Newbie--Any advice on what to do with 4 year old?

[tryingtocope]

Today was another difficult day with my son. He is 4 1/2 years old. He has been exhibiting difficult behavior since he was 2 years old. His behavior is only getting worse.

In January, he was basically kicked out of his preschool. From the beginning of the school year he had been hitting children and specifically was always fighting with one little girl. By January, he refused to do his school work and would not sit down. His last day there he hit two girls and spit on a teacher. He has similar behavior at another preschool when he was 3. He was always hitting there also. The school thought something was going on but the pediatrician thought the difficult behavior was because of the new sibling.

After he got kicked out of his pre-k, I took him to the pediatrician. He thought it may be ADHD/ODD and suggested I take him to a child psychologist and psychiatrist. I called around and after 2 months finally got him an appointment. He has an appointment next week with the psychiatrist.

Am I doing the right thing? My mom told me that if I took him to a psychiatrist before he even starts school, he will be labeled and that I should just leave it alone until he starts kindergarten. He starts kindergarten in Sept. I am terrified about how he will behave there. Should I just wait for the school to have him evaluated if the behavior continues?

He is at home with me and driving me crazy. He explodes constantly. Many times I don't even know why he is angry. He hits me, hits his baby sister. Screams at us. Will throw everything in his room. He cries a lot when he is angry. He also now has started slapping himself when he is upset.

I appreciate any advice. Thanks.

Michelle

 

[jal]

Hi,

I am relatively new here too for posting, but have been lurking for a long time. I can absolutely relate to your situation. My difficult child is 4.5 now. He started exhibiting around 18 months to 2 yrs. He was also kicked out of preschool at 2.5 for uncontrolable behavior. Hitting, running from the classroom, rages where he tore apart classrooms. He was then "tolerated in a home daycare", we later transitioned him to preschool where they could not control him and subsequently kicked him out. He is currently in another preschool with very caring teachers.

We used a psychotherapist and a behaviorist to hone our parenting techniques, but nothing worked. He has been to a pyschologist who said ADHD, then BiPolar (BP), a child psychiatrist who said ADHD only and is currently with a new child psychiatrist and working with an evolving BiPolar (BP) diagnosis. He is currently doing wonderfully on Abilify. ODD has lowered immensely.

Honestly, in my opinion going to the right psychiatrist has made a world of difference. My difficult child is calmer, more apt to think before throwing something or getting angry and it has only been 4 weeks under the new psychiatrist's care. Preschool has seen a major decrease in ODD. We are happier for it and so is difficult child. We are not yelling, being called to pick him up from school and all enjoying family life for the first time in a while. It is not perfect, but it is much better.

We did a school evaluation to see if he qualified for sp-ed preschool, which he did not, but we do have another meeting with the elem school team next week to make sure if he needs services when he goes in Sept that they will be there. I too worry about labeling him at this young age, but the stress of the past 2.5 years has been unbearable. Take a look in your family history (on both sides) for any red flags (depression, alcholism, BiPolar (BP) etc.)


<span style="color: #3333FF">He is at home with me and driving me crazy. He explodes constantly. Many times I don't even know why he is angry. He hits me, hits his baby sister. Screams at us. Will throw everything in his room. He cries a lot when he is angry. He also now has started slapping himself when he is upset</span>

My difficult child did these things too. The word NO set him off like you wouldn't believe. He was hitting husband and myself when he was angry. He would kick at us and went through a period of biting himself in anger.

I hope for your sanity you go through with the psychiatrist. Just to find out what is up with your child. It can be upsetting, but remember he is going through some scary times in his mind too and you need to offer him all the help you can. For me it was worth it as now I get a lot more I love you's from him than I hate you's.

 

[tryingtocope]

Thank you for your response. I have considered ADHD and BiPolar (BP) also. My sister in law suffers from anxiety disorder and depression. My mother in law and father in law are alcoholics. Two of my brother in law's have substance abuse problems. My husband also has a substance abuse problem although he recently quit. He is a very angry person and I wouldn't be surprised if he has a mood disorder that has not been diagnosed. And one of my sisters is autistic. Given my husbands family history I wouldn't be surprised if he has a mood disorder.

