First Post - My 4 YO is Aggressive at School

[Chantillylace]

My son is 4 ½ and has had trouble in school/daycare since he was 2 ½. He was a “biter” until he was about 3 ½ and now we’re having difficulty with other forms of aggression at school. We do NOT see these behaviors at home.

Some background information: He hit all of his developmental milestones on time or early. I am a speech language pathologist, so I know for certain that there are no hearing or speech/language delays. He does have sensory processing difficulties (fear of heights/vestibular, loud noises) and it is possible that these aggressive behaviors are how he’s handling the over-stimulating environment of school.

Also, he is *technically* diagnosed with ADHD, but I am not certain that it’s simply his age or maturity level… or even sensory. He is not on medication. We tried it for 10 days at his pediatrician’s insistence (she felt like he was severe enough). It worked great for the first week, and then the combination of not taking naps and not eating well sent him spiraling out of control and he was sent home 3 days in a row from school. I just can't do that to him again.

We’ve had a child development specialist come to his school and she gave recommendations to his teacher (this was at his old school, not his new school where he has started pre-k). She also gave me recommendations for parent-child interaction therapy at home, which I have been doing. The problem is… he doesn’t HAVE these issues at home with us. At all.

We have recently put him in private pre-k because the classes are smaller and the teacher is great, but the same problems are happening. He does not do well with change and transition, and he has a lot of difficulty with social skills–which we have been working on. His school sent him home the other day for hitting his friends, and he told me this morning that the school day is too long and he wants me to pick him up early. :/ I think we’re starting another spiral downward if he continues on this path at his new school.

How can we stop this? Where do I go from here? Thank you in advance for any help! I'm sorry this is so long!

Some things we’ve tried in the past: “Hands are not for hitting” book, drawing pictures of his day and talking about how he’ll handle certain situations, asking the teacher for help when he’s upset, finding a place to play by himself or asking the teacher to give him a place. Also, we’ve done the basic rewards/consequences scenario that only seems to work for short periods of time. Actually, all of these things worked - for short periods of time.

 

[InsaneCdn]

Has he ever had an Occupational Therapist (OT) evaluation? That would pick up sensory problems - and motor skills issues, as milder issues are often missed until well into school (grade 2 or so).

And then... Can I challenge your thinking on Auditory Processing Disorders (APD)? I do not question that your son doesn't have language processing difficulties... as a Speech Language Pathologist (SLP), you'd be picking up on that really fast. But... is your home fairly quiet? The reason I ask is... ours is (and was) a quiet home. My difficult child started into major problems in Grade 1... and after 10 years of work and research and testing... he has an Auditory Processing Disorders (APD): auditory figure ground. People with this disorder have difficulty filtering out background noise, focusing on the "important" sounds. Kids playgrounds are notoriously noisy... and the kid who can't figure out what is going on, may react in unexpected ways. Classrooms are just as bad... not from obvious noise, but because there is so much white noise built into the environment... rustling paper, the scratch of pencils and crayons, sharpener, the heater... Just wanted to toss this into your thoughts, because if we could have caught this in Grade 1 when it showed up... I highly doubt I would ever have needed to find this board.

 

[Chantillylace]

Has he ever had an Occupational Therapist (OT) evaluation? That would pick up sensory problems - and motor skills issues, as milder issues are often missed until well into school (grade 2 or so).

He hasn't had a full-blown Occupational Therapist (OT) evaluation because our insurance doesn't cover it, but I have had our occupational therapist do a little check sheet for sensory issues. He was in the "definate difference" range in three different sensory areas and borderline in 2 more areas. She gave me some things to do with him at home. He's been screened several times for gross and fine motor skill delays and passes the screening every time.

As for Auditory Processing Disorders (APD), I just don't see that in my son. He doesn't act out when I take him to the playground, when he has playdates... nothing. Also, when we go to my mom's house his cousins (5 of them) are sometimes there. It gets very loud and stimulating, and he doesn't act up then either. But I'll keep an eye out for this.

Thank you so much for the response! I need all the help I can get! I just don't know what to do anymore!

