New & here's my story (for today)

[flachic]

I'm truly exhausted today & can't believe it took this long to figure out a support group would be SO wonderful!

I don't even know where to begin. I don't exactly recall where it started. Since every day begins with a battle, it's hard to pinpoint when the battle became a full-blown war.

I remember now..when I mentioned that perhaps a fine should be given for certain behaviors. difficult child flipped out! Started blaming my husband, hitting, kicking...over & over. The time out did not work. The loss of a privilege did not work. He was so out of control--it's been at least 2 years since we've seen this extreme of behavior. Screaming, yelling, throwing things...threatening to kill me (in detail), etc. He ran away (to the corner). Came home & said he wanted to call his sitter because he didn't want to live with-us anymore.

Long story short--all the consequences were in place, & we thought he'd gotton it all out of his system. Patted ourselves on the back. But then..when the sitter said no to something or other, it began again, in earnest (I was 15 minutes gone on my way to work). She has 3 kids under 4, & they had to lock themselves in the bathroom. difficult child said 'something' about a knife (still unclear) & would not let the sitter have any peace--followed her, as she sat in the bathroom & continued yelling outside the door. I sent my husband to pick him up, trying to avoid a worse situation. husband had to break in (difficult child locked him out), & physically remove him from the house. All the way home, difficult child is threatening to jump out of the car.

I left work early, relieving husband of duties. Our counselor had called in the meantime & difficult child totally calmed down. I had to give him the news the sitter quit & that was extremely hard for him. He loved her & she was the only one other than us who could handle his behaviors (but it was never like this).
At this point, I'm not sure what to do. I have my consequences planned out, we're not giving up, & I hope this 'break-up' with the sitter will send a message to difficult child that you cannot abuse people.
I feel so embarrassed & feel totally alone...I feel like I can't talk to people about this because then they'll judge you or your child or whatever. I told my employer a very abridged version to be able to leave work. & I do alot of self-blaming when it comes to his behavior, because of the times I'm not able to use self-control when he flips out & I end up screaming at him or whatever. I did better today. But I also feel so resentful. And then I remember how good his heart is & how he does seem to want to behave most of the time & can control himself at times. I just don't know where to go from here....
Any feedback would be fine. I'll answer any questions & read any replies with an open mind. I just want to not feel alone anymore.
Thanks for listening.

ps..i don't know if i did all the user name/log in name/profile info/signature stuff correctly, so please disregard any mistakes =)

 

[Hound dog]

Welcome to the board

You're not alone anymore.

It certainly sounds like you have your hands full.

Is difficult child currently in treatment? Is he taking medication? Any history of mental illness in the family on either side? Anything out of the ordinary that might be triggering these new more aggressive behaviors? How does difficult child do in school? Does he have an IEP in place?

Sorry about the questions. But they give us a better idea of things to suggest.

First off, if difficult child is threatening bodily harm to himself or others he should be taken to the ER to be evaluated. This is for his safety as well as those around him.

It's super late here, and I'm brain dead from being in classes all day. lol Hopefully someone will reply with some more suggestions.

((((hugs)))))

 

[flachic]

First, I want to thank you for your welcome & reply. I don't mind the questions & I will clarify anything.

difficult child is in outpatient treatment with a MSW, every other week. Has had prior counseling. Never had medications. School has always been a challenge & I began homeschooling 4th grade...this is our 2nd year. Next year, I plan to send him to a 'Free School'. His issues in school have always been 'acting out', 'attention getting behaviors', and he was evaluated several times, most recently at the end of 3rd grade (2 yrs. ago almost exact). He was always diagnosed with anxiety & depression.

I have no info on his biological dad. I have no info on my own, for that matter. I personally have had some issues (is it showing on my signature?), and my mother had issues with ptsd (undiagnosed), and alcoholism. I had attempted suicide once and was a 'cutter' before 'cutting' was an actual diagnosis, or symptom.

difficult child was very (physically) aggressive on a daily basis 5 years ago. We've seen a decrease in that behavior, though we'd like to see the aggressiveness extinguished. The verbal aggression is new (within the past year).