I know I should take him. It is very difficult for me because I am home with him all day and he is constantly screaming at me, saying mean things, etc. My husband isn't very supportive and when I complain about his behavior he says that I am stressing him out. Anyway, that is a whole other issue.

I had hopes of returning to work and actually have an interview next week. But I am scared to start a new job while he is acting like this.

Does anyone know if I get him diagnosed by the psychiatrist, will the school accept the diagnosis? Should I not mention it to the teacher? If I mention it, will the school district have him evaluated? I guess, I'm confused about what to do. But I know that it is unlikely that his behavior will change by September.

Michelle

 

[jal]

First things first. Go to the psychiatrist appointment and see what he/she says. I can only guess with your family history and your child's behaviors that the psychiatrist may recommend some medication. I say that because I see a few factors that you and I share. father in law, alcoholic, mother in law - anxiety, depression, 2 nervous breakdowns, recovering alcholic, Paternal Gr. Grandmother - nervous breakdown, Paternal Aunt - manic depressive (BiPolar (BP)), my dad- recovering alcholic (5yrs) - I have a cousin who is BiPolar (BP). husband - Obsessive Compulsive Disorder (OCD), no medications. My difficult child's preschool teachers are aware of his diagnosis. They had to be, they saw it all and they hooked me up with a Mom of an adopted BiPolar (BP) difficult child, who recommended our current psychiatrist and therapist. Plus at times he's had medications administered at preschool.

The school system is aware that we had concerns for our son, since we had him evaluated. As we are meeting next week I am concerned about throwing the BiPolar (BP) out there ONLY because his psychiatrist says he is working with an EVOLVING diagnosis of BiPolar (BP), because of his age and that BiPolar (BP) is a serious diagnosis, he doesn't want to jump the gun. Which we are happy with.

If you get a diagnosis from the psychiatrist, when your child returns to school or goes to kindergarten they would have to accept the diagnosis. I am learning a lot now on IEP's and testing through the SD on this site. I do know that when we had our first SD evaluation done last Sept it was conducted by an Occupational Therapist (OT), SW, and 2 Sp-ed teachers. No comprehensive testing, just history and visual oberservations. At that time we had a diagnosis of BiPolar (BP) & ADHD. They did not question diagnosis or try to change it.

 

[momof4insc]

I am new to this website too, but my story is similar. My son has been a violent child from about the time he was born :smile: His 4 year old kindergarten teacher saw some concerns, but since he was there for only 2 hours, she saw no reason to have him tested. There were no triggers, he just turned into a differnet boy, most of the time having no recollection of what he had done. He went to kindergarten and the behavior I had at home was seen there. He threw desks, chairs, books, anything not bolted to the floor at his teachers and other students. He kicked his teachers and the principal, he was out of control. The only thing suggested was stiffer punishment at home. I was having daily conferences with the teacher. Home life for me was unbearable, I was in Hell. My sons sisters got the biting and hitting. I got the throwing, kicking, and verbal abuse. The animals got the kicking and malicious behavior. My son was and still is a self mutilator. He likes to scratch or cut himself when he is angry. Hitting his head on the floor (we have a slab foundation), and hitting himself in the head. He progressed to the first grade with a note to work on his behavior over the summer. First grade started off on a bad note, he stabbed a student with a pencil, then threw a rock and hit a boy in the eye. Once again, if it wasnt bolted down, it was a weapon. His teacher and I had conference after conference and we decided to have him tested. I am glad we did, he was diagnosed with conduct disorder. He has been seeing his therapist every other week for over a year. The medications he takes help him too. He still has some rages and impulsive behavior. I wish I had taken him to his pediatrician earlier, but I went with the advice of others (I went to parenting classes for 2 years) instead of going with my motherly instinct. I wish you luck and remember, PATIENCE is the key.

 

[tryingtocope]

Thank you momof4 and jal. Your advice and words of encouragement got me through a difficult day with difficult child.