 

[InsaneCdn]

Just our experience, but... we did NOT see the Auditory Processing Disorders (APD) either. It was only at school. Teachers felt difficult child just wanted one-on-one attention, and were not prepared to give it to him (a double whammy, because HE knew he needed it, AND wasn't believed). We believed school. (big mistake in this case)

How long does he spend at school? How does that compare to the length of time for play dates and such?
Is he worse in the afternoon than in the morning? Worse on Friday than on Monday?
Are there ANY patterns to the behaviour?

 

[Chantillylace]

How long does he spend at school? How does that compare to the length of time for play dates and such?
Is he worse in the afternoon than in the morning? Worse on Friday than on Monday?
Are there ANY patterns to the behaviour?

I drop him off at 8am. His school is over at 3pm and he goes to aftercare until about 5pm... sometimes 5:30. Before this school (he's been there a month), the problems were usually in the afternoon and almost ALWAYS associated with hunger or sleepiness (if he didn't take a nap that day). At this school, they have a snack in the afternoon and then another at aftercare, so hunger doesn't seem to be a problem anymore. Now his issues are happening in the morning. It's usually about twice a week right now... which is a lot better than it's been in the past. 3-4 times or more a day! This week it was Monday and Wednesday. I have a feeling he is having trouble today (he fussed and whined the entire way to school), but I told his teacher this morning that he wanted to come home, and she said that last time when she said she was going to call his mom that he started crying for me. So, she may be keeping him there because he wants to come home.

The other patterns that I've seen in the past are if he didn't eat a good breakfast, woke up too early, or stayed up too late, then he would often have a bad day the next day. He has an explosive temper when it comes to being hungry or tired.

 

[InsaneCdn]

Keep a log... sleep patterns, food patterns, behavior patterns. It's amazing how, when you write it down and go back and look it over, things "show up".

If you want a format, there's one on the Site Help and Resources forum.

Being hungry and/or tired... are huge triggers for many difficult children.

 

[Chantillylace]

How does that compare to the length of time for play dates and such?

I forgot to answer this. Play dates are usually only about 2 hours or so, but when he goes to my mom's with all of his cousins they will sometimes play for 4-5 hours. Still not as long as school though.

I have to say. I am a no-nonsense parent. He has very consistent discipline and I used to hover around other kids to monitor his behavior. I don't have to do that anymore. As long as I'm there - he does great. Even if he's playing outside and I'm inside.

 

[Chantillylace]

Keep a log... sleep patterns, food patterns, behavior patterns. It's amazing how, when you write it down and go back and look it over, things "show up".

If you want a format, there's one on the Site Help and Resources forum.

Being hungry and/or tired... are huge triggers for many difficult children.

Thank you! I checked out the charts and they just look like a bunch of randomness on this computer that don't seem to link to anything. I'll have to check on my home computer to see if they work. I will definitely start charting that!

 

[InsaneCdn]

Its not under charts...
Easiest way to find it is to search for posts by susiestar... (use advanced search)... she has the link in her signature.

 

[BusynMember]

I work at a busy preschool with 3 and 4 year olds. We have all sorts of kids and the aggressive ones are the minority and all have problems, although not all are diagnosed. I would have a complete evaluation, not just an Occupational Therapist (OT). He could have one of many things going on. It is best in my opinion to test all areas of function and also tell the professional (I prefer neuropsychs) all about your family history. Can you share those with us? Anything on either side of his family tree? Genetics is huge. Neurological differences are inherited as is mental health problems.

How is your family life? Does he live with both parents? Has he seen any abuse? Experienced any?

Like I said, it could b e so many things...I'd check with a neuropsychologist.

 

[TeDo]

It sounds like your suspicions about the ADHD diagnosis are valid. If he has sensory issues, has he been evaluated by an Occupational Therapist (OT)? I mean a THOROUGH evaluation? I would also highly recommend you ask the school to do a thorough evaluation for possible Special Education services. It could be that he gets an IEP that builds sensory breaks into his day at set times or that he be allowed some "down time" to regroup part way through the day. The request needs to be in writing sent Certified Mail with Return Receipt Requested. Make sure you specify you want Occupational Therapist (OT), educational, emotional, psychological, and behavioral evaluations done. Even if you know certain things are not the cause, have them do a thorough evaluation anyway. The day they receive the request starts a federal timeline they must follow and as long as he's in the evaluation process, he's protected from being sent home too often. How many days has he been sent home so far this year?

