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4 yr old girl PDD-NOS ASD SPD - ANGRY!! Bi polar too????

My 4 year old girl has been dx PDD-NOS (mild autism spectrum).  She also has Sensory PD, and a few other fun things.  VERY INTELLIGENT and verbal.  She has not been an easy child to parent but we love her more than life itself. Dressing is a nightmare...hairbrushing...forget it.  Foods- she is EXTREMELY picky.  She is downto only wearing leggings and t-shirts now.  Lately, she refuses shoes and her coat most of the time.  Sticker charts, rewards, time-outs, etc...do NOT work.  Her hearing is EXTRA sensitive and she has to wear earplugs in loud places or she melts down right away. These are things are are used to.  However, lately, she is so angry and screaming most of the time.  The tantrums are WORSE than ever, worse than at age 2 or 3.  She is SOOOO angry over the littlest things all of the time - if something is in the wrong place, or i gave her the wrong plate with her food, or wrong color cup, or her toy was knocked over, or something was not in the right way...etc....she seems like she is mad or unhappy about something most of the time.
She screamed for forty minutes straight at the local chrismas light parade tonight because she wanted to RIDE in the parade, NOT WATCH it.  No matter how much I try to explain why we cannot ride in the parade, it does not matter.  She screams and screams.  At times my husband and I get so stressed over her tantrums that we give her time outs or remove the toy she is obsessing over.  She has never been spanked, or hit yet she hits us, pulls our hair, and scratches us when she is angry.  She gets so mad when commercials come on TV that she hits the TV! :)
We are worried she could be bi-polar too on to of everything else. ?  Please say it is not so!
She see's developmental docs, occupational therapists, goes to a special ed preschool, takes vitamins, takes omega 3's, probiotics, etc....so we think we are doing everythign we can.  But maybe she needs meds or something else?  

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Avatar universal
Hello Dr. Macdonald,
Thank you very much for  your reply.  I looked on the website and there are no BCBA doctors near us.  But, about 100 miles away there are about a half dozen, so we will try one of them.  THANKS!

So, we have one more question. The day after I posted this about her very challenging behavior, she started acting happier.  We have had about 5 days now of excellent behavior.  She is talking, listening, playing,  having fun, and just being almost a typical kid.  We have actually had outings without much screaming.  She still throws tantrums over things but it is a tolerable amount and they only last a minute. Maybe like a typical 4 year old almost.  It is like we can talk some sense to her right now.  The thing is, she cycles like this.  When we are in a bad cycle no amount of any reinforcing, sticker charts, etc does anything for her.  It is like she is just totally out of it, and screaming most of the time.  Then, it changes and she is great for a while.  This is one reason we thought maybe bi-polar?   And, the fact that a clinician that was at our house and witnessed soem of the behavior said her anger was extreme, and it could be bi-polar.  But, then we have these wonderful times like right now.  Of course, we look for anything that caused the good times, or the bad cycle and there is nothing we can think of.  recently, we started Super Nu vitamins and we are hoping they are helping.  At least that would give us some control over something and be able to help her.  However, we know logically that the bad cycle is probably coming again and we should not get our hopes up.

thanks for listening...

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340680 tn?1196785573
In general, when a child has a diagnosis of autism and is presenting challenging behavior I would recommend looking for specialized clinical help. Specifically, I would suggest finding a clinician who has worked with children on the spectrum and who has certification in Behavior Analysis (BCBA). You can find people in your area of the country who are certified by going to the following website link http://www.bacb.com/consum_frame.html  and type in your state.

As for your daughter, the behaviors you describe all fall in line with a diagnosis of autism spectrum disorder. The challenging behaviors, including tantrums and resistant to changes in routines are very common in children with autism. An experienced clinician can evaluate the situation by conducting a functional analysis and develop a treatment program to help reduce the rate of challenging behavior. Another important part of your interventions with your daughter will involve identifying a variety of preferred reinforcers that can be used to increase appropriate behavior. Children with autism as young as your daughter do not present bi-polar profiles. Get good clinical help and you will find that these challenging behaviors diminish.
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Avatar universal
I just read your information on your daughter and I can def. relate. My son, 4 1/2, has many of the same things that your daughter has and like her they go in waves. He screams, hits, bites, scratches, mostly his older brother almost daily and gets upset over the smallest things. We have been to a psychologist and a psychiatrist who both say he is ADHD and PDD but I'm wondering if there is more. When he is upset he pushes on his fingers and walks on his toes and his feet turn on his ankles. His tantrums can sometimes lasts for 1 - 2 hours if he is very upset and he destroys items when he is in a tantrum. He repeats words sometimes, this is not always, but when he does it lasts for around a month or so and he throws the same word, or sometimes phrases, into a sentence that doesn't make sense. He also talked at a very young age and has done numerous things that just don't go along with his diagnosis. We are very confused. He is on medicine that seems to help with the ADHD but he has never caused a problem at school, it is when he is home that it is a nightmare. If he can't have a certain food, which he chooses for dinner he throws a tantrum. If we won't watch what he wants on TV, a tantrum. I know we are doing everything we can by seeing the Doctors but I still feel that there is more. We have applied to get help in our home, still waiting on an answer, but we feel that we our out of control. One of my biggest fears is we have a younger boy, 2, who is watching these fits and learning from him. I don't believe he has ADHD or PDD, but he learns from seeing his brother. I also have been looking for support groups to go to because we really need other parents to talk with to just get some of the stress out. I can't seem to find any in my area. Any suggestions would be helpful.
Thank you for posting and for listening to me!
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