We went to the park today and he had several meltdowns within ten minutes of getting there. I moved my seat because the sun was in my eyes. He wanted me to stay where I was sitting before and even though I explained why I switched my seat, he would not accept that. He started screaming at me and when I refused to switch my seat, he hit me in the face with his hat. I warned him to not hit me again and if he did we would leave the park. He continued screaming at me and hit me again. I grabbed him and left the park. I don't know if I did the right thing, but I didn't know what else to do. He is constantly having meltdowns especially if I refuse to do something he wants, say the wrong thing or I'm on the telephone.

Anyway, the afternoon was better. I need to read The Explosive Child. I started reading it but didn't get too far.

Thanks again.

 

[mightymouse]

Yes, in my opinion you did the right thing at the park. If he is anything like my son which it sounds like he is, leaving was the only thing you could do.

My 3.75 yo son sounds a lot like all of the previous posts except that he is not violent (yet, but he has that 'look' in his eyes) but screams and yells hateful things and turns into a totally different person when things don't go exactly as he wants. My opinion differs though on having him labeled. I just started the process of having him evaluated because he is eligible for pre-K at ps next year and I want a diagnosis before he starts. I feel like if he starts and I can say, "He has (fill in the blank)," the school and I can start off on the right foot and do whatever we need to from the start to deal with whatever it is that he has. If I didn't have him evaluated, I feel like I would spend a long time with the school just blaming me and trying to get me to correct the problem with discipling at home, which I have been trying to do since birth!

Jal, you said that if you get an outside evaluation, the school will have to accept that. Is that a federal law? I don't know anything about the laws concerning any of this. The reason I ask is I have a friend whose child was recently diagnosed with ADHD and MDD. When she took the diagnosis to the school, they said she would need to be evaluated by a psychologist from the school district before she could qualify for an IEP. What are your thoughts?

To ttc, it sounds like you are dealing with a lot with your son and husband and I sympathize with you. My son's father has been AWOL since birth and I read posts like yours and I am glad. I would rather be dealing with this on my own that with someone who is angry and unsupportive. From my own experience with family members, in my opinion most people with substance abuse problems are probably self medicating an underlying mental illness. With the issues in both my and the bio dad's family, I am scared to death of a diagnosis for my son, but hope that once I have one I can begin to see some hope with treatment.

 

[BusynMember]

I would make sure that, along the way, this child sees a Psychiatrist for diagnosing and, even more important, a neuropsychologist. Pediatricians are really not trained to diagnose childhood disorders. And I can not tell you how many non-MD therapists misdiagnosed my son with ADHD/ODD and bipolar. In his case he has neither, but he ended up on tons of medications for two disorder he doesn't have. He is on the autism spectrum and your child has some symptoms of that too, so you don't really know yet what you're dealing with. It took us 11 years. Unfortunately, the treatment of each disorder in different so if he gets misdiagnosed with ADHD/ODD, a very common misdiagnosis, he'll be put on stimulants. But if he really has bipolar, that will only kick it up and make it worse, especially over the long term. If he is on the Spectrum, he needs early intervention yesterday! The rages and behaviors should simmer down or even stop (they stopped with my son) if you get the diagnosis right and, if necessary, the RIGHT medication. Therapy can help you cope with the child, but I wouldn't count on it to help your child change until he is getting the proper treatment, and that can take a while to figure out. Both bipolar and autism are very hereditary, and they mimic each other, as does ADHD, so I suggest a neuropsychologist. They do extensive testing to point in certain directions and they can pick on problem spots. Seeing a neuropsychologist finally got my son on the right track. A multi disciplinary evaluation can be useful too, but my son had two of them and even they missed the boat. As for school, I don't trust them and frankly would not rely on them to properly diagnose. The price is right, but ya get what ya pay for--not much. Schools have an agenda and don't hire the best and brightest. I'd worry about school after the child is in better shape. JMO from long experience. I posted a few links you may want to look at. One is an online test for Pervasive Developmental Disorder (PDD). Sorry, I truly think Mom is wrong here. The earlier a child gets help for anything, the better the prognosis, label or not label. If he has it, he has it and the label HELPS, not hurts. Good luck and hugs.

http://www.childbrain.com/pddassess.html

 