Has he ever been seen by a child psychiatrist, PhD level child psychologist, or neurospychologist? That would also be something I would do sooner rather than later. Personally, I would also get my own outside Occupational Therapist (OT) evaluation. They are usually more thorough than any that the school will do. If you find a GOOD one that works primarily with kids, it can be a godsend. It was for us. Our school Occupational Therapist (OT) said there were no issues but our private Occupational Therapist (OT) evaluation found writing issues, visual perception issues, as well as some processing problems.

Welcome to our little corner of the world. You'll get a LOT of support here from people who have been there done that and survived....and some that are still trying to but making progress.

 

[Chantillylace]

I would have a complete evaluation, not just an Occupational Therapist (OT). He could have one of many things going on. It is best in my opinion to test all areas of function and also tell the professional (I prefer neuropsychs) all about your family history. Can you share those with us? Anything on either side of his family tree? Genetics is huge. Neurological differences are inherited as is mental health problems.

How is your family life? Does he live with both parents? Has he seen any abuse? Experienced any?

Of course I'll share family history! First, his dad is diagnosed with ADD. He was diagnosed this year, and it was missed as a child. He was/is not hyperactive, just inattentive. My dad is not diagnosed, but he probably Asperger's. He is very bright, socially awkward, completely unaffectionate, and he has a HUGE temper when certain things don't go the way he thinks they should. I see a lot of my dad in my son, but I don't really think my son has Asperger's.

He lives with both parents, married, no abuse of any kind. He has a nurturing environment. I don't allow him to watch PG movies, commercials, or anything else that I haven't seen and approved. He has a baby sister who is 1, and he absolutely adores her.

 

[Chantillylace]

Also, I had some behavioral issues as a child that I remember being pretty bad, but my parents tell me that I wasn't as "bad" as my son. I went to developmental first grade.

 

[Chantillylace]

It sounds like your suspicions about the ADHD diagnosis are valid. If he has sensory issues, has he been evaluated by an Occupational Therapist (OT)? I mean a THOROUGH evaluation? I would also highly recommend you ask the school to do a thorough evaluation for possible Special Education services. It could be that he gets an IEP that builds sensory breaks into his day at set times or that he be allowed some "down time" to regroup part way through the day. The request needs to be in writing sent Certified Mail with Return Receipt Requested. Make sure you specify you want Occupational Therapist (OT), educational, emotional, psychological, and behavioral evaluations done. Even if you know certain things are not the cause, have them do a thorough evaluation anyway. The day they receive the request starts a federal timeline they must follow and as long as he's in the evaluation process, he's protected from being sent home too often. How many days has he been sent home so far this year?

Has he ever been seen by a child psychiatrist, PhD level child psychologist, or neurospychologist? That would also be something I would do sooner rather than later. Personally, I would also get my own outside Occupational Therapist (OT) evaluation. They are usually more thorough than any that the school will do. If you find a GOOD one that works primarily with kids, it can be a godsend. It was for us. Our school Occupational Therapist (OT) said there were no issues but our private Occupational Therapist (OT) evaluation found writing issues, visual perception issues, as well as some processing problems.

Welcome to our little corner of the world. You'll get a LOT of support here from people who have been there done that and survived....and some that are still trying to but making progress.

Thank you so much! I'm so glad I stumbled on this site! Hopefully I'll be able to put in some insight for others as an Speech Language Pathologist (SLP), but right now I feel like I know nothing about behavioral problems!

He hasn't had a thorough Occupational Therapist (OT) evaluation. I'm almost positive my insurance won't pay for it, but I may have to go ahead and get one privately. He hasn't seen a child psychiatrist or any of the above. A child psychiatric was going to be my next step. Do you know which one (child psychiatric, neuro psychiatric, etc) would be best? I'm not as interested in the diagnosis as I am the help, but I also know that they go hand in hand sometimes.

