I have a 4 year old son. He has been to a psychologist, pshychiatrist and therepist. 2 different offices. Psychologist was first. This one diagnosed my son with have ADD, ADHD, ODD, and OCD. He then referred us to a psychiatrist because of the severity of his case because his thought was he would need to be put on medication.
We then saw the therepist for the initial evaluation. I expressed my concerns. Agressiveness, easily aggrivated, COMPLETE disreguard for his belongings, not sleeping at night (by this I mean he went to bed at 8:30 and wouldn't fall asleep until midnight or after, and got up 3 times during the night, and woke up at 5:30).
As for the disreguard for his toys, by this, I mean the punishment would be having toys taken away. After the second time in doing this, he would go and get a trash bag and hand it to me and tell me "ok, throw it away. I don't care mommy" - at tjis point he was THREE. He pulled all the clothes out of his dresser drawers, out of the closet, then, would take the bowl in his potty seat that we had put in his room for middle of the night potty issues, would pee or poop in it, then fling it around the room. And ripped the pages out of every book he had. And before someone says it, I DID TAKE THE TOYS AND BOOKS AND EVEN THE CLOTHING OUT OF HIS ROOM. This resulted in him using his fingernails and peeling off the paint on the walls. Then at one point tore open his pillow and ripped apart his blankets.
Therepist decided we needed to see the doctor. She too said all of the things the psychologist did, with the addition of insomnia (which I too suffer SEVERELY from).
Saw the doctor. Doctor gave us 4 medications to research in case we changed our minds on medicating our 3 year old. Which, we did eventually change our minds on. He was put on ritalin. Worked our way up to 25mg in the morning and 10mg in the evening. He was also put on, after we worked our way up, 1.5mg risperidone every evening at dinner time to help his behavioral issues at night and to help him sleep. Which, I must admit, the risperidone did help him sleep. However, the ritalin, even though it did help with the out of control hyperactivity, also somehow caused him to space out in his preschool class. (Put him in preK so he would have other children his age to play with and socialize with in hopes it would help).
So. Here it is. He has had ALL of his toys taken away, aside from books which I have him sit and read even if it is just making words up. He is now getting up 5-7 times a night, and has now resorted to sneaking food (by the way he has been off all medication for over 2 months now, so no its not the risperidone causing him to be hungry). He has become even more verbally aggressive with the addition of phsyically aggrissive which is now causing issues in school (he pushed a little boy in his class, then took a toy from another and hit him with it) and is becoming very physical with myself, my husband and my daughter (his almost 2 year old sister) as well. He knows he is to behave if he wants his toys back, but continues to disobey and spits when he is asked to do something. He now also CRIES, AAALLLLLL the time. For nothing, and everything. He hits and kicks our 3 dogs and 3 cats (yes he has even been nipped at once or twice, which you would think would have had SOME impact, but continues to do this anyway --scares me more now that he has begun to do this with our 70lb, 11 month old german sheppherd--). He knows about Santa and has been told he will be put on the naughty list. His response has been "so? I don't care. You don't tell him what him what to do. He'll bring them anyway".
So. No toys, he gets sent to his room, is made to do chores, sits in a time out chair, goes to bed early, has any other "priviledge" taken away if it is needed... and probably just about anything else you could think of. I cannot do this anymore. I am utterly exhausted, and have been pushed beyond my breaking point, broken and am almost to my shattering point. I have researched every other possible alternative and tried them all for endless weeks all of them failing. I am embarrassed to take him into public for the way he acts, and feel like a failure as a mother that I cannot find a way to control my FOUR year old son.
Well, a couple of things come to mind. The first is what did you pay these doctors for? It sounds like all you got was one visit and no counseling? Working with a child with ADHD is much tougher that working with a child who just has a discipline problem. The methods differ a lot. In fact, I would say that at least some of what you are doing (can't blame you, you are trying) with a 4 year old is counter productive. Are you still getting help from the therapist?
Another thought is that you said the meds were working, but he spaced out. Thats a pretty common complaint when the dose is to high. I realize you worked your way up, but was it done on the doctors timing or did you just do yourselves? The body needs awhile to adapt to these meds. For many kids it does take trial and error to hit the right dose and many times even the right medication. So I kind of wonder how much communication you and the psychiatrist had over the meds. I don't usually think that meds for kids this young are a good idea. But if you have tried all else, its usually time to try something else. This leads to the point of trying all else.
On the ADHD forum, I recommend this book a lot, "The ADD/ ADHD Answer book," by Susan Ashley. It may not have all the answers you need, but it will have a lot of them.
