5 year old with violent outbursts, poor concentration, very hyper

[iamsoooangry]

This is about my nephew. He is absolutely adorable and charming with adults, lovely smile, seemingly happy boy. At school he spents his first reception term bullying another boy, he was getting this little boy to do things the little boy did not want to do. Lots of outbursts of anger according to the teacher. He is now not bullying the little boy anymore, the latter has learnt to be more assertive, and the teacher keeps them separated a lot.. But my nephew given the chance wants to be with this boy. Infact he has always had quite a clingy personality, first towards, the mum and the day, had nursery he had 1 best friend with whom he manly did playfightng. Now in reception he clings to this boy who does not want him around.

We were wndering if violent outbursts, a preference for aggressive toys and games, clinginess, anger, hyperactivity, poor concentration can indicate some sort of neurological problem, or are merely the product of my sister's parenting.

HOpe you can help, we are all very worried.

[daisy5678]

Always worth checking it out.

2 routes: first, via the school, asking for an Educational Psychologist observation, who will be used to typical kids that age and can offer views on strategies etc.

second, via GP, getting CAMHS (child and adolescent mental health services) to have a look at him to see if there is something neurological.

It could be that these things are just him, just being a child and will settle down. Or it could be something like ASD/ ADHD - only further investigation will tell. Good luck.

[MojoLost]

I don't think poor concentration can be a product of your sister's parenting at all. I really think your sister should follow up these problems with a professional.

My son is 4.5 and has a general delay (he has a brain injury). He has poor concentration, is very hyper. He is not aggressive, but gets angry when he is tired and invades the space of other children. He is not clingy but due to his problems needs constant attention. My DS2 is not like that at all, so I am certain these problems are not due to my parenting but due to DS1's neurological problems.

[iamsoooangry]

it is very hard because my sister is a bit in denial. just spoke to her and she is convinced that the aggressivity is part of being a boy, apparently other boys she has round end up being aggressive as well, but i suspect they are aggressive back. anyway friendships after school have come to a halt, nobody wants their kid to hang out with my nephew which is sad.
i don't think it would be autism as dn is very good at interacting, the real issue i guess is the lack of concentration and the violent outbursts and lack of empathy. what are the main points of adhd?

[coppertop]

If the other children don't want him around then I'm not so sure that his interaction would be that great tbh.

One thing that occurred to me about the bullying in reception is whether this was more about wanting to control things than about actual bullying IYSWIM. For example, my eldest boy wants people to do things his way and play games with his rules. If they don't he gets upset and wanders off, but a child with a more forceful personality might try to make another child follow those rules.

[magso]

I agree with GMS - professional advice is a wise course. I also cringed at the 'just her parenting' comment - although I understand you are worried about your DN - and is is a difficult path to tread! Quietly reading up on developmental difficulties and being there in the background to support your Dsis and dn is a lovely idea. Advice from well meaning family can be difficult to accept- hense saying it might be a difficult path!

Of course your dn may just be a typical boy at the extreme end of the boisterous/adventurous/impulsive boyscale ( who likes to play with other similarly boisterous boys).

Having said that my son had similar ( although much more extreme traits) on starting school - so I heard 'he is just a boy' 'his head will catch up when his legs slow down' many times! He also had difficulty with a couple of friends he was not able to notice when they had had enough. He came up with the logical conclusion of taking their shoes off - when his freind could not play in puddles because it would muddy his shoes! Yes ds has ADHD and ASD/autism. Once I knew he had these conditions I could understand why he does things# and put stratagies in place to help him.

#For example ds used to react to a gentle touch ( his ASD)by pushing(hitting away) instinctively. This looked like aggression. Ds is oversensitive to gentle touch - it hurts and shocks him. He has learnt other ways and Ot therapy has desentitised him a little. He likes firm touch only.
Ds used to pinch when he held an arm. He got into lots of trouble for pinching children. Ds has little language so he tends to touch to get attention rather than say the name. He has poor motor control (holds too tight)and poor sensory feed back ( part of the sensory difficulties of asd) so is unaware it is too tight, and due to his asd cannot pick up subtle signs of anothers discomfort. He has been painstakingly taught to be gentle - or not touch.

A book called something like 'Is that my child' might help ( hopefully old enough to be in the library) HTH

[magso]

Sorry cross posted with CT (slow typer). Agree suggests social skills might be a concern.