As for the ER, we didn't do that today. I am so afraid of him being misdiagnosed, put on medications that won't work, or having something taken way out of control that I just want to make sure I'm doing the right thing at the right time. We've had problems in the past with the routes that have been taken. How do I know what I'm doing is right?? What should I absolutely avoid?? What should I trust in??

Thanks again....your input is appreciated greatly!

 

[Allan-Matlem]

Hi,
The starting point in my humble opinion is to lower the rope , avoid confrontation, create a happy and relaxed atmosphere , which means avoid saying NO, try reach compromises and don't try to DO to him by consequencing or punishing , try to start concentrating on the relationship , just talking about general stuff, working with as opposed to doing to him. Maybe the baby sitter can spend one on one fun time with him and try to mend the relationship. I highly recommend a budy-tutor , older brother etc It is not easy, trying to teach him a lesson, makkes a kid resist even more , we some way have to reach out to them through the back door. Education is a process and a long one
take care , nurture yourself, despite our kids we should be coping better , being a source of happiness and optimism.

Allan

 

[Marguerite]

Hi and welcome. You said, " His issues in school have always been 'acting out', 'attention getting behaviors',... "

I know it's easy for some people (schools love to do this!) to call this "attention-seeking" but when you have a kid with anxiety you can get reactions like this if you push their buttons too hard. The trouble is, you don't always know ahead of time what will push their buttons. Just as they're not doing it on purpose, neither are you.

A book that gets recommended a lot here is "The Explosive Child" by Ross Greene. It can totally change your understanding of your child, and in doing so makes it easier to head off these sort of behaviours. It's not a cure, but it can be a huge help. And once you learn to help him prevent the explosive reactions to feeling threatened or overwhelmed, you can see what is left, which makes dealing with him and getting help a lot easier - there is a less 'noisy signal', so to speak.

He has just lost his sitter and will be sad about this. He will also be anxious - who will help look after him now? But make sure that you don't punish him further - he is punished enough, just by losing her. And it is all a matter of direct consequences for his own behaviour. Do not let him successfully blame any of you in any way, he has to own this. But stay calm when you talk to him, talk to him with the respect you wish he would show to you and don't react if he begins to get angry or upset. He needs to learn self-control, but when you react or punish, you make his anxiety worse, which makes it even harder for him to control himself. And frankly, when he gets angry he is NOT dealing with the problem. The current consequences of getting angry are actually letting him off dealing with the main triggers, because the problems then escalate so fat that he no longer has to deal with the cause.

For example, this latest big rage was triggered when you were talking about fines for bad behaviour. In his head, he was probably thinking, "How can I handle THIS? I can't control my moods!!?! I'll be broke and bankrupt within five minutes of them bringing this in! It's just not fair!" I suspect he's also saving up for something that he really wants, and this would hurt him badly. In his mind, he then begins to panic that he'll NEVER reach his goal, with you and husband handing out fines. His anxiety then escalates to the point where fines or no fines, you now have a lot more serious issues to worry about. I suspect you never went back and revisited the subject of fines - and frankly, there is no point, in my mind. He's now lost so much that a fine is nothing, now, by comparison.

The thing is, he really does sound out of control. This is impulsivity and raging. If he could control himself, he would. If he had been able to think clearly, he would surely have realised that even without punishments, there were going to be dire consequences for him. But once started, he just couldn't stop. Punishing him for what he couldn't stop is adding cruelty into the picture and taking away even more control, when his grip on control is already flimsy.

