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violent behavior in a 4 year old

my son has severe violent out busts when he doesnt want to do something he will hit bite kick scream bloody murder say he wants to cut peoples heads off, he has taken this out on adults and my dogs, we have been seeing a specialist which they said he is adhd, they put him on adderall and clonidine, which he does focus better and sleeps better, he has nightmares 3 to 4 times a night, even a few night terrors to where nothing has clammed him. he also does this thing when in a high state of emotion that he tenses his whole body till he shakes, grinds and pops his teeth grunts and does what we call crab hands (hands up by head hands in fists), when angry he tenses and grinds his teeth and a big part of the time nothing stops it. i dont know what to  do i drive 200 miles just to see his dr and i feel after 4 months we are not getting any where, does any body have any ideas what to do? he has been booted from 2 daycares and now grandma is at the end of her rope ready to quit sitting for him..


This discussion is related to 4    yr. old has severe anger.
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13167 tn?1327194124
SM - I keep reading this in different places.  The rage doesn't look like a seizure - it looks like a temper tantrum,  but somehow is related to seizure type activity within the brain.    This isn't the case with normal temper tantrums that often seem to stem from a specific incident,  these seizure-rages doesn't appear to have a very obvious cause.  
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973741 tn?1342342773
Gosh, I will say that my son also does this contorting but it isn't seizures.  But I guess that should be ruled out.  For sure.
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757137 tn?1347196453
Yes, RockRose, I was thinking seizures.
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13167 tn?1327194124
I agree with the others  and want to add that there is some science recently that suggests aggressive mood swings like this can be seizure related,  and can be treated with low dose seizure medications.

Google "temporal lobe epilepsy anger" and see what you think - it might be worth talking to the doctor about that angle.
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189897 tn?1441126518
COMMUNITY LEADER
     Wow,  first of all give grandma a big hug from all of us.  This can not be an easy task for her (or you).
      You mention the violent outbursts as your main concern.  Specialmoms ideas are right on target.  The other thing you might try is a series of books aimed at this age group.  A book like, "When I feel angry" found here -  http://www.amazon.com/When-Feel-Angry-Way-Books/dp/0807588970/ref=pd_sim_b_5
      Can be helpful.  While it will not cause overnight changes, it will give both you and him a common vocabulary.  And it will reinforce in another way all of specialmoms good ideas.
      And I really do think that identifying the "triggers" is important.  If you can share some of the things that he doesn't want to do and goes ballistic, it could help us.  There are things like sensory integration disorder where kids will go nuts over what to us are just a normal thing.
    I also wonder if these violent outbursts are the only thing going on that bothers you?  I mean these are huge problems.  But, if there are other things that he is doing, we may be able to give some practical ideas.
     Finally as allmymarbles said - this is complicated.  You need more immediate help then someone who is 200 miles away.  your child should be getting behavioral therapy weekly.  But I assume that being in a small town has eliminated that possibility.
    Oh, I forgot to ask - since he has been on medication have the violent outbursts gotten less?  Does he still have them when on medication or mainly when the medication is wearing off (in the afternoon)?
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757137 tn?1347196453
This sounds more complicated than ADHD. Does he have a neurologic problem as well? If you are seeing a child psychologist, sometimes they miss physical problems.
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973741 tn?1342342773
Oh my goodness, I'm sorry he is having such a hard time.  One thing that is important to remember, is that HE probably dislikes how he feels when he is in a meltdown as much as you hate it.  It feels terrible to a child.  

My son does not have adhd but sensory integration rather.  This is very similar to adhd as both are related to the nervous system.  With sensory and add/adhd, you get base level responses and self soothing is very difficult.  

One thing we've done to help our son along is to have him see an occupational therapist that works on behavior modification.  She's helped my son with techniques to calm himself when he begins to excelerate into a meltdown.  How he can read the signs he is headed that way and what he can do to stop it.  You CAN slow your own nervous system or minimize an outburst with great effort.  He may be showing inappropriate behavior when melting down, give him alternatives.  When he is really having a bad time, have some go to things he can do.  he can go to a cool down spot, he can give him self a hug as deep squeezes slow the nervous system, he can open and close his fists (slows heart rate), he can deep breath, he can count to 10, he can use his words, he can do a wall push up, he can chew a piece of gum.  All of these things slow the nervous system and help a child calm themselves when they don't naturally have the skills to do this.

An occupational therapist also helps you know what do do and what to look for with meltdowns.  most of the time there is a trigger.  Looking for it and handling it is helpful.  Then also, seeing when he is STARTING to get upset and offer choices of what he can do to make it better is helpful.  

There is a program called "How does your Engine run" which is so great for kids.  They can picture this.  There bodies are engines.  It can run just right where they feel good.  Too slow when they feel tired, sleepy, disinterested, floppy.  Or too fast when they are hyped up, bouncing off walls, crying, ,mad, melting down.  So you simply say when you notice he is getting upset "oh no.  Your engine looks like it is begining to get too high.  What can we do to slow it back down."  Then go to your list of tihngs that work to calm a child's nervous system.

As you are using some medication to help him, these are just some ideas to add to that.

Also, various activities really work wonders to regulate the nervosu system.  Lateral movement/linear movement such as swinging or bike riding can have a laten effect of calming and helping with focus.  Swimming is perfect to soothe the nervous system.  Jumping on a trampoline or mattress on the floor is awesome.  Climbing on a play structure, doing the monkey bars or zip line, even climbing a tree all give soothing input to the nervous system.  

I do wish you luck.  I'm here any time if you need to chat or vent or need support.  I know how hard it can be peace
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