Anger issues?- Update in post

[Deleted]

I'm asking for my friend. Her son is 8 almost 9 and still has epic tantrums, hitting, kicking, screaming for 30-45 min at a time. These are frequent not quite daily, but can be. He has no other symptoms of anything else going on except maybe when he is tired, or we think he might be hypoglycemic. No diagnosis or past trauma. Her pediatrician is not helpful. Pedi shrugs it off, but he is not the one dealing with it.

I would think the simplest explanation is get him into some kind of counseling, but her H is not on board. I don't know if there is an underlying issue though, but the pedi has not said there was. Any suggestions or ideas what could cause them? I don't think they are age appropriate, but I could be wrong.

Update- She and her mom (who is a part time caregiver) picked up some books suggested and some other ones.  Since they are taking that recommendation seriously then hopefully they are also taking my suggestion for a new pedi seriously.  I hope they see some good progress.  While I still think they/ he could benefit from a psychologist or psychiatrist, I will leave it up to new pedi to suggest as being from the medical field, I think that would be the most influence on her.

[spooko]

How does your friend deal with the tantrums when they happen? I don't want to imply poor parenting. I've just noticed with my own DS that certain things help and certain things hurt. Wondering whether she's unknowingly exacerbating the situation.

[Deleted]

I'm not always there, so I don't know all of it. I know they have used him going to his room or time outs.

If he tantrums at my house he goes in the car with her.

I mean I do think there has been some exacerbation because he has been perhaps overly coddled and receives attention for them. He is overly big and strong for his age, so that makes it difficult. They have had to chase him in a parking lot and restrain him, not sure if that was only once.

I think it was never completely addressed as a toddler and they thought he would grow out of it and he hasn't. I was told they got worse when her H went back to work but that was 3 years ago.

She has also taken away privileges but he doesn't care if things are taken away.

[luvboston]

First take him to a new pediatrician bc this is a huge safety issue. Does he do it at school? She could also talk to the school counselor and see what they say. If it's behavioral she will have no choice but to take him to be assessed either privately or by the school.
It sounds like they need a serious intervention. Has she tried feeding him when he starts a tantrum?

[Deleted]

Oct 9, 2016 15:39:03 GMT -5 luvboston said:

First take him to a new pediatrician bc this is a huge safety issue. Does he do it at school? She could also talk to the school counselor and see what they say. If it's behavioral she will have no choice but to take him to be assessed either privately or by the school.
It sounds like they need a serious intervention. Has she tried feeding him when he starts a tantrum?

This is what I told her to see a new pedi. Her H is apparently against counseling, and I assume talking to the school counselor. But I am hoping that if she does the new pedi that her H would maybe take his/ her recommendation.

They do feed him when he has a tantrum if they can.

School is less of an issue. I think it's more minor there, but she kept him out one day to work on it, so maybe it's more of an issue than I've known.

[akafred]

Clearly this is not typical and the child needs help. He should be thoroughly evaluated, not by a pediatrician but by a psychologist.

Meanwhile I can't recommend these books more highly:
* The Whole Brain Child
* No Drama Discipline (same authors)
* The Explosive Child

I suggest them in that order. Quite basically, his prefrontal cortex is not as developed as other kids his age. This means he has issues with emotional regulation and probably other executive functions. It can seem like he is just "spoiled" etc, but to a large degree he literally cannot control it. But there are things that she can do as a parent to help him.

[Deleted]

I am hesitant to mention psychologist because it has been brought up in the past, and they aren't there yet and it has a bad connotation for her that could shut down the conversation. I think we all just thought parenting or environment or he'll outgrow it, but then now it hit me that it's likely a medical issue. I was hoping if new pedi says psychologist and with her reading these books you recommended she will get there too. She is in the medical profession so I hope that she will realize this soon. 6 or 7 we can see but coming up on 9, it's becoming obvious to me anyway that it's not age appropriate.

I was wondering about the parts of the brain not being developed but then I didn't know about other things like depression or anxiety or something, but I think your guess is perhaps the closest given there are not as many symptoms for other issues.

