COMPLETELY contrary 4 year old making parents' life a misery!

[ShinyHappyPeopleHoldingHands]

Can I tell you about my BF's four year old? I don't know whether his is a special need or not, even though dealing with SNs is a large part of my life. Can you just tell me what you think.. or if anything strikes you about my description of this behaviour?

Friend's DS became difficult to handle from being a 1 year old. He talked early, gave every indication of being quite advanced, intelligence wise but used to have awful tantrums. We called it "early terible twos" but it has just gone on and on and got worse and worse.

He has the most terrible rages when he can't get/have what he wants and in the old days, it seemed just a bad variation of normal, but now you can see him activiely seeking something to kick off about, he doesn't even have to have been told "no", it can just be something like getting up when told. His meltdowns used to involve vomiting at will (he seems unable to do this most of the time now although he tries!) as well as wee-ing and pooing at will. He went through a long phase until quite recently of physically attacking his parents during a meltdown but that seems to be less so at the moment.

BF, who is a very good mother and known by all her friends, including me, as being very good at dealing with children (kindly but firmly) has done nothing to cultivate this behaviour, although as time as gone on, she and DH (and us too!) find ourselves "pussy footing" round him a little because his meltdowns are so long, and violent and sometimes it's so darn inconenient for him to have one! They happen anywhere his parents are.. and sometimes us (as our families are so close we are all like family). He starts from the moment he wakes up these days.. doesn't want to get out of bed for school (he gets enough sleep; it isn't that),doesn't want to get dressed, doesn't want to eat breakfast until it's too late to eat breakfast, THEN he wants it.. won't wear coat, won't carry book bag, won't walk (BF has to half carry/half drag him to school, sometimes half dressed, which luckily is not a long walk.)

At nursery, the leaders were only aware of this behaviour from what BF and her DH told them and the fact that he would sometimes arrive with a red and tear stained face but would switch to behaving nicely as soon as he arrived. School has been a bit different. Although he loves school, has friends, gets on well and does his work (and is still v.bright) he has to be dragged all the way into the classroom most days, by the teacher herself. He seems immune to the fact that he is making a spectacle of himself in front of the other children.

It's as if he HAS to have something to "kick off" about.. he actively looks for it all the time! Eg today we all went out of sunday dinner to a pub; he immediately said he didn't want any (just to be contrary, you could see by his face) then as soon as we ordered, he wanted some. He does this a lot about everything.

It's exactly as if he HAS to know where the line is, so he can cross it, ALL the time, almost all day, every day. And he crosses it immediately. It's as if he NEEDS to cross lines even if one hasn't been drawn.. he'll establish what and where the line just SO he can cross it!

He completely exhausts and stresses out his parents who do their very best to "jolly him along" (distraction tactics) to avoid him kicking off, but he won't be distracted by the "jollying along" very often anymore.. his whole day (when not at school)revolves around doing it.. so, so does theirs! They are getting no pleasure out of him and he from them because of this and it obviously affects his 7 year sister as well. Everything has to be about "appeasing K" (I find myself doing the same) so as to avoid a meltdown if possible, although he is not spoilt and he by no means gets whatever he wants. He loves his playstation but he is banned from it most of the time because they use it to make him understand that his behaviour (eg in the morning before school) has consequences. This obviously causes further meltdowns.

They are having sessions with a counsellor and at family centre. She has been helpful in helping them understnad him a bit more but the behaviour continues.

I feel he must have ADHD or something. I am v. experienced with children and maybe a lot of what I have described sounds normal, but trust me, it's not.. it's too persistant and prolonged. It's as if he can't stop himself behaving this way. BF mentioned ADHD to the GP before he referred them to the counsellor but he said no because he doesn't do it at school. (I know at least one other parent with an older child with diagnosed ADHD who is far far better behaved at school than at home.)

My mum is convinced (since seeing something on TV) that it is some kind of autism, but I know enough about autism to know that it is far more than just difficult behaviour.

Can any of you offer any thoughts?

[stripeymama]

Could it be PDA?

My db (9) has this and it does sound quite similar - it is quite often not (or mis-) diagnosed and not all professionals accept it as a diagnosis.

HTH

[ShinyHappyPeopleHoldingHands]

That's v. interesting SM. Have just read the What Is PDA and the Diagnostic Criteria section. There is a lot there that sounds like him.. some which is maybe/maybe not.. but the main thing that jumps out at me that isn't K is that his speech is very good and always has been.. he talked well from an early age. Do you think that rules this condition out?

[mollythetortoise]

bumping for you. no experience but agree (i have a 4 year old dd) that this is not normal 4 year old behaviour.

