view.
Take care
J.
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L.W. answers from San Diego on June 13, 2010
Wow. You must be really tired. Sounds like you are doing a lot of great parenting... and like you're in a very similar situation to what happened with us and our oldest daughter.
We adopted her from foster care as a toddler. The first year we wrote off as a time of bonding, healing from their trauma and building attachment. It was exhausting, but expected... Then year two continued in that same exhausting manner, despite counselors telling us we were doing everything really well and consistently in dealing with the rage and aggression due to transitions and directions (like the kind you mentioned).
To make a long story short, we got a full developmental evaluation at San Diego Children's Hospital when she was 3 1/2, and while they couldn't pin down a diagnosis, it did provide documentation of the problems. At 4 1/2 years old (before kindergarten), we had her evaluated by a child psychiatrist because I was really worried she's completely fail at school and with friends. Best thing we ever did. Turns out it was ADHD (and, in her case, bipolar as well). As soon as we started medications and high doses of omega-3 for mood stabilization, our daughter blossomed. I cried for months after that because it was like I finally got to meet my daughter for the first time and not live in post-traumatic stress mode of dealing with her overwhelming behaviors all day every day.
She's still a piece of work, 4 years later. :) But I would never change how we handled it. Sounds like you're doing your best and it's still bad for the family, so it's probably time to go see someone. Doesn't hurt anyone, and it can offer you direction in dealing with the tough transition behaviors.
I'd also recommend you have a place where you can feel how you do without parents judging you or your parenting. If you want a good laugh, come by my site. I've got two "spirited" kids (love the wording!) and I do a lot of laughing to thrive despite it all :).
All the best,
L.
http://livingpower.blogspot.com
http://twitter.com/mylivingpower
Encouraging moms with intense challenges, who choose to thrive anyway!
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M.P. answers from Portland on June 13, 2010
I think that you should get an Early Intervention evaluation. I am familiar with the process. My grandson has speech apraxia and behavior issues. He has also raged since he was 2-3. He's now 7. We thought the rages were the result of frustration over not being able to be understood. He started with speech therapy and preschool arranged by the Intermediate Education School District. He's been in a therapeutic preschool and is currently finishing first grade in special ed program. We're awaiting an appointment with a developmental pediatrician. He's been diagnosed with ADHD by his regular pediatrician who made the referral because of the multiple difficulties that my grandson has.
Beside the speech difficulties his most prominent and difficult to deal with issue are his rages. Like your son, he can be calm and having a good time just seconds before he flies into a rage and starts hitting and kicking. What has delayed his getting increased medical attention for his behavior is that at times he responds positively to intervention, such as calming down when sent to his room so that he has less stimulation. He has been pretty much aggression free, tho still easily angered for weeks at a time only to suddenly start hitting and kicking in a rage. Everyone gives a sigh of relief thinking that we, including him, have passed that hurdle.
He was not referred to a developmental pediatrician until a couple of months ago when his aggression increased and his teachers no longer knew how to help him. He's been suspended from school 3 times in the last few months because he's went into a rage, hitting and kicking when his teacher was unable to calm him.
As a professional you know that the earlier a condition is diagnosed and a workable treatment plan put into affect the more successful treatment is likely to be. I urge you to get an evaluation. Your son's rages are above and beyond the normal.
I empathize with you. Having a child that has such strong feelings tears at our heart strings. We want them to mature out of the rages but when they don't we feel perhaps it's our own failure to find the right way to parent. I am so glad that the medical field is improving in finding ways to treat these children. I see a difference in the help available in the 3 or so years my grandson has been in the system.
You have done and are doing the things that should be helping your son and they are not working. Your son is so fortunate to have you as his mother.
I don't know if this is helpful but I think I've stumbled on a way to work with my grandson. Keep in mind that I'm his grandmother and don't deal with him full time. He stays overnight with me one night/week. I take him to school the next morning. When he is the center of my attention the entire time he doesn't have meltdowns. When I want to do something else at the same time he wants my attention he has a meltdown that consists only of verbal anger and tears. When I immediately stop what I'm doing and spend 10 or so minutes with him before going back to what I want to do he mellows out again. If I ignore the tantrum, which is what works with most children, it escalates into aggression i.e. name calling, hitting, kicking. During those minutes I validate his feelings and get him started doing something such as playing with his "hot wheels" or I give him his stuffed animal Donkey or Bull Dog. He gave them names based on what animal they are. Sometimes he wants me to hold him. Sometimes he stays a couple of feet away from me.
