anger in children

We have recently seen a pyscologist and they have diganosed my 4 year old with explosive behavior disorder.  We are starting therapy sessions next week.   They are  using a method of watching him Play to diganose and get to the problem.   The problem is, he WILL NOT misbehave in public or with other people except his immediate family and at home.  He is an angel everywhere else.  I am NOT convienced the play therapy and talking while he does this will NOT solve anything.   And as you know therapy is extremely expensive even with insurance.  As a teacher myself and taking counseling classes, I want the therapist to talk to him and let him know what is expected of him and us and say outloud what the plan is and the consequences to his behavior.  Not just visit during play time.  Is that an unreasonable request for them at the age of 4?
We also meet with a medical doctor in two weeks to discuss medication if needed.  I wanted to see if the therapy helped first.  If he suggest meds,  what is a VERY safe, but effective med that he could be on at age 4.  I have read lots of names, but they are usually dealing with ADHD and not the explosive disorder.

thanks for you time and input, waiting to hear from you!  :)


This discussion is related to Four Year Old with Explosive Anger.

[jeanie223]

I, too am an educator, and I am very conservative when it comes to medicating kids.
I have a few concerns based on yr post. First, I havent heard of explosive behavior disorder. (in children) In adults, this type of thing would show up as an Axis II personality disorder. In children, particularly 4 (very young for this kind of diagnosis, ADD/ADHD as well -  and I would hold off on the meds until a second or third opinion is obtained..cheaper than treatment I'm sure...) ALSO - (I have personal experience in this - my 5 yr old girl had wild tantrums, and I was very worried,, and took her to different drs...) What I learned was - Very often, when a child ONLY has these behaviors at home, and NOT in public, it indicates they ARE able to control their impulses, and behaviors, which would NOT make it a neurological problem. (like add/adhd/disorder of some sort) particularly so young, these diagnosis dont seem to make sense, without these behaviors significantly affecting them in ALL areas,not just at home.Some kids ARE more sensitive, and responsive to certain kinds of parenting, so what worked with my older, didnt with my younger. I have taken so many classes, and consider myself a "good mom" but still, I took some classes/talked with a family counselor on how to deal with it, and we set up a strict behavior mod. plan at home, and she improved dramatically. (and it didnt cost a lot..) (u r an educator - think behavior plan at school, but more strict and intense for home, cuz kids listen to us less, usually)  This psych doesnt quite sound right on to me. NO. IT IS NOT too much to ask to have a clear plan and purpose/expectation for your child/and explicitly explain this to the child (in child term of course..)  in therapy. Have you heard of ODD? This is something I hear of much more often professionally, and with very young kids. I would save the money, and immediately get a second or third opinion on this. I will repost with a website that may help...
I would get a second opinion for sure.
Also, you didnt report the symptoms/behaviors you are seeing. It just doesnt seem to add upwith this dr.  from your post. Be cautious. An dmaybe put up some of the behaviors??

[jeanie223]

Also, it seems like if he cant verbalize goals/ect,doesnt give you a detailed  FAMILY plan (because the behavior is happening only at home...)  but willing to take yr money, adn "visit" AND is the one who diagnosed this "disorder" - this just sounds all fishy to me.

[jeanie223]

Start here: and please read the Dr's response carefully. ;-)

http://www.medhelp.org/forums/ChildBehavior/messages/32618.html

then for more info:

http://www.cnn.com/HEALTH/library/DS/00730.html

http://www.emedicine.com/ped/topic2793.htm

http://www.familymanagement.com/facts/english/facts24.html

http://drgreene.blogs.com/drgreenecom/2007/12/temper-tantrums.html