[stripeymama]

I'd say not - db was a very early talker and had a good vocabulary very young. He does have a slight speech impediment but this is possibly due to the fact that he is bilingual (english and hebrew) and gets confused between the two languages/pronunciation.

I think PDA can vary a lot, for eg db reached all milestones with no problems until about three, whereas others show signs of developmental delay much earlier.

The 'meltdowns' sound so familiar - db gets frantic about 'being looked at' when eating (esp. in cafes) and cannot grasp that his behaviour is simply attracting more attention. He often ends up in hysterics and has been known get in such a state that he is sick.

He tries anything he can to get around rules - he puts a lot of thought into it! And does not give up on things easily.

[twocutedarlings]

More info on PDA here, on the NAS site Shiny.

www.nas.org.uk/nas/jsp/polopoly.jsp?d=528&a=3352

Sorry i dont know how to do links

[mimsum]

this sounds v like my ds1 at 4 - and to some extent now - he's 10 - although the problems have mutated ...

he has an alphabet soup of diagnoses - TS/AS/ADHD/anxiety disorder

Shiny wrote: It's exactly as if he HAS to know where the line is, so he can cross it, ALL the time, almost all day, every day. And he crosses it immediately. It's as if he NEEDS to cross lines even if one hasn't been drawn.. he'll establish what and where the line just SO he can cross it!

This is so familiar, as is the persistence, ds could vomit at will when he was little too - it is absolutely exhausting, especially as negative consequences to behaviour just don't seem to make any difference - it's like he's not able to access the right bit of his brain at the crucial moment when he's kicking off, so even though he knows perfectly well what the consequences of a certain course of action will be, he'll still go right ahead and do it anyway

The most helpful book we found was "The Explosive Child" by Ross Greene

Ds has had lots of input from various psychologists/psychiatrists - he's now on medication (clonidine) for tics and adhd symptoms and he's definitely easier to live with, although still no picnic ...

To me it very much sounds like your friend's son has some kind of special needs - it may well be a syndrome mix rather than one thing on its own, which can make it tricky to diagnose

[ShinyHappyPeopleHoldingHands]

Hi Mimsmum

Yes I think it's looking as if there is some kind of SN as well and so do his parents although its the last thing in the world they want to hear, obviously. But all of us close to him are realising this behaviour, the degree and the persistance of it, just isn't normal.

BF has the book .. I ordered it for her from Amazon some time again; think she too has found it quite helpful.

Mims can I ask you what you DS is like at school? And also Stripemama re your brother? K hasn't been in school long but there are no indications of any problems actually occuring within school hours and he gets sticks for "good work" etc, and presumably the teacher would mention it to BF and her DH on the occasions that one or the other of them has to physically wrestle him into the teacher's arms!

What kind of process did you have to go through to get a diagnosis? How and when (what age were the boys) when it was made?

Appreciate the info as are my friends (K's parents) who will also be watching the thread.

2CD thanks for your link also.

[ShinyHappyPeopleHoldingHands]

*stickERS not "sticks' He is not, to our knowledge, getting "the stick" at school.. although perhaps that's where his parents are going wrong.. lol

[sarah573]

Hi, I though PDA too (by the third paragraph, didn't peep at stripeys post!!).

My DS1 is ASD and I believe he has PDA.

Definitely worth looking into.

[ArmadilloDaMan]

MY dsis was diagnosed as being hyperactive (20 years ago) but was always much better behaved at school and could cope with it easier than home. Very strict defined rules with same routine every day. My mum was very strict with routine at home, but it is not always poss to keep things the same. Also after having 'behaved' all day at school she exploded when she got home.

[HonoriaGlossop]

I'm a social worker and have worked with children and families but am not setting myself up as an expert at all; what I would want to check regarding the possible PDA is to look at the difference between his home and school behaviour...I don't know much about PDA but I would want to check what the reasons or explanation could be around his ability to sustain 'normal' ways of relating when at school. I think they could do with going to their GP and asking for a referral to a paed.

Also I think now we're into the second term, that it would be very reasonable, in light of the parents' concerns, to request a meeting with his teacher so they are actually armed with real information about how he is at school. Yes, I would imagine if there were concerns they would have been told but it is best to have the information anyway.

And I would say they need, in the meantime while this is investigated, to really downsize their expectations of him, even if it means their life is somewhat restricted. For example, we avoided cafe's, eating out, etc with ds at this age, and he was a completely 'normal' well behaved boy; we knew he wouldn't have sustained sitting down to a meal, he has ants in his pants!! I think his parents need to acknowledge that due to these difficulties, they need to change things a bit and not take him out to places if they want to avoid public meltdowns....I don't mean forever...even kids with difficulties change and mature, etc.