As for the evaluations with school. Right now he's in private pre-k. We chose it because of the small class size. So the school evaluations aren't an option right now, but if he does get kicked out of school (again, sigh&#8230, then we will probably look at public school because we have the IEP as back up if he keeps having a lot of trouble. He's only been sent home once so far, but I was told by the principal that she would be sending him home every time he hits from now on.

 

[BusynMember]

I would not trust the school district's testing over private testing. Just a warning...they have a vested interested in not finding anything wrong with your son and, in our experience, the school district never did a very good job. I'd go private first. Along with that Occupational Therapist (OT) I would still see a neuropsychologist. It is unusual for Occupational Therapist (OT) issues to cause the sort of issues with other kids that your son has. Learning issues, yes. Hurting other kids...not so much. There is a reason he can't control himself...I'm not a big fan of stand alone ADHD and am guessing that if you get an intensive evaluation by a neuropsychologist and an Occupational Therapist (OT), if you want to add that (remember that an Occupational Therapist (OT) is not an expert in behavioral issues), you are covering all the bases. My motto is: Better to be safe than sorry! I believe that with all my heart too!

 

[InsaneCdn]

I'm backing MWM... The comprehensive evaluation (typically, neuropsychologist, or child developmental/behavioural team, or PhD level child psychologist) is the only way your going to get answers... but, given that some things seem to be sensory, unless you know for certain that the comprehensive evaluation will cover Occupational Therapist (OT) in detail, you're better off to get an Occupational Therapist (OT) evaluation done while you're waiting to get in to the other evaluation.

Occupational Therapist (OT) is limited in what they can diagnosis... but they do have therapies to help, and can recommend accommodations and other interventions. An Occupational Therapist (OT) report IS used by other evaluators if it is available.

JMO - and experience - but being at least 3rd generation ADD/ADHD (really runs in the family), and being ADD and having two ADHD kids... those behaviours don't sound like ADD/ADHD to me, either.

 

[TeDo]

He hasn't had a thorough Occupational Therapist (OT) evaluation. I'm almost positive my insurance won't pay for it, but I may have to go ahead and get one privately. He hasn't seen a child psychiatrist or any of the above. A child psychiatric was going to be my next step. Do you know which one (child psychiatric, neuro psychiatric, etc) would be best? I'm not as interested in the diagnosis as I am the help, but I also know that they go hand in hand sometimes.

As for the evaluations with school. Right now he's in private pre-k. We chose it because of the small class size. So the school evaluations aren't an option right now, but if he does get kicked out of school (again, sigh…), then we will probably look at public school because we have the IEP as back up if he keeps having a lot of trouble. He's only been sent home once so far, but I was told by the principal that she would be sending him home every time he hits from now on.

If the private school gets ANY federal money, they HAVE to follow an IEP or do the evaluations to determine need. If it's 100% privately paid by you, then I don't know if there's anything you can do.

I'm with the others as far as specialists. I will qualify my recommendation by saying that it needs to be a GOOD, reputable one. There are some not great ones that won't help at all. If you get a good one, they usually give great explanations and recommendations. That was our experience anyway. We found the best in our state.

I'm not trying to diagnose but some of what you've said reminds me a LOT of my difficult child 1 and I never thought he was on the spectrum either but as he's gotten older, it's become much more obvious. If you think it MIGHT be a possibility, find an autism specialist to rule it in or out. My difficult child 1 has HUGE sensory issues that our Occupational Therapist (OT) was a great help with. By addressing these issues, he's learned to use some of the things to calm himself. But then again, we school at home now so he CAN. Schools are not equipped to handle some of these things much less help with them, at least not in our experience and at his age. Most of the things that work are not "age-appropriate" and could not be accommodated.

I am very glad you stumbled into our family too. All advice and suggestions are always given with the best of intentions. Take what works, try what sounds like it might, ignore anything that doesn't. Also, your expertise will be appreciated. We do have another Speech Language Pathologist (SLP) here but she's having internet issues so doesn't check in as often right now. Again, I'm glad you're here and I hope you find this to be as great a support as I have for 2 years now.

