Hitting and Hurting Mom - Almost 4Yr Old

Dana,
My heart goes out to you, I think you are a great parent. Just reading this, I cannot imagine how hard it has been on you. I just wanted to send hugs. I would consider seeing a behavioral therapist.
You are a good mother!!!

Yes, I have been there. I'm so sorry you are dealing with this, because it is heartbreaking when you're in it. So many times I felt like I was a bad parent, and I felt like I could not bond with my child because she was in constant flight -or fight mode.

I wrote it off to being immature for her age. "She's just a very young 3 yr old, 4 yr old, 5 yr old...." but by 6 and 7 something that I thought was just a stage she would outgrow, was clearly more. At age 5, I connected the worsening aggression to Red #40 dye and removed that from her diet. She also reacted to Juicy Juice for some unknown reason.

At age 7, a friend pointed M. to the Feingold program (www.feingold.org) because things that had temporarily calmed down were worsening again. We started that and noticed that apples were a trigger food for her as well.

At age 8, she was put in an outpatient hospitalization program for 11 days when she could not even sit for therapy to help her. By this time, she had had an eye-blink for a year that allergy medicine was not touching. It was here that we got a diagnosis for Tourette's.

Something was still not right though, and trusting my gut, we continued to investigate and research on our own via internet in the evenings after she was in bed. During this time, we had another diagnosis of Bi-polar and she was just starting meds. The meds made things temporarily better and then rapidly WORSE. Her tics grew and were now full-body writhings, along with the rage attacks and some bed and day-wetting thrown in. Sometimes she would exit a rage non-verbal, and we had eegs, etc to rule out seizures. Nothing was coming up positive.

Finally one night we hit on a link between OCD, Tourette's and rages- a disorder called PANDAS. I read in tears and disbelief because it was absolutely a perfect fit. We contacted a local doctor (one of very few in the world) and got our diagnosis. Basically the child has an undiagnosed and untreated strep infection that causes the brain-stem to swell. Often you can see their pupils strangely dilated because of this.

Long long story short- we are just a year out of treatment and she is doing amazingly better with those behaviors. We are still battling exhaustion, but have a diagnosis of Lyme (probably congenital) now and are starting treatment for that.

My point is, whether your child has PANDAS or not, you have to look at the situation holistically- neurological, behavioral, and psychiatric things do not exist in isolation. There is something physical going on that is most likely beyond his control- it could be something as simple as an allergy to a shampoo or it could be as complex as an immune or autoimmune disease, but my bets are that he doesn't CHOOSE to act this way.

Please let M. know if I can help. We've run the gamut with diagnosis and I can recommend books and doctors/therapists in our area, etc if you are interested in diving into some testing. I'm also here if you just want some support and a listening ear.

M.
www.chickiepea.wordpress.com (our food blog with some of our story)

Adding this-
Here is the website for a pediatric doctor in our area who treats PANDAS, there is diagnostic criteria on his site:
www.webpediatrics.com

I love the way Manda responded below.

Although I do not have first hand experience with a child like this, your child sounds like my neighbor’s 9 y/o son. His anger was so out of control that at age 6 he grabbed his baseball bat (plastic not aluminum) and hit her with it. He was constantly thrashing their home.

She took him in for testing for ADHD/ADD, made Dr. appts., etc. One Dr. asked her to keep a journal of what he ate and when he acted up.

Within a couple of months she realized that he would get into these rages about 30 min AFTER eating sugar/sweets.

She admitted that he ate a lot of sweets because she always had a hard time saying no.

Well she started to limit his sweets a little at a time and she noticed a HUGE difference!!!! I even noticed a difference.

In your case it may not be sweets but it could very well be something in her diet. Again, I agree with what Manda said below too.

Dear Dana,

I am so sorry that you and your family are having to go through this. I am currently reading "The Explosive Child" by Greene. His main idea is for some children punishments don't work. They know all there is to know about punishments. What you need to do is help your child, before they explode. He talks the importance of baskets - A, B and C. I haven't finished yet, but throughout the book I have been saying "That's my child." It has helped. He isn't too young to start seeing a counselor and/or psychiatrist

Take care
J.

Hello Dana,
Man, can I relate. My boy, same age as yours, displays similar actions. Like you, I have tried it ALL and have even resorted to spanking (which I swore I would never!). I recently read an enlightening book called "Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies" by Kenneth Bock because my kiddo has a food allergy (currently working on figuring that out), has also had issues with asthma and also shows some ADHD symptoms. [This book also talks alot about PANDAS, by the way.]

Anyway, I recently took him off gluten (we are already off dairy due to asthma issues) and I can honestly say, he's been much better behaved. The hitting has significantly subsided and his rages are very infrequent anymore. However, a new discovery this week...I think he also has a red dye allergy because he had to get on antibx this week (which he's never had) and his rage is coming back with a vengeance. [I am assuming it has red dye in it to get that strange pink color, or maybe it contains gluten - anyone know?]