His teachers, at different times, have tried to wean him away from the stuffed animals but they always allow him to go back to having them tho I think he's to keep them in his book bag. I sometimes wonder if he emotionally NEEDS to have one of them in his hands. At my house he has access to them anytime he wants them Some days he never takes them out of his book bag. Other times he holds them and wants them when he goes to bed. He can also have them anytime he wants at home. He does not have as many raging meltdowns at my place or home. Of course there are more demands on him at school. His routine at my house is very simple and child oriented. He is able to be uninvolved with anyone most of the time when he's at home. If he doesn't want to eat dinner, he only has to eat a couple of bites and then can get down to play. It's OK with him if he doesn't get anything to eat for the rest of the night until his and his sister's bed time snack.
I think we have adjusted our expectations of him so that less is required of him. Because of that when he is required to do something he perhaps has more ability to comply. I've heard his parents say to him, "I didn't ask you to pick up your toys. Now it's time to sit down at the table. You can go back to them after dinner." I, sometimes feed him as I would a toddler when he's not interested in eating. He nearly always eats most of his food when I do that. It feels to me that he needs some sort of one on one attention in order to stay calm when he's feeling stress. He feels stress much more acutely than the average child. He is pulled between wanting to play and wanting to eat. I can see the tension in his face. I'm not sure that this is the right thing to do for the long run but it does give all of us, including him, a feeling of success.
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B.B. answers from Portland on June 14, 2010
My 3 yr old has meltdowns and they seemed to start right around his birthday. We found that giving him choices and time alone in his bedroom worked to difuse the meltdowns, which sounds like what you are doing. The other thing we did was require apology because physical aggression is NEVER ok. We also gave him consequences for his actions to teach him that while it is ok to say you are upset and to be angry, it is never ok to act like that. Consequences included, loss of a favorite activity, removal of toy, etc.. Rewards for acting appropriately included a sticker chart with a reward (city bus ride, trip to the park, etc) after filling the chart.
My son still has the occasional meltdown but nothing like before and he usually calms alot quicker. He has started verbalizing his anger or dislike for a situation rather than throwing a tantrum.
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E.M. answers from Denver on June 13, 2010
Our daughter had rages at that age and still has some pretty big temper tantrums at 4.5. We eventually had her evaluated at age 4 because of her short fuse and rages--that is exactly what I called them too. So it sounds like you are doing everything by the book and figuring out that typical discipline does not work, you limit his sugar and give him plenty of exercise. The story of my life! Our daughter was diagnosed with ADHD at just over 4 yrs. old. Extreme temper tantrums and rages are typical for young ADHD children because they have a very low tolerance for frustration--the littlest thing can set them off. I suggest you get the book the Explosive Child. While it is geared toward slightly older children, it will still help you understand your son and how and why he is reacting this way. Now, I am not saying your son has ADHD--I'm just saying what you've said so far sounds familiar. When we had our daughter evaluated, we weren't concerned with hyperactivity or attention span (what people associate with ADHD) we were concerned with rages. As we went through the evaluation process, we realized her hyperactivity and attention span for her age were WAY off for what is typical for a 4 year old--and of course, a certain amount of those things is VERY typical for most young children. An evaluation will only help give you more information about how to work with your son. If there is nothing to find, then you will be told he is a normal, healthy challenging kid. And even if this is the case, they may be able to offer you some parenting tips for his challenges. If there is something else going on, the sooner you find out the better!!
**Our daughter is finally mellowing out a bit and thanks to her diagnosis we are able to parent her in a way that helps her.
**We looked at our daughter's diet and like your son, she eats healthy fresh food and VERY little junk. But we did want to cover all the bases. Again, it can't hurt.
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J.C. answers from Chicago on June 13, 2010
I would look into Early Intervention. You are doing a great job, but sometimes you need someone who can look from an objective view.
Take care
J.
1 mom found this helpful
H.R. answers from Myrtle Beach on June 14, 2010
Seems your getting lots of advice to get evaluated. He is 3! He is a kid and kids seem to do what they want. If he is not getting the reaction he's looking for he'll eventually stop.
I think your doing a great job. Have you looked into natural health? Drugs are just going to cover symptoms. Did any of these episodes start after vaccines??? Just a few questions to ask yourself.
I wish you all the best! Being a parent is the hardest but most rewarding job.
A.T. answers from Portland on June 14, 2010
see dr. palmeri at portland family homeopathy. She's great with our kids allergies & it helped their moods improve. Good luck.... portlandfamilyhomeopathy.com
C.D. answers from Los Angeles on June 13, 2010
Wow! I was blown away by your the techniques you were using--until you explained what your background was! It sounds like you're doing everything absolutely perfectly! You might want to try doing a reward system using positive reinforcement. They've worked wonders with my daughter, who has high-functioning autism.
It does sound like you should get your son assessed. It may be nothing, but if it is something, the earlier you get help, the better. My daughter also has a horrendous time with transitions. She didn't get aggressive, though, she would just have meltdowns.
I think Early Intervention is for children who are under 3 though. So, you'll either have to get your son assessed by your local school district or privately.
Good luck!
C.
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