New here...and reeling from today's psychiatric visit

[spiritworm]

I just have to say I love this site! Found it a few weeks back and am so relieved I'm not alone! My 3 year old DS is very oppositional and aggressive...we had thought that maybe he was simply a 'spirited' child until the last 6 months, where he's had some really miserable episodes of behaviour. Violent meltdowns that sometimes last hours, lots of head banging and hitting, biting, scratching at our faces; was asked to leave one daycare already. I used to think this was some kind of terrible twos thing; that he`d eventually grow out of it. But I`ve recently discovered that there's a family history of BiPolar (BP) on husband's side of the family, so I'm wondering if he has some sort of mood disorder

My step mother is a school psychologist and highly recommended a colleague of hers to help us out with our issues. We were able to bypass his typical year-long waitlist (our supported child development worker even knows of him and praised his work). At our first phychologist app`t with him, we discussed the behavioural issues + history (I brought in a 8 page print-out detailing his general behaviour, recent episdoes, developmental history, and the exhaustive list of parenting techniques we have employed; the second app`t I brought DS in for some one-on-one evaluation...said no developmental or cognitive delay...no further evaluation recommended at this time. The 3rd app`t was going to outline strategies for managing DS`s behaviour. Finally...gasp...some help.

And here`s what he recommended: 1-2-3- magic!? Are you kidding me? It was a parenting 101 session. Catch them when they're good + praise them dramatically, and immediate consequences when bad etc. etc....I just can't believe it! I don't think he heard what I've been saying (or wrote in my documentation, for that matter)..my boy is resistant to standard discipline techniques. We've tried and tried and tried. The advice in standard parenting books offer little resolution to our difficulties with him. It's like there's something just not there in bis brain...his desire to please those he's attached to is pretty much absent, unless of course it's something that he wants to do himself. I was so looking forward to this appointment as I thought it would offer some real solutions...some steps in the right direction. I just feel so devastated...I was so hopeful about this appointment. I suppose I`ll stay on with him for a few more sessions (as he`s so highly recommended) to see if anything useful develops out of this, but this just doesn`t feel right

So, a question for you all: For those of you out there who've tried the psychologist route, is this how a psychiatric would start out some kind of behavioural modification strategy (i.e. laying a basic framework maybe) or is this just plain silly?
I'm half-way through the explosive child, and am finding it amazingly refreshing and helpful...it just seems that the 1-2-3 magic thing is just way too basic.

Glad to have found you guys!

 

[smallworld]

Spiritworm, welcome! I'm glad you found us.

I'm going to be honest here -- and I am sharing my experience, which may not echo the experiences of others here -- in our many years of seeking help for difficult child 1 (who has the most severe issues of my three children), we have never been helped by a psychologist. They have all recommended behavior plans based on rewards and punishments, which has not worked at all for difficult child 1. I have asked if they have any other techniques in their toolbox, and they say no. I'm surprised that they don't have anything more sophisticated to offer. And I agree with you that Magic 1-2-3 is way too basic.

difficult child 1 has significant mood issues, and he's on his fourth doctor in as many years. The only doctor who has ever made a difference is his current psychiatrist, who sees him weekly for medication management and psychotherapy. He "gets" difficult child 1 and agrees with us about behavior plans. We feel our parenting style is compatible with Ross Greene's approach and try to incorporate it into our daily life as much as possible.

Where does that leave you? I'd give this psychologist a little more time, but if you don't think he's going to help, you should probably look elsewhere. You might want to consider having a multidisciplinary evaluation at a children's or university hospital to get a better idea of what's going on with your difficult child.

Again, welcome and good luck.

 

[flutterbee]

Welcome to the board. I'm glad you found us.

I'm with you and smallworld on the 1-2-3 Magic. It got us nowhere. A lot of psychologists have their preferred list of behavior modifications. Her second psychologist, who was highly respected in our community, would go on exhaustively about the reward chart he preferred (to the point that I would find myself zoning out - the man liked to talk). I did give it a valiant effort. It was a disaster. By that time, difficult child was 8 and I had been dealing with her behavior since infancy - so I had been around the block. Like you, I always just considered difficult child willful and stubborn (which she is, by the way - not a bad thing if it can be redirected) and had been compensating with my parenting. I have certainly never parented my two children in the same way as their needs and abilities have always been vastly different.