So, for you, it may be as simple as removing some trigger from his diet to help calm him down. It may take a few weeks though to notice any changes. If I could give you a hug, I would! It's so hard to have a kid like this and you feel so helpless. You can't help but feel like a bad parent and simply overlook the judgement from others, but just know, you ARE a good parent and you are not alone! Believe M., I know how you feel.

I would recommend the book "Your Defiant Child" and set up a system where he is positively rewarded for every bit of good behavior. Also, try to spend fun individual time with him. The book recommends taking 15 minutes of special time with your son and allowing him to chose the activity. We also set up a happy "peace island' place (with a beanbag and stuffed animals) to go when he starts feeling upset (rather than the time out which seemed more punative). These steps can help quell a child's anger, put more of a positive spin on things and make the house a happier place. Good luck!

Hi Dana,

My heart just breaks for you because your son displays many of the characteristics that my son did (my son is a little younger). I know how much of a struggle it can be. We were at wits end and did not know what to do. It got to a point where we stopped taking him out in public, on play dates etc because we just never knew what mood we would be dealing with. We decided to try the program at Tuesdays Child (http://www.tuesdayschildchicago.org/program/core.htm) and it really changed our lives. They offer an 8 week and 12 week program. It is a non-profit so you pay on a sliding scale based on your income. It really turned our world upside down. It turned out that all of our "traditional" parenting methods we had been using were exactly the wrong thing to use for our "high energy" child. We really had to throw out everything we thought was the right thing to do and re-learn how to parent our son. Fair warning - the program is not easy. It is a huge time commitment and takes a lot of discipline from the parents (I think this goes to show that these behavior problems are not easily solved) but it was worth every second we spent there. My son went from having 2 to 3 hour long fits/tantrums a day to maybe 1 10 minute fit a day now. Like anything - it isn't a full proof solution. We still have days that don't go well but we now feel like we have the tools to deal with his personality and temperament. I no longer have two hours of anxiety before a play date. :) I really cannot stress enough how Tuesday's Child changed our lives. If you have any questions about it - please feel free to message M. directly.

Good luck to you!!
M.

I don't want to judge you on the spanking, because most parents have lost their tempers and hit their kids, but I do hope that you understand that you are teaching him how to behave with your behavior. Children learn what they live. If you want him to learn how to calmly manage his angry feelings, then you are going to have to learn to model that for him. I know it is hard to be calm with an out of control child, but remember that he is a small child, with some sensory issues (I'm assuming that is what the OT is for), who is having a rough time of it as well. You are the adult. It's not about tolerating or not tolerating his behavior, it's about helping your son learn how to manage angry feelings, something that is hard for many of us.

You might want to look at some books that might help you understand him better, and give you more ideas of how to respond. Playful Parenting by Lawrence Cohen, The Explosive Child by Ross Greene, The Challenging Child by Stanley Greenspan. If those do not help, seek help from a therapist (social worker, counselor, psychologist, etc.) with knowledge of both sensory issues and parenting, like floortime or something called Relationship Developmental Intervention, or RDI.

Hello Dana,

I have been and still am in the same exact situation. In fact, we had a violent tantrum tonight with my 3 1/2 year old daughter naked standing in the garage screaming. I have also tried every "trick in the book" to get it to stop. My daughter is very bright which the doctor thinks is partly to blame. She was getting out of a five-point harness car seat while I was driving almost daily. It had actually come to a matter of safety for her. After a particularly violent episode (we were up to 6 fits per day each lasting at least 30 minutes) I took her to our pediatrician. A little background info...she seemed to stop when preschool started (never does it in school) and started up again in November after the birth of her little sister. The pediatrician referred us to a child psychiatrist who assured us that "nothing was wrong with her" and that "she will definitely out-grow it at some point". He then referred us to a child behavioral psychologist who came up with a "game plan" so to speak. It involves daily star reward charts assessed on an hourly basis. She gets a star for each hour that she 1) does not have a fit, 2) listens to directions, and 3) does not hurt others. If she gets 80% of the starts she receives a small reward for the day, if it is 90% she gets a reward and if it is under 75% she goes to bed early (easier said than done). It has been a slow process over the last 8 weeks, but we are now down to one tantrum every two weeks and they are much less violent. She has not been hurting anyone like she did in the past...she bit my mother several times as well as her older sister. The doctor said that we could now start to give her stars on a three-times-a-day basis (morning, afternoon and night). He recommended the hourly rating system in the beginning so that we could get a tighter control over the situation. I hope that some of this helps you as it helped M.. Please feel free to send M. a message if you have questions or just need to vent...I have been in your situation and am still there so maybe we can help each other. Best of luck to you and your little guy.