Probably, the most detailed web site is the following. Take you time going through it as it has a ton of information. The book is a bit easier to go through, but this site covers a lot. The site is : http://www.healing-arts.org/children/ADHD/index.htm
By the way, from your comments about what he says, he sounds like a pretty sharp kid. That complicates things, because he is using his intelligence to help him manipulate. Realize that with ADHD (if he has it), at his age he acts without filters (without thinking). He then needs excuses to explain why he did it. And many times, kids are not even aware they did something because it is so spontaneous.
So some thoughts. He has a lot of energy. He needs to burn off that energy. Unfortunately, some of your discipline measures are doing just the opposite.
Taking away toys, privileges, etc at this age is not a very effective measure because the kids don't look into the future very well.
Any discipline should be immediate and consistent and probably a timeout. The book, "SOS Help for Parents," by Lynn Clark, gives very detailed directions on how to make this work. When he is 8 or older, a lot of what you are doing will be more effective.
Also you have a two year old daughter. How was he before she was born? I do wonder if some of this is a reaction to the attention she is getting? If so, you and your husband need to start trying ways to pay him more attention. This could be a lot easier if we weren't in the middle of winter. Because taking him outside and running him around would be great!
So I think you have a pretty smart kid who (sounds like) has ADHD, is highly frustrated, and possibly attention starved. I feel for both of you. Main recommendation is to read up on ADHD. Understanding what he is going through and how to work with ADHD kids will be very helpful. Maybe get back to your doctors. They should have been telling you all of this anyway. Do change your style of discipline to what is effective with ADHD kids. The two sources I mentioned give a lot of ideas. You also might want to google sensory processing disorder or check out this site -
as some of this could be going on and it is not treated the same way as ADHD.
By the way, don't feel like a failure. You have all ready done a lot. Being a failure would be not trying. Do take a look at some of the other posts on this sites about their 4 year olds for other ideas. Hope this helps. Best wishes.
There are also some very good ideas from members of this forum in this link that you might find helpful - http://www.medhelp.org/posts/Child-Behavior/Anger--frustration-mangement-for-my-5-year-old/show/1410486
tlynn, is there anyone in your family with mental illness? Usually in cases like this they look for gross neglect in early childhood (doesn't sound like the case here), inappropriate or absent parenting (doesn't sound like the case here) or a family history of mental illness.
I agree also that the discipline methods are ineffective in such young children, especially ones with ADD (and I'm shocked at how high his dose of ritalin was - WOW!). Think of how well kids with ADD usually do on video games, where the feedback is instantaneous. That's what he needs - instantaneous rewards or punishments. Since he now doesn't have any toys and won't have any in the foreseeable future, that's not even on the radar screen for him, and not helping him learn.
I think you need a behavioral therapist for him, not another doctor who will give him more meds. His little neuro system is still growing - meds can't be good for that.
Behavioral therapy, with a design for immediate rewards/punishments would probably help him much more.
Best wishes. I got tired just reading your post. : ( Must be very frustrating.
I have depression and ADD/ADHD, my sister has ADHD.. depression stems back to my father, who medicates with alcohol.
Now, I DID keep his FAVORITE toys (monster trucks, his train set, etc...) & have explained to him that by being a good listener, and helping mommy and daddy, he can earn them back (put into toddler context of course).
Yes. He IS very smart. Which makes discipline that much harder as you can well imagine. His response to being put on Santa's naughty list and not receiving any gifts, was "so? You don't tell him what to do. He'll just bring them anyway". He is VERY smart, and VERY stubborn and headstrong.
As far as his other toys go, he has ALWAYS been more interested in books than noisy and obnoxious toys. I don't have a single picture of him with a toy in his hands, just books.
Also, I did not mention this in my original post. We have been living with my husbands parents. He is NOT attention starved. My father in law takes him with him when he goes out bac cut firewood and into his shed when he works on his racecar (father in law drag races); and he also takes him to the race track when he goes; my husband takes him to the fire station with him (he's a volunteer) whenever he has a chance to go up, he goes to my grandmother house to play with my 2 little cousins (both boys' one is 5 the other is 3), OR, someone takes my daughter and I take my son places, like to the park, out to eat (not recently) etc. No one gets more attention than the other. Never have. And he and I have one on one time for reading, playing, counting and all of that. If ANYTHING, i'd say he gets more of the attention.