Ross Greene's approach really puts things into perspective and takes the angst out of deciding which battle to fight. With my difficult child, we only work on one issue at a time. Everything else then pretty much falls into Basket C to some degree and as she masters the issue of the moment, Basket A and Basket C change. We really don't have a Basket B. Her anxiety is such that that is really all she can tolerate at one time.

I also agree with smallword that if you just aren't clicking with this psychologist, find another. Give him a chance, but if it's just not working don't waste too much time and energy going down that road. We've been through several - all of them highly qualified, but just not a fit for us - and the one we have now (an MSW) just really gets it. She doesn't have a stock list of behavior mods; she considers the needs and abilities of the individual child. IOW, she realizes there is no one plan out there that works for every child. I got her name from our school guidance counselor.

I further agree that a multi-disciplinary approach is wise. That can be done through a children's hospital or university hospital or, as in my case, through a group of professionals in individual practices working together (however, it would probably be more expedient going through the hospitals).

I hope you made it through my rambling. :smile: Again, I'm glad you found us. This is a great group of parents here.

 

[SRL]

Hi Spiritworm--I'm glad you found us! Reading that description of the psychologist I thought you maybe lived in my town ;-) because that same guy practices here. Rave reviews from many parents but when you dig a little further what you find out is that many times the success stories are due to parents who were inconsistent, children who were difficult but not disordered, or things like mild ADHD. Children with more serious issues often don't do well with 1-2-3 Magic, but we always see exceptions to almost everything come through here now and then.

I could have written your same paragraph about my child having no desire to please me from the time he was 18 months through about age 7. He literally could have cared less because the drive to do what he wanted was so strong within him. In hindsight that was one of the first red flags that something wasn't riht but of course at 18 months we thought we were dealing with a very strong willed child.

As you know, violent meltdowns that last for hours with head banging and aggression that happen more than very occasionally are outside of the limits of typical three year old behavior so I think you are wise to pursue an evaluation and to do your research. 1-2-3 Magic is a style based on adult authority and that style often exacerbates our difficult little people. When I changed to The Explosive Child strategy mentioned above I was shocked at how much I'd contributed to my son's non-function simply by trying to be a good parent by helping him learn compliance. When we switched gears we had a far calmer household and while it's not been a straight shot by any means, it's been a very successful journey...so far anyway!

I agree with the others--if you don't see results soon (as in within a few weeks) you need to look to other professionals. For these younger children the specialty areas that parents here are reporting more accurate results from are pediatric neuropsychology and developmental pediatrics. I'm not saying other specialists can't be helpful but for a child this young wiht these issues I would want one of those specialists involved in a multidisciplinary evaluation.

In the meantime, if you want to start doing some research into specific disorders, mood disorders and Autistic Spectrum Disorders (especially higher functioning)is often what brings parents of younger children to our board. Keep an open mind and be aware that very few children hit all of the symptoms on the list. There's a list of links to the right on the board.

 

[totoro]

Hi and welcome-
As someone who comes from a long line of mental Illness etc. I found that keeping an open mind and trying to work with the symptoms was key!

Especially with a such a young one. Our 3yo is "just" Sensory Integration Disorder (SID) right now... we are working on all of her symptoms, but that is her diagnosis so far.

I also found that for our first child and trying to "prove" things it helped when we had video of symptoms. I also listed every behavior mod. in my parent report: 1,2,3, Magic- attempted from 6/2005-8/2005. difficult child did not respond to method. etc. Something like that, I even listed that we had her room cleared of all external stimuli, and it did not affect her!!! Time out's everything...

Some doctor's won't take the time to read this stuff, but at least it is there if they do take the time.

Welcome and good luck. THis is a long road take a deep breath and gather lots of patience.