[yurt1]

He seems like an extreme version of ds3. He also does that thing of constantly trying to find the line then trying to cross it. I don't think ds3 has anything up with him at all, although I think he is sensitive (by which I mean easily put out of kilter- things have to be 'just right' or he'll lose it - he's a thug in other ways )

I do agree its not autism, and I also agree PDA is a possibility. Or ODD but I don't know much about that.

[HonoriaGlossop]

Yes I thought ODD yurt, but again is that something that 'comes and goes', as in the child being able to sustain good behaviour at school? Worth a thought though.

(Oppositional Defiance Disorder)

[Pannacotta]

I really dont know anything about SN but he sounds quite like DS1 who is 3, he is also very easily out of kilter and pushes boundaries a lot of the time, and has the most explosive rages/tantrums. It is very hard to get him dressed/nappy changed (potty training abandoned as he wouldnt sit on potty) and meal times can be very difficult.

So to me he sounds extreme but yet fairly normal, though I do agree its very hard to deal with this sort of behaviour.

[HonoriaGlossop]

I agree Panna, the behaviour sounds very challenging but could well be normal....I think it's worth investigating the possibilities of some condition or other, but it still could be nothing label-able...and I'm guessing but I think it may be harder to get a diagnosis for a child who CAN behave perfectly well at school.

Are you absolutely sure that your friends haven't simply got locked into a power struggle type situation with him? Does he get attention for his behaviour? If you've all started pussyfooting round him then in some ways his behaviour is getting rewarded....And are their expectations realistic - are they flexible with their expectations of him?

Just putting things out there, just thoughts really.

[mimsum]

Sorry Shiny only just seen your question

You asked what ds is like at school, well it's very variable really

He has days when he's fantastically well-behaved and days when he's literally bouncing off the walls

Certainly when he was younger we'd have a 'honeymoon' period during the autumn term when he'd somehow manage to hold it in at school, but go into meltdown as soon as I picked him up (I had to develop a very thick skin as he'd literally be rolling around the ground in the playground shouting at me - and of course none of the other parents stared, tutted, or thought that if he was their child they just wouldn't put up with it )

But as the term progressed he'd have worked out where the line was and started crossing it. E.g. at the first parents' evening in Y2 his (newly qualified) teacher told me very patronisingly that she'd had no problems with him at all - and that she thought it was because she was very strict! A few weeks later he was barely in the classroom at all ... and it was that fact that persuaded us to try medication

he has a statement and a fab LSA who has to spend lots of time with him some days, and other days just works the room and is there 'just in case'. There isn't necessarily any external trigger - it's just that some days he seems to be able to cope with life better than others

It's v hard to explain the difference between the extreme end of normal and a child who's left normal some way behind ... If I tell people who don't know ds1 v well about his behaviour they'll be nodding and saying "oh yes, my ds does that too" and inside I'm thinking "no - there's just a completely different quality to what ds does"

it's v confusing as well as ds has such a mishmash of conditions and I think it's the mixture which makes it all so explosive at times

sorry that's got very long and rambly - I'm v tired after shoe-horning ds into bed ....
if your friend has any questions she's welcome to get in touch

[mimsum]

just to add ..

getting a diagnosis wasn't too hard for us - although it's been added to by every consultant we've seen ...

there was obviously something up with ds apart from the behaviour as he started ticcing at 2 - and between 2 and 5 they were really big motor tics and loud vocal tics - both have subsided a lot (especially since medication) but there are still days when he literally can't sit still and holding them in takes up an awful lot of brain power which then can't be used for concentrating or behaving well ...

ds started ticcing very early - it's much more common for children to start around 6 or 7 but often parents are convinced from much earlier that there's something not right

one of ds2's friends has just been diagnosed with adhd at 7 - she's been struggling to get a diagnosis since he was about 3, but until very recently was told his behaviour was normal. Like your friend, she's a fantastically good, calm parent, but standard good parenting just doesn't work with children like these

[stripeymama]

Hmm db has problems at school, though AFAIK they are less pronounced than at home. I think the 'meltdowns' only tend to occur when he is with his parents/close family, but the line-crossing is constant wherever he is.

He is a very smart child - can work out how things work, how people are thinking and how to get around them, can memorise episodes of favourte programmes and remember tiny details of things he is interested in, but is not doing well at school. His reading/writing seem to be poor - but he can do both, he just doesn't seem to want to. He is easily distracted from school type work, but if something takes his interest he is captivated and cannot be tempted away.

He was diagnosed at 6, but had been suspected as being ASD from about 4.