[tiredmommy]

FWIW, I had my daughter evaluated by the school district at age four. She was not labeled. While she did not qualify for services at that point, the director pointed out that we all (school & family) had some very valuable information on an at risk child to use if and when an eligibility question arose again. They know she's at risk socially, has slight speech issues, and rated quite high intellectually. These scores will be good to have in the future if she starts to slip academically or have behavior problems in school. We have something to compare current tests to. This early testing also helped to put me in a favorable light when I needed a monitor for the bus that Duckie rides due to her needing to carry an epipen. We had a relationship with the office that handles that.
The thing is, you would probably be setting your son up to fail if you sent him to kindergarten as things stand now. By reaching out to the school district early, your family appears proactive about your son's struggles and less complacent. I think most schools would rather know in advance that they have a student who will need some extra services and special accommodations so that they are in place before there are meltdowns in the classroom or kids being hit.
Good luck, I know just how gut-wrenching this sort of decision is.

 

[jal]

Mightymouse,

I would think they would have to accept the diagnosis, but I am sorry I am not 100%, as I am learning about this process. When we went into our first referral for special education meeting with with-a diagnosis of BiPolar (BP) and ADHD we were never told that difficult child would need to be additionally evaluated by any professionals hired by the SD. They basically listened to our concerns, we completed a structured developmental history, a Battelle developmental history, a sensory profile and a multi-disciplinary observation was done. This all showed difficult child's behaviors were out of the "norm". Between this meeting and our regroup meeting about 1 1/2 months later we switched to a psychiatrist who said he was just ADHD and placed difficult child on Ritalin. It helped some in the am, so when they did the final evaluation he was pretty calm and they decided he was "better" and all his behaviors now fell into the norm and he did not qualify.

We are going back to the SD next week for a meeting.

by the way tryingtocope, I also think you did the right thing at the park. It's tough, but try not to let them walk over you! I have done the same thing, it sounds heartless, but my difficult child didn't get to see Santa because he couldn't control himself. Warning after warning after warning, he couldn't hold it together so we left - broke my heart.

 

[tryingtocope]

This morning he already had a blow up throwing toys at me and screaming at me to leave his room. Ughh...I'm glad I can at least post about this because my husband doesn't want to hear about it. He says it stresses him out. My mother isn't very supportive either because she just thinks he is going to outgrow this, but he is already been doing this for 2.5 years and it is only getting worse.

I will take him to the psychiatrist on Monday. I will update everyone on what he says. And then I'll go from there. I'm reconsidering my job search at this point. Financially we could use the money, but I'm just not sure how he would adjust to another preschool (already been at 3). It is hard because I have a lot of school loans and therefore pressure to work in my field. I left my job because I was pregnant with my second and was working very long hours. My difficult child was already exhibiting the difficult behaviors and my husband couldn't handle being the primary caregiver. So now a year and a half later my difficult child has become more difficult and I have mounting pressure to find a job.

I just want to do what is best for him at this point. I agree that if he gets diagnosed I'll be setting him up for failure if I don't contact the school. I will also look into a neuropsychologist.

Thanks again for the advice.

 

[jal]

You are doing the right thing going to the psychiatrist. Sending support your way. Just to let you know I have been close to where you are and it can get better.

 

[tryingtocope]

Thank you for all of the advice. I will be looking into part-time. I worked as an attorney for a year but hated it. It also didn't help that my difficult child started showing difficult behavior and I was never home. So I'm glad I left that and hope that I can find part-time doing something else. A lot of the pressure I feel is from my mother and the other people (former co-workers and acquaintances) I think are judging me.

I have to get better about taking care of myself. I admit I've been eating for comfort and don't spend much if any time doing anything for myself. My husband and I haven't gone on a date in two years. I'm serious...It is sad, but we don't get much time alone at all except when the kids go to bed and by then we are wiped out.

Anyway, I hope things will get better. I guess I have to be patient. I have to take this step by step.

 

[sickandtired]

Boy this sounds so like me in alot of ways....i will be posting about me in a minute....just glad to have found people who feel as frustrated and emotionally exhausted as I do!!