 

[JJJ]

1-2-3 Magic didn't work on my children when the were unstable. When unstable we use Explosive Child's basket approach. Once stable, we use a modified 1-2-3 Magic ( we actually count backwards from 5 )5-4-3-2-1-consequence. The longer count and the clear end to it gives my kids time to process what they are doing and make a decision (good or bad), it limits their time in trouble for impulse control issues as it gives them a chance to fix it. But prior to medication stabilization, I could have been counting in Swahili for all the good it did.

 

[TerryJ2]

Welcome SpiritWorm. So sorry for your troubles.

But prior to medication stabilization, I could have been counting in Swahili for all the good it did.

LOL LLL! SO true!

 

[spiritworm]

Thanks so much for all your advice and encouragement! I've calmed down since yesterday...still disappointed though. I guess I expected a longer evaluation into what my boy's strengths and weaknesses are, and then from that evaluation, some guidelines on how to help him with certain skills he's lacking (low frustration tolerance, impulse control for e.g.). I'll give his advice a go and try this stuff again (so as not to be defiant myself, tee hee). I do have other things on the go...an aggression study at our children's hospital (if he's screened in, he'll get 'backdoor' access to a team of specialists; apparently waitlists are typically a year long). I'll shake my pediatrician down for whatever he can give me at our next visit, place our name on any waitlists, and continue reading anything I can get my hands on. I've definately learned a lesson from this though--not to put so much hope in one person. Looking back on it, I think I was a bit foolish to think, based on other peoples' recommendations, that this guy would be the key to getting some help. WHo knows, maybe next time, he'll surprise me and offer something insightful. In the meantime, I'll try different routes.

 

[wakeupcall]

Spiritworm, cover all the bases you can find. My difficult child has been in therapy since the age of four. Honestly, I can't say that I think it's helped much, but the school sure works with us better knowing that we have him on medications and he has regular therapy. I guess I keep thinking that some day all of the medications and all of the therapy will make a difference. Keep trying....you never know what may work.

 

[Evanlee]

I was told to use 1-2-3 Magic by the Mayo Clinic... My son was discharged, got so upset and triggered that he was re-hospitalized the same day as discharge. I tried their version of 1-2-3 Magic--which was start counting and then deal out a punishment. Be consistent. Be firm. Eye contact, get on their level. They believed in 1-2-3 so much that they refused to give my son any kind of medication.

I found 1-2-3 Magic is practised different ways and has different variations. My advise keep what works change or discontinue what does not.

One Opinion on 1-2-3 Magic

Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in Children and Adolescents: Diagnosis and Treatment
http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm#_Toc135732019


You need a behavior modification or management plan.
Is that what "1-2-3 Magic" is?
Yes, that is a good example. For behavior modification to work, the program must have certain properties:
1.A few important behaviors need to be targeted. Rather than targeting "being good," you might try no hitting and no swearing.
2. The behavior must be clear cut and not fuzzy. Things like "listen when I tell you something" won't work, because it is too unclear. A better idea would be, "Sit down and look at me when I ask you to listen."
3. It must be consistent. There is no bending of rules in this sort of thing: no difference between the baby-sitter, mom, or dad.
4. The rewards and punishments need to be geared to the individual.
5. The rewards should not be money or things that are bought, but rather should be privileges which you can grant or activities which the child can do. Behavior Modification should not require a bank loan.
6. There needs to be an even mix of negative and positive reinforcers. The program should not be like candyland, but it also should not be out of Dorchester Prison. A typical Positive one would be a later bedtime on the weekend or a choice of dinner. A typical negative one would be going to your room or no TV.
7. It should be simple and straightforward so that your child easily understands it. If your child can read, it should be written down. If possible, your child should sign it and agree to it.

 

[BusynMember]

Count my son in. 1-2-3 Magic was a bust. We put him in time out, he got right up, threw the chair and tore the 1-2-3 Magic book that the psychologist had lent us!!! My experience was that psycologists were not useful to my son. And at age 3, it's hard to say what's going on. If there are any speech or developmental issues, I'd see a Developmental Pediatrician and treat the symptoms. You may be able to test him for Early Intervention with the School District.