But so often, our discipline methods are aimed to punish what we call bad behaviour. We were brought up this way and we turned out OK, so it must be good, right? Maybe for a lot of kids, but there are some for whom this is disaster.
Not punishing them is not necessarily spoiling them. It's a matter of going back to basics. What do we want to achieve here? We want them to learn. We want him to learn what is right and what is wrong, we want him to learn self-control, we want him to not rage at people, we want him to do well and be happy.
He's going nowhere until he begins to learn self-control. His locking his dad out of the sitter's house - he knew he was in trouble, he knew he was in the wrong. He just couldn't stop. So he DOES know right and wrong. No amount of further punishing is needed on this one. The problem is his anxiety tipping him into panic, and then raging. He can't be reasoned with while raging, so everything you do or say to him, especially if you're warning him to control himself, is only making him worse. Once he calms down, THEN you can sometimes say, "Let's talk," and ask him to try and SAY what is upsetting him, because nothing should be set in concrete until you can work it out together. If you can involve him in a behaviour management method, then he has some ownership of it and is more likely to listen to you when he is calmer. When he learns that your aim is to help him learn to stay calm and to help him learn self-control, he will have more trust in you (right now, he doesn't trust anyone, including himself).

He's facing consequences right now. He's probably remorseful at some level, although he may be using denial to cope with a lot of the really bad feelings he must have about himself. But without using blame (because not every situation requires blame, and using it all the time teaches them to try and blame someone else, because that's what people do to them) try and talk to him about his lack of self-control. No blame - it's just what IS. Does he have any thoughts about this? What does he want to do about it? How does he feel? All you're doing is listening, and trying to support and help. Discuss with him what HE feels should happen. If you find any bravado, any level of bluster, try and gently hose it down and ask him to be realistic. Remind him you're not blaming, but this must be discussed rationally with him because it can't continue. You want him to be helped, you want this to stop and you recognise he's not able to do this alone.

He sounds like a bright kid. I hope this works.

If you can, read the discussion on "Explosive Child" in Early Childhood. I'm sure there's something there. In the archives, if nowhere else. I strongly suspect you are going to have to change your thinking about discipline. Not that you've been doing it wrong, but probably it's been wrong FOR HIM. The good news - the technique you need to use is also fine for 'normal' kids. And I found it's easier, getting easier all the time as you start winning and he starts to gain self-control.

It's not in a child's nature, as a rule, to want to be bad. They want to be good, they want to be loved and they know that bad behaviour makes them unlovable. All you need to do is show him you love him and want to support him in his aim to gain self-control and be better behaved as a result. It's a start.

Marg

 

[kris]

good morning, flachic. i'm glad you found us.

okay, first off you need to take some slow, deep breaths.

my first recommendation is that the very next time your son gets violent like that whether it's toward you, husband or anyone call an ambulance & request transport to an ER....when you call tell them he is mentally ill so they know what they are walking into. the cops will show up to to help contain him, but will be unlikely to press for an arrest.

get yourself a copy of THE EXPLOSIVE CHILD by ross greene. many people here have used greene's method with-good success...myself included.

has your son ever had a neuropsychologist evaluation & if so, when?? why no medications? there are medications that can help with-the aggression. you say he's depressed, but is that an official diagnosis & who gave it? again, why no medications???

how is he with-homeschooling? is he generally cooperative? or not so much?

if you look to the right side of the page you will find links to many of the disorders we discuss here. read through some of them & see if anything strikes a cord with-you in terms of the behaviors he is displaying.

kris

 

[SRL]

At this point I think you need answers and a successful treatment plan more than you need consequences. Until he is stable he should never be left alone with other children. Please don't avoid a trip to the ER if he's out of control--sometimes that is fastest way to get a child help.

The one question we always ask here is what kind of specialists did the evaluations. The reason is that there are professionals who as a whole are far more accurate in diagnostics while there are others that jump pretty quickly to treatments. I'm not saying anxiety and depression aren't part of the puzzle but you want to make sure that you are aware of everything that is going on. Often there are other issues (such as sensory issues making the anxiety worse) which make the behaviors very cyclical. Developmental pediatricians or pediatric neuropsychologists would be the best diagnostic options at this age--usually a referral is needed from a pediatrician.