And, he has been this way long before I had my daughter. Especially the hyperactivity part. All of the things that I mentioned about him destroying things, happened at least a yr before i had my daughter.
My husband and I did decide last week, that we would try and teach him to play the Wii, because majority of those games involves physical movement. He has never played video games before. (on a side note he beat my husband at a bowling game twice (: )
We have been seeing a therepist since last December. I have been given many things to try, a lot of them to reinforce positive encouragement for good behavior; we have made compromises (shaking on it as well saying "deal"), I've had hhim step to the side and take 3 deep breaths, and say his ABC's to try and calm himself down (this was during the self-calming part of the therepy). He has even gone to a "group therepy" type of thing with children his age who have the same issues going on a few times. But to no avail. Now we HAVE however not been to therepy in about 3 weeks. Only reason being, for the same reason I weaned him off the meds, we were going to therepy 2x a week, and to the doc at LEAST once a month, and nothing was working or changing. i could do the same thing at home without having to drive a half hour and sit in the waiting room forever. (he has state insurance, this is the only office who see's children this young, and the 2nd office is over an hour away... not an option).
To RockRose:: It was under the doctors watch and his recommendation. This was over the course of about 7-9 months. he was increased because there was LITERALLY no difference. he may as well have been swallowing m&m's. We had also tried Concerta, which was an utter failure. I was not too keen on putting him on medication, but after 2 years, i needed help. and now it has been 3 years, i haven't gotten any further, and am finding myself desperate. I myself am in parenting classes and cousiling.
And as another comment for now, time out is our primary punishment. But, as he ends up there more than 10x daily, i do not find this effective. He gets an extra minute for getting up or for talking or what have you... but makes no difference to him =/
I would suggest to do some reading on "parefnting the defiant child". Sometimes when children act like this they´re trying to tell us something with their behavior, they´re not happy with something, they don´t feel right with something.
Great idea using the Wii. Try some of the ones like downhill skiing that also make you move. The boxing one is great for that - but maybe not appropriate in this case.
I am sorry when I said possibly attention starved. It was at the end of a long post, and I had just reread your post for the thousandth time and noticed the 2 year old. On this forum, I have seen lots of cases where the older child has been the sole attention of the parents. Then baby comes along, and its not the same. So I thought I would mention it. The only thing I would add, is that in your eyes he is getting enough attention. Wonder how he feels? He is only 4.
I do think that all of the things that you are doing will pay off in the end. He is still so young, that he really can't control a lot of what is happening. As he gets older, he will have more and more control. So hang in there.
This really is complex. But the main thing I think is that you really have to understand what ADHD is and does to kids. It does effect how you work with them. By the way, that is one reason why I gave the link to sensory processing disorder. He may not have it, but it mimics ADHD a lot. And many ADHD kids have both. The reason it is important to figure out, is that the treatment for SPD does involve different things, and certainly not meds. So I think it is worth checking out.
I am glad to hear you are using timeouts. I still think the SOS book is worth reading because it really shows how best to use timeouts. The one thing to keep in mind is that it takes a child about 3 weeks of immediate, constant, timeouts to effect a behavior change. If that chain is broken, the change isn't going to happen. You might try (and this will be difficult), ignoring (if possible) some of his actions and really concentrating on the main one that you want to stop. As Ashley said (in the other book I recommended), " AD/HD kids engage in so many inappropriate behaviors, it is impossible to set a consequence for them all" (p126). " Behaviors that all children should be disciplined for include physical violence, property destruction, cursing, and threats of violence."
The final thing, ( well not really) is his intelligence. When you say, "it makes no difference to him." Well, it could, but he is not going to let you see that because he has already learned how powerful lack of emotion is when dealing with his parents. Because he has no filters at this age, he is gaming you. Anytime you deviate, he wins. It makes it so much tougher. So as I said earlier, you really have to pick your battles. Don't give up on an action because nothing is happening or changing. It just takes a lot longer than you think.
A thought on meds. You said that he was on them for 7-9 months and literally no difference. If you put a non ADHD child on ritalin, you will notice a change instantly! The fact that it made him spacey also indicates too high a dosage. To high a dosage will not make a non-adhd child spacey - it will send them off the walls. I am sorry the doctors office is so far away. I don't think you got the information that you needed. I am definitely not saying you should medicate him. I just want you to understand that it is a complicated situation and I am not sure you got the best advice.
And I am really sorry that you are forced to drive so far. That's not fair. It means, you have to do this kind of by your self. Do take the time to look at the things I have recommended. It will help. I wish I could help more. Best wishes!
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