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Need help with 5-year old behavior problems please

I have a 5 year old son who was diagnosed with PDD/ADHD at the age of 1.  He has been in OT and Speech since then. Last year as a Pre-K student he was non-verbal (although he talked at home) with his teachers adn other students.  He did talk to his OT and Speech therapists.  This year he went from a very shy, non-talking, introvert to a very loud disruptive and abusive child towards his peers and teachers.  As a Kindergartner he has gone to a new school which is much larger than his Pre-K school but the class size is smaller.  He continously makes loud noises, speaks loudly, burps and makes funny noises throughout the day thinking its' funny.  When the teacher asks him to be quite he just laughs and gets louder.  He has been hitting his peers, spitting at them, tearing up their papers, stomping in the halls and throwing his chair across the room. I'm at a total loss as what to do.  We have been very strict with him at home, taking away his favorite toys and making him earn them back.  Putting him on time-outs.  It's just so hard to tell if he really understands his behavior and actions.  He is currenlty taking a high doss of Concerta and it's alwasy worked very well up until this point.  But honestly I don't think it's the medicine but more of a behavior issue.  Does anyone have any suggestions, advice or anything that we can do?  both my husband and I are Active Duty military and its hard to constantly run to the school because of his actions.  We are on a waiting list to see a behavior therapist (social worker ) unfortunately in the area we live that is about the best we can get.  There is no ABA available within hundreds of miles.  Any help would be greatly appreciated.  Thank you
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Avatar universal
We have tried to stop the negative attention as well.  It only seems to make it worse as he gets louder and louder and more disruptive.  Currently the school is trying incentives like trips to the treasure chest and anything with superheroes as he loves them all!  I've tried "mommy will eat lunch with your twice a week if your good." or daddy.  Because, we did notice that he loved it when we visited so we got the clue that he was getting in trouble just so that we would have to come to the school.  So, we told him we weren't coming unless he did something good from now on.  The hard part is knowing what he truly understands and doesn't understand.  They have also been giving him a fiddle toy to help him concentrate while at school.  This worked for a while until he figure he could just throw it across the room and hit people with hit.  
It's weired because he not throwing tantrums, in the true since of the word.  He doesn't cry and throw fits or throw himself on the ground.  He is just loud, disruptive, bully and thinks everything is funny.  He can't put himself into another person shoes.  There is no empathy for him.  The other thing is it all started right after his tonsilectomy.  Prior to he was a very quiet at school (exept at home he was still loud) and shy boy.  He received the tonsilectomy due to chronic sinusitis, sleep apnea etc.  The doc even mentioned that it was the worst sinus infections he had ever seen.  So now he's able to breath better, smell better, hear better etc.  I'm not sure if it's sensory overload or just a coincidence.  I was hoping that since it helped his sleep apnea he would get a better nights sleep and it would help is ADHD but it's seemed to have had the opposite effect.
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Avatar universal
Well - if he wants attention, stop giving him attention.It includes negative attention. That is what ABA people would tell you anyway:) Probably, he sees teachers/you getting all worked up about his behavior and it is reinforcing enough. Trust me, this happens with neuro-typical children as well. Of course, teachers have to remove him from the "scene" in order to prevent anyone from getting hurt....Avoid taking him to a "time-out" or "principal's office" because there is no better way to avoid activity he does not want to attend. You can discuss after he is calm and behaves appropriately.
I figured out that my son loves going to the office in his pre-school because we were playing "school" with stuffed animals, one of the "students" hit a friend and said that "now I WANT to go to the office". They've stopped taking him to the office. Behaviors that he was sent to the office for all but disappeared. Go figure.....
How about reward systems - do they use any? In order to get my son to sit down and transition through activities, his teachers have to use reward systems (choice between snack, playing with toy, etc) paired with visuals......

Ask teachers to take notes as to when tantrums occur, they should be able to tie it to specific activity he is trying to avoid, or specific things he has the highest anxiety about.
Does he try anything to calm himself down?

Mine talks to himself (I cannot have it right now, and yelling will not help me to get it), takes deep breaths and counts to ten, or plops down in a yoga pose and says "Namaste" :) Drawing angry pictures helps. He threatened the teacher in his pre-school ones that he will punch a hole in a wall (saw dad do that when he was 1.5 years old) - teacher suggested drawing the hole on paper, helps very well. Since he is PDD - it may be very helpful to invent a "calming ritual" - they usually remember it very well:)

My son is suspected mood regulation disorder (runs in dad's family), some PDD traits are present, did not have any major language delays until 3 y.o, he is not good with conversations, has high expressive and lower receptive language.

Do not get too frustrated about lack of ABA in your area - it is not a rocket science, it is breaking down skills in small segments and teaching each segment separately, gradually fading out prompts. Look into conferences for ASD - they usually have plenty of opportunities to learn. You may even want to try to consult with ABA therapist online for parent education. I am not sure what level of functioning your son is, but every little bit helps.

Many psychologists actually do not reccomend 1x1 ABA for higher functioning children.

Good luck:)
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Avatar universal
He's been seeing a neurologist since just over his first b-day.  He was extremely delayed and non-verbal.  I guess you could say he didn't get the "OFFICIAL" diagnosis until after his 2nd b-day, and he continues to see his doc every 6 months for changes.  

As far as I can tell nothing really triggers his tantrums.  He just seems to want the attention and gets it anyway he can.  But when we try to get him to quiet down or listen or stop hitting he just thinks it's funny.  He does have an IEP and I'm on e-mail daily with his teacher, special needs teacher, speech therapist, etc about his behaviors.  We are constantly brainstorming.  I feel the school is being very helpful but I wouldn't want to be the mother of the child he is hitting.  That really bothers me to know he is being disruptive and hurting others.  We have been using visual cues and schedules but this doesn't semm to help either.  

Looks like I'll have to talk to his doctor about the meds.  
thanks for the response.
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Avatar universal
Hmm - neither PDD nor ADHD is usually diagnosed at 1.....

Effect of medication on young children is unknown and very often something that has worked before stops working....

what triggeres his tantrums? Does he have IEP? Having either one of the diagnosis should qualify him for services. They may need additional supports (visuals, schedules) for him to help with transitions

Good luck
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