Dear Heather,
It sounds like you have your
handsHand or foot spasms
Hand tremor full at home. The good news is that your son behaves appropriately in the out-of-home situations. This brings reason for optimism. It also indicates that there is something amisss in the parent/child interaction, and that should be the focus for some professional attention. You have tried a number of things, and I guess you've concluded that they don't work. However, it may be that the way you have implemented the tactics - for example, time out and reward systems - is the proble, not the tactics themselves.
Seek a consultation with a pediatric
mentalMental retardation
Mental status tests health or behavioral health professional. It's important to reach an accurate diagnosis and then to develop strategies to employ at home to manage your son's behavior.
If you want to compare your approach to time out with recommended methods, utilize the SEARCH function in this Forum and you will see other questions and answers that deal with this issue.
We also added essential fatty acids; we use a product called Efalex which has DHA, an essential fatty acid shown to improve behavorial problems. After only two weeks of doing both of these things the tantrums stopped and he became calm, obeyed, compliant, and verbalized his anger instead of acting it out.
A good book about essential fatty acids and behavior is "The LCP Solution" by Jacqueline Stordy and Malcolm Nicholl.
A good site for support and advice on behavior problems, ODD, ADHD, etc. is conductdisorders.com.