My 4 year old son's behavioral problems

[wmklein1972]

My son is 4 and has been expelled from 3 year old pre-k for violent outbursts toward the other children. He is extremely smart and well ahead for his age academically. He is going this Thrusday to a doctor in New Orleans for testing for ADHD, which runs in my family, and Asperger's Syndrome. I have been at wits end trying to work with him to improve his behavior, to no avail. Can they give medicine of some sort at 4 years old that will at least make it possible to work with him better and enable him to go back to school? His teachers cried when he had to go because he can be so very sweet and smart, and in a split second, he snaps and punches someone in the eye. I am stressed and trying not to show it, but I feel so alone! I hate having to fuss him all the time. I need some advice on what they can do to help him and what I should ask when I am there.

[Jason C Bourret, Ph.D., BCBA-D]

You are asking two important questions about your son's problem behavior.  One, can medication help.  Two, what else can be done to help him.  You are certainly not alone in having to deal with this.  These are questions that I get commonly and I have included below some comments that that were given to another parent that I hope might help you.

There are medications that have been shown to have a beneficial impact on problem behavior in some individuals.  If you plan on going this route, make sure you find a prescriber that has experience working with children like your son and make sure that you are comfortable with the plan for treatment and monitoring the effects of the medication.

Regarding the problem behavior, although medication can, in some cases, be effective in suppressing problem behavior, the intervention that has been shown to be most reliably effective is applied behavior analysis.  Over 20 years of rigorous experimental evidence has shown that children can learn appropriate alternatives to severe problem behavior given the right teaching arrangement.  Behavior analytic interventions typically involve identifying the situations that are most problematic for a child and the things that are most rewarding and systematically teaching a child more appropriate ways of handling problematic situations and of obtaining reinforcing things and events.  These interventions are individualized to the needs of the particular child and, with the right services, the prognosis for treatment of severe problem behavior can be quite good.  I recommend that you also look into identifying a board certified behavior analyst who has experience treating behavior problems exhibited by children like yours.  You could start at the certificant registry on the BCBA website: http://www.bacb.com/

[testedandtruemom]

My son is 6 1/2 years old.  Very bright, above grade levels in all subjects.  His parents are divorcing somewhat amicably.  We have shared custody and he sees us both regularly.  He has trouble keeping friends as he cannot sit still for even a minute.  He fidgets constantly unless he is focused on computer or Xbox (at his father's).  I limit his computer time to 1 hour and he becomes ENRAGED battling out for hours on end.  I reason, I entertain, arrange play dates, etc. he will not follow instructions if he does not want to do something.  The teacher says at school kids are hesitant to play with him as he often gets in trouble and they want no part of it.  He is so hyper.  He cannot sit still.  He recently (6 weeks or so) starting clearing his throat constantly.  He does it all through class and it is disruptive.  I have a pending appointment with mental health in hope of some direction.  I have not yet taken him to family doctor.  I am concerned he may have an underlying condition.  He can become so enraged he throws tantrums which include hitting me and walls, throwing himself on furniture, etc.  Any thoughts?

[MaryannesMom]

I have a 10 year old daugther with Asperger's, who was in trouble in preschool.  She was never violent, but wouldn't do what was asked of her, and yelled & screamed (she still does this).  It is so hard for these kids because they are so smart, & so bored with school.  Medications would work for about 2 weeks on my daugther, then she was back to her normal self.  I also didn't feel comfortable giving her the medication at such a young age.  I went to the school when she was 4 & told them she was reading at a 2nd grade level, was IQ tested at the top 1% of the population, and will not sit at a desk at school.  At that time, they really didn't know anything about Asperger's at my school, so they pooh poohed me, said I read to her a lot as a child & that is why she could read, & told me they wouldn't do anything different with her than any other kid.  Well, I knew that wasn't going to work, so I ended up homeschooling her until 3rd grade, when we finally figured out through her pediatrician that she had Asperger's.  We went back to the school & they then tested her & agreed, so she was able to receive special services then.  She is now in the 6th grade & not doing well at all (behaviorally).  Our school transferred her to another school after the Christmas break because they couldn't deal with her, & the new school, even though they have a program supposedly for Aspie's (there is only 1 other Aspie in the class), is not doing so well either.  I hate to sound like a downer here, but please know that you are not alone.  Since I was with my daughter 24/7 for the first 7 years of her life, I read every parenting book, tried every trick offered, was constantly accused of not disciplining her enough & that is why she is like she is, & was living in a constant state of extreme stress.  When I went to the school I felt that there were no answers for her.  They (the experts as they call themselves) made me feel like an insuperior idiot & they could "fix" her.  Now they have tried all their "tricks" and she is showing worse behaviors than ever.  So here I am back to where I was when I sent her to school thinking there are no answers for my daugther, & wondering what the heck we can do with her now.  I work outside of the home now & am not in a position to homeschool her again.  Sorry if I am going on & on, but I want you to know there are people out there that do know how you feel.  Unfortunately, we are far & few between.  Good luck to you.