 

[tiredmommy]

1-2-3-Magic made my daughter uncontrollably anxious, though it does work when used sparingly now.

 

[spiritworm]

Well, I'm halfway through the book. Nothing new and insightful here yet--just the same old standard discipline practices. Reading the book though, it's kind of shocking how it seems as though the author is talking about someone else's kid--a typical kid. I wish all I had to worry about was whining, run-of-the-mill sibling rivalry and complaints of 'I never get anything'!
Some of the stuff this guy says has me shaking my head! The author includes tantrums as 'countable' behaviours and describes them as sometimes humourous events--funny enough to take a picture of a tantrumming kid and laugh about it later. Wow, my definition of tantrum must be alot different from the author's--certainly nothing humorous about the ones I see. I could not imagine counting and providing a consequence for tantrums or meltdowns. IN our case is would make his behaviour sooo much worse if he were already in that state and it would be cruel to punish him for something that's so beyond his control. Empathy and calm-down time are the only way to go in my opinion (once he let's us connect with him again that is).
The author also comments how parents can create ODD in their kids (!!) and his general authoritative tone makes me very anxious (one of the boy's triggers).

Trying to keep in mind that whatever book you read, there's things you agree with and others you don't
Anyways, we're trying it with him now (the method is pretty much similar to the time-out method we were using before we decided that time-outs weren't working for us--ha, ha). He's been in a very good mood the last couple of weeks--all I have to do is glance down at my forearms for evidence--bruises and bitemarks are fading. So it's been going OK. But if the miserable moods return we'll have to return to a mainly 'expolosive child' approach.
I've been meaning to start a new post to get all of our opinions on some fo the appointments we've recently had...but can't seem it find the time yet. Hoping to get that one out soon...
Thanks for everyone's advice and support!!

 

[M&Co.]

Have you tried the Feingold diet? Information is here: http://www.feingold.org/

My son has allergies to almost everything. His allergies don’t manifest themselves in “regular” sorts of ways. Instead, the allergens trigger a lot of his bad behaviors; banging head on floor, hitting, kicking, spitting. When the moons align and the gods shine down on us and we have low allergen (mold is a particular problem for us) and pollutant days, he's the child I know he's suppose to be; sweet, affection, articulate, non-hyperactive.

We've been on the Feingold Diet for a month or so now, and it has helped. When he accidentally gets something he shouldn’t (MSG makes him hyper, artificial vanilla makes him have a low frustration level, hyperactive and violent ) it is obvious that he’s gotten into something he shouldn’t have.

 

[momof3boys]

What I've started doing is interviewing psychologists (and others) over the phone. I ask what books they recommend to people with kids who don't respond to typical discipline. If Ross Greene's book isn't on the list, I move on, and don't even bother meeting with him/her. I hope that you can find someone who can really help you. Its so frustrating when the so called experts can't even help! Good luck.

 

[Mrs Smith]

Trust your gut and find someone else. I wish I hadn't given some "experts" as much time as I did. Medication and development were the things that had the most positive effect on my son's behavior.

 

[blb]

It sounds like he's using a cookie cutter approach to your child, just what you want, right? :hammer:

My personal thought, having dealt with school psychs and CSW's that were CLUELESS, I would bypass and head straight for a neuropsychologist and MD psychiatric evaluation, especially with your family Hx, clearly there may be more going on.

I think the reason often that CSWs recommend the simplest strategy is because unfortunately many parents are clueless themselves; all you have to do is watch Supernanny to see that. But since you detailed the info in an 8-page report (a woman after my own heart :smile:) chances are you are more on top of the issue to begin with...perhaps even moreso than your CSW.

The problem is that at 3 yo, a lot of the symptoms can overlap other conditions, so if you are thinking of the medication route you want to make sure that the medication psychiatric DR you see is very well versed in the co-morbid conditions, and that his focus on the conditions that you think difficult child may have. IE You don't go to a gastroenterologist for a toothache, so don't waste your time with a psychiatric MD whose specialty is anxiety alone if you think you're looking at a pediatric mood disorder.

Hope this helps