 

[Chantillylace]

I'm not trying to diagnose but some of what you've said reminds me a LOT of my difficult child 1 and I never thought he was on the spectrum either but as he's gotten older, it's become much more obvious. If you think it MIGHT be a possibility, find an autism specialist to rule it in or out.

His sensory issues are a little different than most kids. That's why it took me so long to realize that he had any. He'll wear anything, eat just about anything. His problems start when he has to climb or jump. He won't climb up play places and slide down unless an adult goes with him the first few times. He used to not climb up at all. The first time he "jumped" on a Jupiter Jump was about a month ago. Before that, he would go in, stay on all fours and crawl around in there. If there were too many kids, he would come out and tell me it was too loud, but he would NOT jump. He didn't like the baby swing as a baby. He's never liked his back rubbed, and still won't allow that, but he's very affectionate and gives lots (perhaps overkill) of hugs and kisses. He's cries when the fire alarm goes off and school. His teacher said he clung to her leg, shaking and crying. He's also scared of some vacuums. He says it's just the "loud" ones that scare him.

Also, in the past he wouldn't allow band-aids on his skin, but now he will. He started allowing them at about 3 1/2. He still won't wear band aids in the water though. If he has one on he won't get in the bathtub or the pool. Until about a month ago, cutting his toe nails was a 10 minute screaming session.

As for Autism Spectrum Disorders (ASD), the only symptoms he has are sensory (which you can have without an Autism Spectrum Disorders (ASD) diagnosis), resistance to transition and change, and difficulty with social skills... and perhaps empathy; although, he can recite that hitting hurts his friend's feelings and body.

He doesn't get interested in parts of objects or how they work, he's not overly interested in one topic. Well, he loves lawn equipment and will stop everything to help the neighbors "mow" if they are mowing, but he doesn't talk about it all the time. Actually, his teacher didn't even know he loved mowing stuff until someone was mowing at school one day and he begged her to let him sit at the window and watch. Also, his speech is expressive. He makes good eye contact with people he knows. He recognizes social cues, facial expressions, and changes in tone. His speech is normal - no big words that are completely inappropriate for his age.

Any thoughts? I think it's kind of a fear of mine that if I dig into testing that he'll be diagnosed with Asperger's... but the child development specialist that saw him said that she didn't see it; although, she's not qualified to diagnose - that's one professional opinion.

 

[Chantillylace]

Also, I guess I should add: I have some sensory issues too. I can't sleep with a sheet - only a comforter that feels a certain way, and I can't sleep with anything covering my arms or legs (except that blanket). I'm okay other than that though.

I also have a history of anxiety. Actually, I probably still struggle with it, but not like I used to.

 

[BusynMember]

Not sure why it scares ya, but he sounds a lot like an Aspie to me. My son has obsessions, but doesn't talk about them at school either. (Or now that he is at work, at work). No two Autism Spectrum Disorders (ASD) kids meet every single criteria. My son shows a lot of empathy and compassion and love, but he is definitely on the spectrum. You'd need a neuropsychologist to determine if he is or isn't...there are A LOT of tests. My son was tested for ten hours, in every area of function. Sensory issues and APDS plus the appearnce of ADHD are all a big part of Autism Spectrum Disorders (ASD), but the biggest issue, of course, is lack of social skills. Your son needs help. I wouldn't refrain from an evaluation because you are scared...remember, this is about him It's not about us. Violence towards other kids is also common in childhood onset bipolar. At any rate, something isn't right. My Autism Spectrum Disorders (ASD) son was never violent at all toward other kids.

A lot of Autism Spectrum Disorders (ASD) kids are not diagnosed right until later on though. If he can get the right interventions for his issues, that's the main thing when he is young. However, nobody here, including you, knows what is wrong with him. Your mom gut is telling you that something is...I'd lift my chin and bravely face whatever is going on. It can only help your son, not hurt him. Only not trying to find out everything will hurt him.

Good luck and keep us posted