Is the only treatment happening for him every other week counseling? I think it's clear he needs more support. What's being done to address the anxiety issues? My difficult child struggled with that area and it not only became very debilitating, it also triggered huge behavioral issues.

Developmentally did you note anything unusual, thinking back from birth? Anything in the way of delays or very advanced skills? Unusual or quirky behaviors? Sleep problems? Overly sensitive to stimuli such as light, foods, clothing textures, sound?

 

[timer lady]

Wanted to pop in & offer you my welcome. My cohorts have offered you a great deal of information to digest.

I'd just like to offer that PTSD/anxiety issues presents very differently in children. It's the flight/fight reaction to a perceived/real threat.

Is difficult child worse after a session of EMDR - that is not unusual. In fact, I've learned to expect it.

I hope today is a better day for you & for difficult child. Keep it calm if you can.

 

[oceans]

I agree with the others. If he is threatening others to this extent then he needs to go to the ER. It is a safety issue. If he is admitted, then he will get an evaluation and they will try some medication and therapy that could be beneficial. I don't know why you are refusing medication for him if his behaviors are so off. With the correct medication you should see an improvement in the way he can handle himself and relate to the world his world. That is great that he is going to all the therapy, but it seems clear that it is not enough to keep his behaviors under control. I hope that things calm down for you soon!

 

[flachic]

I just read all of your replies & want to thank you. I actually do have the book mentioned & have read it previously, but I don't recall if I actually read the whole thing or flipped through it. I'm going to try to answer all the questions.

difficult child was diagnosed with depression & anxiety by 2 separate teams of people..once when he was 5 and once at 8. I have to look over the paperwork to see what their titles were.

difficult child had EMDR last week & 2 weeks prior to that. Both times he had 'explosions' that seemed to be delayed a few days.

I am always so torn about the consequences...I have been accused by family members as 'dropping the ball' and 'not holding him accountable for his behavior' (one of those family members is a MSW who works with children). I have been told that I'm not doing enough, I'm doing too much, I'm too close with him, I need to make different decisions...'get him back in school', 'get him in a better program', etc.

I took him out of school because every day he'd come home crying that he was a 'bad kid' & hated himself immensely. In 3rd grade, his teacher put him in a desk, facing the wall, back to the room...for 2 months. His grades dropped. His behavior worsened. That was the decision maker for me. He finished 3rd grade & I began homeschooling. It has been good at times & difficult at times. He's very bright, but rejects some subjects (like math) & I don't have the patience any more to do the schooling. I would say he's generally cooperative.

He likes to control as much of his environment as possible. Has been 'independent' in nature since he was young, yet wants me close by at the same time. People always commented (from 3 days old) on how 'alert' he was. He talked early (as did I). Sleep patterns change regularly (as do mine)...he can sleep alot or a little. Has a huge addiction to sweets. No he hasn't had a neuropsychologist evaluation. No medications because there aren't any for anxiety for children. Some talk of ADD but the behaviors aren't present in all settings...notice more hyperactivity when faced with social situations. He was exposed to so much violence & verbal abuse from birth to age 4 that I wanted to treat him for what may have come from that situation first. I'm also trying to treat myself (in counseling every other week as well--we flip back & forth because I can't afford more at this point--yes we have insurance but I still have to pay $35/visit, which is fine for one visit a week--anything more would be too much).

We have no sitter now & we both have to work on Fri & Sat. Sitters are hard to come by, especially with-a child with-behavioral issues...we went thru at least 5 within the first 3 months of my job (that I've been at for 15 months). This last one was a savior...now I don't know what we're going to do! We have 3 days to figure it out. That's the other stressor at this point!

