Sorry I've been absent for so long, we've been super busy and handling lots of changes. Recently we changed difficult child's medications from risperdal and depakote to abilify and a slightly higher dosage of depakote. The risperdal just wasn't working. Changing over took just under a month and we have been doing just the abilify and depakote for two weeks now. What I have noticed is that difficult child no longer gives any warning when she is going to turn violent. She is still cycling, although it is much easier for her to handle. Over the last week though, I can see her slipping. She can be whining for something, just like any other 3.5 year old kid and all of a sudden she snaps, bites me, claws me, hits me, etc. No two instances are the same. Over the last few days her outbursts have included easy child, who just turned a year old last week. Today she scratched three 8" gashes into easy child's bare back. She never raised her voice, changed her body language or even changed her facial expression before, during or after. I had no warning and was only 2' away when it happened. Within minutes after the entire ordeal was over, difficult child was back to semi-normal until the next whining fit began. Thankfully she went after me that time. Unsure of how to communicate with difficult child, and being concerned for easy child's safety I called the on-call psychiatrist at her psychiatrists office to get some advice. He listened to me as I explained how difficult child is fine for 90% of the day but 3-10 times a day she has very violent outbursts and acts as if nothing happened scant minutes later. Instantly he told me his solution; they have these helmets with a mouth guard which would prevent her from biting (which she has only done a time or two recently and I explained that) and I can tape winter gloves onto her hands to prevent scratching (once again, very unusual behavior for her). He then asked if I had a playpen. I thought he'd suggest putting easy child in there for safety but no, he wanted me to put difficult child in it for the majority of the day. I supressed a laugh at this, difficult child is 44" tall and weighs close to 50lbs. She could practically flatten a playpen in seconds. I was shocked at his 'solutions' as well as the way he kept comparing difficult child, who is diagnosed with bipolar disorder and tests at a 1st grade level in math and reading, with mentally challenged children who are stuck at being 2 years old and with severely autistic children. Now I mean no offense to anyone with children such as those he mentioned, but each kid has to be treated differently and I was outraged at his suggestions. He even told me I could come to the hospital and pick up a helmet this afternoon and got a bit peeved when I told him I refused to try his methods. He even went as far as to ask if I could put difficult child in a crib to restrain her... she turns 4 in September, is fully potty trained, incredibly smart and taller than almost every 5 year old. I wouldnt even us a crib to try to restrain her when she was 2 years old. Sorry, I guess I needed to rant about that, I'm just in shock with his attitude and 'solution' to this issue. Does anyone have any suggestions as to how I can get through to difficult child before we hit the point of exploding? I've tried being super gentle, being firm, indifferent, harsh. I've even tried ignoring her, which results in immediate violence. Should I express my outrage at the on-call psychiatrist's solutions when difficult child's psychiatrist calls tomorrow? The little faith I had left for our childrens hospital is dwindling very fast, thanks to this guy.