[ShinyHappyPeopleHoldingHands]

Thank for the further info. I wasn't sure, when I started this thread, whether I was just going to get told that K is behaving within the "normal" spectrum but I can see most of you think otherwise.

His parents are finding all this info very interesting. They are going to get an appointment with the GP to get a paediatrician referral.

I think I am right in saying that the ODD descriptions fit the bill even more that the PDA ones. I haven't read quite as much on that though.. not had time to trawl through the sites.. (not sure if K's parents have). What is the outlook/treatment etc re ODD?

Mims, that's just what K does re school. BF says he waves happily to her from inside, when he sees her waiting at home time, then kicks off the minute he's out. Nearly everytime I speak to her/see her she is in the midst of - or suffering the after effects of - a huge meltdown over something or other. It's just continous. It's obviously becoming more frequent from where I'm standing. And what strikes me most at the moment is that apart from the fact that he is making his parents' (and sister's to some degree) life a misery, he is doing it to his own. No situation can just be enjoyed by him.. it's straight into the boundary-crossing and the fall out. From the moment he wakes up in the morning, on car trips, at parties.. and he is starting to behave this way for more and more people, even those he's isn't very close to, which wasn't happening before. He caused an "incident" at a party on Sunday which his family were present at but weren't involved in, (until they were called to assist) due to be just down right unreasonable and doing to opposite of what he was asked, repetitively. The "autority" issue on the ODD description stands out a mile.. he has to object to everything, even normal things like eating breakfast. He wants his breakfast, but he "can't allow himself" to just get on and eat it with his sister; he has to protest, refuse and object until they are about to leave for school. Then he'll eat. And they are late as a result.

[HonoriaGlossop]

Again, if he's not like this at school, and wasn't at playgroup either, then dare I say that it may be a power struggle with the parents? It could be a possibility that someone can give them some strategies for dealing with him differently?? In my job I have seen just how very VERY easy it is for even loving and good parents to get locked into downward spirals of one sort or another. I'm not meaning to judge their parenting in any negative way.

I hope some help comes from somewhere, anyway. Sounds grim at the moment, for everyone.

[ShinyHappyPeopleHoldingHands]

Sorry HG didn't mean to ignore your earlier points. I can see what you're saying, and I know I mentioned "pussy footing", but really this is more distraction, trying to get in there with something to take his mind off something which we/they know from experience is likely to trigger him off.. They are having the counselling and do exactly what the counsellor has suggested most of the time - her favourite saying is about "picking your battles", ignoring as much as possible and distraction as well. So I don't think they're locked into any kind of power struggle. DH and I witness it firsthand and we have discussed this (as experienced parents of a handful of children and one particularly difficult one ourselves (who is disabled and with obvious SNs) and we really can't see how we'd handle K any differently ourselves. And in fact have similar issues with him when we look after him although not as bad. The worse is always for his parents at the moment.

But as I said it seems to be becoming more likely to happen around/for others and I wondering if it's only a matter of time before he starts at school.

[ShinyHappyPeopleHoldingHands]

The counsellor's only "explanation" of the behaviour is that he's very bright.. and that at some point in the past, he got a particular outcome from behaving a particular way.. and now wants more of that. But to me that doesn't seem to make a lot of sense in explaining the degree and the amount of this behaviour.. I mean you could say that about any child and yet I have never known one to behave as K does, so persistantly and unrelentlessly. Again, what strikes me is that he is locked into it; it's as if he no longer has much control over what he kicks off over; he just HAS to do it.

[HonoriaGlossop]

hmm, i see what you mean Shiny. If it is something diagnose-able then at least now they are starting the process to find out. It's brilliant they are going to see the Paed about it.

I feel so sad about this - my ds is only just five and I have such a soft spot for boys of this age, and I hate to think of how miserable it all sounds However I'm sure things will pick up with some more help and advice.

[ShinyHappyPeopleHoldingHands]

You're right it is sad because he's such a lovely little boy underneath all this obnoxious, anti social stuff. Very witty and funny;.. he says the most hilarious things in his calmer times!

[Countingthegreyhairs]

I've very little experience of children so probably should resist commenting but just happened to see this on active convos.

Could he by any chance be really, really bright and not getting the same level of stimulation at home that he gets at school and therefore creates havoc at home from sheer boredom?? As I say, this is pure speculation off the top of my head.

The only reason I mention this is that he is kicking-off about all the same things that my dd does, just in a more extreme way. What worked for me was to give her far more control and responsibility and interest because I realised I'd made the mistake of babying her too much and she was capable of much more than I'd realised. However, as this child's mother is very capable and experienced, she has probably already explored that but just throwing thoughts in to the pot as it sounds like a tough situation for all concerned.