I'm going to read those threads suggested (already have them up in another window) & pull down that book. It's so hard to know what to do!!! I feel like we've tried so much, but then maybe we haven't done any of it for long enough.

Thanks again. I feel so relieved to find people who actually Understand!!!

 

[Marguerite]

Oh boy, I can so relate to the way people criticise you for parenting! At least you have husband around - often a lot of the blame makes reference to you trying to do it on your own.

The medication - difficult child 3 is on medications for ADHD. Technically they're not for his anxiety, but because the medications help him focus, he gets less anxious about the otherwise unpredictability of the world around him. When he can make more sense of the world, it is less frightening for him. The medications also helped him concentrate well enough to 'get' the whole concept of communication (not a problem for your son).

And we've been told there ARE medications for anxiety. The doctor put difficult child 3 on antidepressants, but they don't work for him. He seems to have a metabolism for them like mine - I get all sorts of different weird reactions to them, although difficult child 1 can take them and they did help his anxiety and Obsessive Compulsive Disorder (OCD).

other things for anxiety - cognitive behaviour therapy; learning to breath slowly and deeply (difficult child 3 is supposed to practice every night, taking 6 seconds per breath, from the diaphragm and not the upper chest). meditation/visualisation, especially if he can help choose what to visualise - find a place that he likes, where he feels safe and relaxed. Take photos of it, visit it regularly and practice meditation while there, take samples of dirt from there if it's that sort of place - anything which will help capture the smell. Then like the breathing, keep practising it.

I'm glad you're home schooling him. That classroom sounds like it wasn't working for him. It would have been a good technique for my difficult child 3, but like anything we try - if it's not working, stop doing it. It's like medications - if nothing else is working and you're desperate, and a doctor seriously suggests medication, then give it a try. If you see a dramatic improvement than it's a good thing. If there's no improvement to speak of, then there's no point in medicating him.

How to cope with criticism - learn to nod and smile. And then quietly do what you feel is right. If you keep getting hounded, just point out that YOU live with it, they don't, you have already tried a lot of more conventional techniques and for some kids, they just don't work. Tell them you're writing your own research paper on the results and you'll give them copies when you're published.

Because for your son, YOU are the expert.

Marg

 

[smallworld]

Welcome! I'm glad you found us.

Please take a look at the previous evaluations and let us know what kind of professionals conducted them. At this point, I agree with the other posters that you really need to know what is what. I'd recommend new evaluations by both a board-certified child psychiatrist (for the mood issues) and a neuropsychologist (to rule in or out ADHD, learning disabilities and autism spectrum disorders).

There actually are medications for anxiety and depression in children. The SSRI antidepressants (Prozac, Zoloft, Lexapro, etc) come to mind as one option. They may not all be FDA-approved for children, but many competent child psychiatrists prescribe them off-label. These medications have been helpful to lots of kids who have anxiety and depression (including my own). However -- and this is a big however -- you need to know what is driving the anxiety and depression before you put ANY intervention into place. Anxiety and depression can stand alone, or it can be part of bipolar disorder (which would require different classes of medications) or autism spectrum disorders, for example.

In terms of others judging your parenting, I learned long ago that my husband and I are the only ones who really know our kids and who really understand what goes on in this house. We listen to advice only from professionals (and the parents on this board -- LOL!), but ultimately, we decide what is in our children's best interests. Some of our family members are very quick to jump on the "you're too lenient" bandwagon, but the proof is in the pudding. Through medications and very intensive therapeutic interventions, our kids are on an upward trajectory. And frankly, that's the only thing that counts in my mind.

Again, welcome and good luck.

 

[SRL]

I am not a parent to jump quickly to medications, nor are many parents here. But the fact of the matter is that both of your son's diagnoses frequently require a combination of medications and therapy to treat. Prozac is an SSRI medication that targets both depression and anxiety and has been approved for use in children, and in fact is the one medication that has been used in children for the longest period.