[akafred]

I've sat down 3 times to try to explain, and I don't know if I can without writing a book. I'll briefly explain like they do in "The Whole Brain Child." Your brain has a left and a right side. It also has various parts that we'll call "upstairs" and "downstairs" brains. The downstairs brain is lower order parts, like the brain stem that controls basic muscles like heart and lungs, and the amygdala that controls "fight or flight". (There are others.) The amygdala is kind of the "lizard brain" you've probably heard of. The "upstairs" brain contains more finely tuned parts including the prefrontal cortex, which is responsible for executive functions, logic and reasoning, etc. When there is a disruption in the connection between the downstairs brain and upstairs brain because the downstairs brain is "flooded" by emotion, that looks like a temper tantrum or a meltdown. If the upstairs brain is underdeveloped (and it does not fully develop until mid-20's!!!), or if the connections between the upstairs and downstairs brain are weak due to disuse or other factors like fatigue, hunger, sensory issues, etc, it can cause a meltdown or prolong one. Like, even as an adult, we have something bad happen (say, someone cuts us off in traffic) and sometimes we can laugh it off entirely, sometimes we swear but move on quickly, and sometimes we have a little tirade . Our prefrontal cortex and the connection to the amygdala control that.

ADHD, anxiety, ODD are all disorders that affect either the prefrontal cortex or the connections within the parts of the brain, causing people to have weakened executive functions, more or prolonged meltdowns, or even panic attacks. I'm not trying to diagnose him or anything, but what you wrote points to something in this general area. A psychologist IS the one to figure out which is which. (A psychiatrist would work too of course).

For the record, while there are things that a parent can do to help strengthen the PFC and brain connections, these conditions are not caused by "bad" parenting.

[Deleted]

Thank you @akafred. I will definitely pick those up and pass them onto her. I think she has wondered too if she did something to cause this. I hope as hard as it might be for her to get a diagnosis that it will be a relief that she didn't do anything wrong. I think part of her might think that she did.

This is definitely helping me figure out what I can say to her to help push her towards a solution. I'm pretty proactive problem solver and she's a bit more laid back, and he has times when it seems it got better but then cycles worse again to explain the delay in treatment. But I'm going to try to strategically do what I can without straining the friendship.

[akafred]

To go along with the article, something that helps is to think of this as a kind of thing not as a manipulation but rather a lack of skills. If he could do better, he would do better. I am sure he doesn't like feeling so out of control either.

[mrsbuttinski]

@clarypax, Maybe you should invite your friend to join us here. Given your description, she's making a number of poor choices around disciplining him- she's reactive (taking stuff away), she's giving attention and food as a "reward" for the behavior, allowing her pedi to blow her off and her DH to prevail when clearly there is some issue. The time to feed and water a child is before the tantrum- I used to carpool a very edgy character years ago- I offered him sunglasses, a bottle of water and cheese stick as he got into my car which helped prevent the behavior.

Her son's behavior is dysfunctional given that he's almost 9. There is very likely something driving this given his age. I would be concerned that this is something that could get worse as he approaches puberty. You mention he's bigger and stronger than most boys his age- he could be closer to it that she supposes.

I wonder if this is a problem in school or if the structure and clear expectations help him behave better.

[Deleted]

Thank you mrsbuttinski . I think there are some poor choices, but some good ones as well in trying to work with him in his emotions like they were talking about in the Whole Brain Book.

I don't think he gets enough sleep. For me, I would make that a priority and food. However, that doesn't explain it since lots of kids are chronically over tired, and don't do it. I agree that she needs to push back on her pedi and H. I thought it was getting better since she hadn't mentioned it lately, but I think I was wrong.

Her mom is concerned it is getting worse and given his age and strength- the time to do something is now. I think school helps a little bit in the clearer expectations and structure, and the lack of history with the teachers. It maybe a pattern at home, but I do think it is something more that that as well.  Her mom is pretty strict and is a caregiver after school, deals mostly with natural consequences, and he still acts up for her as well, but maybe not as often.