Maybe try a child/family therapist. I'm sure they have seen it all! My heart goes out to you. This is not a fun way to live and it certainly sounds like you have tried everything within your power. Now it might be time to defer to the "experts" and if you don't like one answer, keep trying others. Definitley try and figure this out before he is older, bigger and very angry. Good luck!

This is puzzling-have you had him tested for allergies? Also-maybe keep him at home for a while. What does his doctor say? Has he had a history of strep?

I've known quite a few 3 year old boys who are very aggressive (including my son), so you are not alone. It does get less frequent as they get older. I also find that the more I lose my temper and hit him the more aggressive he gets. When I stay calm and punish him without flying off the handle, the more he stays calm and acts less aggressivly. So my advice is that (a) this is normal at this age so don't freak out that he will become a delinquent, (b) try to calmly punish him as much as possible (e.g., calmly take him and lock him in his room or his car seat) and see if this helps, and (c) be patient. It will get better gradually over time.

Dont' feel bad for spanking. But. Spanking does not work as a guilty last resort used only occasionally when you're really at your wit's end after everything has escalated and he's been doing something for years. He knows he has a lot of leeway before it happens, and he gambles.

Spanking in and of itself is not that major-it's not meant to "Hurt so bad and be so scary that kids live in fear of it and stop everything on a dime when you finally introduce it because it's so grave" like people think. But it is effective prevention when you are always calm, fair with warnings, and your environment is happy, but after one warning, starting at a very young age, it is a firm and consistent consequence as the result of purposely disobeying, and attempting new serious things like hitting or tantrumming.

If used this way, it is much more effective than time outs and many other strategies, and prevents habits from forming. You have to be consistent. You have to be immediate after one warning, and never wait until you are fed up. You must always send the firm message that his consequence is the immediate and logical result of his choice after a warning, and if he decides not to follow through with the action, he can avoid it. Every time. He is not quite 4, so it's not too late. But he's got BAD habits and he has not taken you seriously until now. It will take diligence and it will get worse before it gets better, when he sees you have a new resolve. He will try to outlast you.

If you think that you have been absolutely firm and consistent after one calm warning from age 18 months on his negative or aggressive behaviors and defiance, and he is STILL doing this, you may want to look into medical reasons.

If you think you have not quite been consistent and diligent since age 18 months with calm, firm consequences right away to warnings, then you have to do it now. He is a very spirited child, and it's a lot harder now than it would have been to prevent 2 years ago, but it is better now than it will be when he's 5, so don't delay! You could even add onto his spanking with other consequences after it as his repetition of things continues. NEVER tell him you're mad or sad about his behavior (notice how he doesn't care?) This is translated to "You have power over M." and makes things worse. His natural empathy will build over time when he learns to act right and feels better because he is.

Have a talk with him, Tell him the new rules and that he will have a consequence after one warning for X behaviors. After he understands, you can remove the warning, but a warning is the best way to give the opportunity to make the right choice, rather than just punishing after the fact. This cuts down on the number of times consequences are needed. Calmly give him a spanking, when he does this despite a warning. The next time, give him the spanking plus time away from a fun activity and remove his toys, whatever. Repeat every time after one warning. Don't ever let him get off easy with just the toy removals and stuff. Forget time outs altogether-those are for kids who naturally don't need discipline-they don't phase difficult kids. He's too young to make the connection to delayed things, like losing stuff for a week and earning it back, but it won't hurt to add that on to an immediate firm consequence-BUT NOT INSTEAD OF! Sounds like a bit much? Don't worry, it's temporary, but he will try to make you back down, so if you can't keep it up, don't start it.

Make sure you also improve his environment with more love and attention during non discipline times and definitely watch that his diet is healthy and he gets enough sleep. Dont' be angry, just enforce. Discpline is for teaching and it is from love, not anger. I was raised this way and so are my kids and we almost never need discipline.

In the next 2 years (it may only take a week), if your diligence hasn't improved this, there are lots of resources to look into if he has a neurological problem. My step sister had two sons with a negligent wuss dad acting like this after her divorce. With lots of firmness from extended family when she moved back home, and her new husband, they are now awesome, happy, great kids.

Is his dad around? Dad needs to take the lead on discipline and be very firm and ALSO spend a lot of loving quality time with his son so he feels accepted and looks up to him as an example.

This book is great: www.backtobasicsdiscipline.com

What about ADHD? My nephew is getting evaluated for this b/c of impulsive behavior...not exactly what you're describing, but can't sit still, always jumping, running around, does things sometimes that hurt people b/c he didn't think about it being wrong before doing it.

Dear M. M, I just read your blog and am so glad I did. I have a 3.5 year old son who is having the same issues. At first I thought it was his age or that he was going through a phase but something deep in my heart is saying something different...have you found any relief and if so, can you please give M. some advice?