Many other medications are being used off label with children successfully, both in mental as well as other medical issues. Is it anyone's top choice to medicate their children with such medications? Of course not. But when it gets down to the point that a child and family cannot function many of us start making some hard choices. My son's anxiety was so severe and everything we'd tried in terms of non-medication interventions failed so we went with a medication trial. While there were side effects it also nipped the anxiety long enough for him to develop some coping skills for those particular issues. The anxiety returned when he hit the next roadblock but we did have some short term success and gave him some much needed relief. Most of us wouldn't leave a child in extreme physical pain if we had access to a medication that had worked successfully in adults but wasn't yet tested in children, but we stop when it comes to children in extreme emotional pain.

Again, this is a very personal choice but when nothing else is working it's time to change the plan. He will have a much better chance at a stable, funcitonal life if you can get him stablized before the teen years hit and your time is running short.

Did your son have an IEP in school?

 

[tiredmommy]

You've been given a great deal of advice. I just wanted to add that you may want to look into NonVerbal Learning Disorder (NVLD) due to his anxiety & school struggles. Here's a link:
http://www.medication.umich.edu/1libr/yourchild/nld.htm
Your son has had a tough row to hoe in life, there are red flags to many possible root causes. It sounds like consequences just don't work for him, so it's time to try something new.

 

['Chelle]

Hi flachic :smile:

The first thing that the school worker said about my difficult child in grade 2 was "have you looked into Aspergers" and "his behaviors look like anxiety" (he would end up hiding under desks). Then the rest of the 5 people in that meeting kinda took over and nothing more was said. I do wish I'd listened to her, because 3 years and a lot of hard times later he was diagnosis'd with Pervasive Developmental Disorder (PDD) (just misses Aspergers by a criteria or two) and most of his behaviors stemmed from anxieties of not "getting it" and needing to do things "right" (meaning perfect). We did put him on zoloft and with that and therapies he's been able to maintain in school. The zoloft helped with his ocdness and anxieties. I don't usually say much about medications as it was a hard decision for me to make, and it's up to you and your doctor but medications can help. We are weaning my difficult child off right now, and see if he can now maintain without with all he's learned and done the last 2 1/2 years. He's almost off, and so far so good. It doesn't have to be a forever thing. Sometimes they just need to have some help to calm down and learn how to cope with things when the medications aren't there.

Again, welcome to the site. Hope we can help.
:flower:

 

[busywend]

Welcome!

One thing to add to the others - do not let anyone tell you that you are doing things wrong unless they have a proven method for you to use instead.

The fact is every kid is different and no on thing will work for all our kids. One thing is for sure - traditional parenting does not work often for difficult children. Punishing and taking away don't seem to work until the child is stable.

 

[flachic]

He has just lost his sitter and will be sad about this. He will also be anxious - who will help look after him now? But make sure that you don't punish him further - he is punished enough, just by losing her. And it is all a matter of direct consequences for his own behaviour. Do not let him successfully blame any of you in any way, he has to own this. But stay calm when you talk to him, talk to him with the respect you wish he would show to you and don't react if he begins to get angry or upset. He needs to learn self-control, but when you react or punish, you make his anxiety worse, which makes it even harder for him to control himself. And frankly, when he gets angry he is NOT dealing with the problem. The current consequences of getting angry are actually letting him off dealing with the main triggers, because the problems then escalate so fat that he no longer has to deal with the cause.

Thank you for that. This particular part was very useful today, when I was so ready to hand down a whole list of 'consequences' to help him be accountable for his behavior. I read this over & over & my husband read it as well.
Thank you.

 

[Marguerite]

Hang in there. It seems insurmountable at first, but keep holding on to this thought - somewhere in there, is a good kid who wants to do well and who wants you to be proud of him. When he rages, he adds despair to his own burdens - despair that he will never be able to reach his goal of 'normality'. That's when you need to reassure him that it's the behaviour you don't like. Him, you love always, unconditionally.

I suspect that if you asked him to help set punishments, he would be far harder on himself than you expect. Once you all can understand and accept the idea of using teamwork to help him learn self-control, you should see some amazing improvements. Of course it won't be perfect - he will still have poor impulse control, high anxiety and a lot of frustration. But it's just a case of changing attitudes all round and maintaining that change as consistency. The consistent attitude is more important than interventionist discipline. When he goes off the rails he's probably mentally beating up on himself harder tan anything you could do. If you can help him keep it in perspective, he should soon see that the light at the end of the tunnel is NOT an oncoming train.

Just keep loving him, even when it's not easy. And remember, you can give yourself time out too, if you feel you are losing your patience. And tell him, if you need to, that this is what you had to do. He needs to know that you aren't perfect either. That way he may feel he has a chance of making it. He may also choose to adopt your coping strategy - difficult child 1 will go for a walk when he feels close to losing his temper. He learnt that one from me.

My mother was perfect. There was no way I could ever come close to being someone like her. But she was my goal. As a result, I always felt set up for failure, but I also became a perfectionist. This did me a lot of damage until I learned to reach a point at which I had to accept I'd done my best. In doing this, I had to fly in the face of my mother's oft-repeated wisdom, "Near enough is NOT good enough."

Which means I now recognise that my mother was not perfect, after all. And only very recently, have I finally come to understand why she was so driven. So sad. But freeing, for me. At last.

Show him your humanity and frailty if things happen that way. Apologise to him if you get something wrong. This also helps set him an example. It's all part of showing respect to hopefully teach him respect.

If he were a somewhat difficult flatmate who you couldn't evict, because his name is also on the lease, you would deal with things differently to how we tend to deal with our difficult children. Sometimes it helps to think of them in this light.

Whatever works for you!

Marg

 

[Allan-Matlem]

Hi,
What is accountability ?

Accountability is not paying the price but rather a commitment to the future , a vision for the future . With this vision for the future which is achieved by helping the kid acquire skills and come up with a new plan. Only then a kid will be able to deal with the past , make resistitution , mend relationships. The apology comes at the end and it will be meaningful , not mere words. Try move away from ' doing to him' but rather working with him , dealing with his perceptions and building that relationship. It is a different dynamic and it will take both of you to move from a win-lose dynamic to a win-win dynamic.
The first step is to relax the atmosphere , connect . Consequences will just escalate tension and undermine the relationship , the most important tool in helping your kid

Allan

 

[BusynMember]

Wanted to pop in and say "hi" and offer consolenses and sympathy. I agree that focusing on consequences probably will not do any good. I would get this child diagnosed by two professionals (I'd personally forget social workers, counselors and even psycologists) and focus on Psychiatrists (with the MD) and a neuropsychologist exam (which will test for all sorts of problems that other professionals usually miss). To me, (I have bipolar and my son is on the autism spectrum) your child sounds like it's much more than ADHD. It *could* be a mood disorder and, if it is, Prozac or any antidepressant and any medication for ADHD, including Straterra, will only make him have less control of himself. I've been there/done that with wrong diagnoses, especially from non-MD therapists. If your child and your family are living a life of hell, then, in my opinion, medications can improve the quality of everyone's life. If he is talking about violence, again, I urge you to consider having him diagnosed for a possible mood disorder. ADHD does not usually cause violence. I hate medications. I have to take them because if my bipolar is out of control, adult or not, I rage! And it's not pretty when an adult rages--nor can I control it without medications. My son is on the autism spectrum and was misdiagnosed with both ADHD/ODD and bipolar. He has neither and is NO LONGER on medications, however he is also more of a "quirky kid" than a behavior problem. I urge you to get the Big Guns to diagnose him. in my opinion, as a layperson mom who's seen it all, I would do therapy after he is stable. I doubt he can really control himself now, no matter what consequences you impose on him. Hugs and take care.