[iamsoooangry]

agree with the control issue..

dn has always had a very explosive temper, very macho and bad tempered, we always assumed that's waht he was like...at nursury which he started around 18 months he screamed the house down and cried for months...made a friend finally around 3, a boy with whom i have seen him a few times, all they seem to do is play killing games or play fight, sometimes the playfights become real fights and they get hurt. He is totally in love with this boy, they basically hang out and are macho together. I think it makes him feel secure because he is a tall big boy.

reading your posts though i don't recognise my dn, the sensory stuff might apply to him, , tbh i think he hits because he is in a state of constant paranoia that other kids want to get him, so if they bump into him by mistake he will do a nasty face and hit them. I think that is what worries me and my sister, when he gets angry (becasue my sister does not want to get him a treat, because it is time to go to bed, or whatever), he looks so nasty and angry that we actually become a bit afraid of him...

[coppertop]

"tbh i think he hits because he is in a state of constant paranoia that other kids want to get him, so if they bump into him by mistake he will do a nasty face and hit them."

My ds finds it hard to read other people's intentions and presumes that it was done on purpose. Yesterday, for example, a little girl of about 18mths old knocked a box of building blocks off a table and they hit ds. He immediately presumed that it was done on purpose. He wasn't physically hurt but was upset by the perceived injustice of someone deliberately hurting him. Again, if he were a more forceful child his reaction could well have been to lash out as your nephew does.

Difficulty in reading social cues, intent, facial expressions etc all come under the umbrella of difficulties with social skills.

I know you said that he interacts well but tbh the more you post about him the more I get the feeling that all is not as it seems.

[iamsoooangry]

One thing that he did the other day (i don't see hikm often as he lives in different city), we were on an outing with other families and kids, one of his school friends started crying because she hurt herself, and dn started laughing and repeating her cries. A couple of other boys who are normally quite empathetic and more on the kind spectrum joined him too laughing and calling the girl a baby. So maybe that is not so significant.
He is obsessed with this boy of his class, the "bullying" is finished, but he follows him around and wants to play with him all the time. We thought that maybe he had some sort of attachment problem, as a baby/toddler he was incredibly clingy towards his mum and dad and the pattern seems to be repeating itself with his friendships. He is quite angry with his mum and makes nasty comments to her about what she does, but he can also be loving (according to my sister, never witnessed any affectionate behaviour, but as i said i don't see her for very many hours when i see her).
He regularly hits my sister if he does not get his way, but he can also be the sweetest and most charming of boys...

[coppertop]

But again your example also fits a pattern of not 'reading' other people. If you listen to the sound of someone crying as an actual sound then it can sound funny. It's an odd noise. Just as the way some people can make odd noises when laughing.

If you have other people around you reinforcing that view (other boys laughing) then of course you will carry on.

I have one boy (ASD) who is fairly aloof around people, although he does now have friends. My other boy (AS) has a tendency to become almost obsessive about particular children. Throw in a complete lack of understanding about personal space and you have a situation that needs to be carefully managed. On the one hand friendships are to be encouraged but on the other hand you have to ensure that the other child is not uncomfortable with it.

Sudden mood swings are not that uncommon either.

I don't really understand what it is that you are looking for tbh. You say that you are worried about SN but then seem to be looking for ways to attribute the behaviour to your sister.

[iamsoooangry]

I suppose I swing between thinking that dn is just a boy who needs firmer boundaries and thinking he has some sort of sn. i just want to know what strategy needs to be taken to help him and my sister.

I actually just found a site about Attachment disorder and the symptoms describe my dn from head to toe. Things like
low self-esteem, needy, clingy or pseudo-independent behavior, inability to deal with stress and adversity, resists comforting, lack of self-control, overly friendly and treating strangers like the primary caregiver, aggression and violence, difficulty with genuine trust, intimacy, and affection, lack of empathy, compassion and remorse.
Dn has sessions with the sn teacher at school with a bunch of other kids, my sister thinks it is because he still does not recognise letters, but I wonder if they are trying to figure him out. I feel quite depressed about this, not knowing what is in the future. Thank you for posting to all of you.

[iamsoooangry]

Sorry Coppertop what is in simple terms the difference between ADS and AS, are you familiar with Attachment disorders? Would a school counsellor be familiar with the latter?

[coppertop]

I have no experience of attachment disorders but after reading your list had a quick search for a checklist.

Obviously I know nothing at all about your nephew or what his home life is like/has been like but so many of the things on the list I found could apply to my boys. It would take too long to go through each point (the list I'm looking at has 33 items on it) but lots of those can equally apply to autism. I'll C&P the main ones:

1)My child can't keep friends for an age-appropriate length of time. - Yes, due to social skills difficulties.

2)My child doesn't do as well in school as my child could do even with a little more effort. - Yes. Until fairly recently ds1 had fairly average marks at school. With the right help he is now several years ahead in some areas.

My child pushes me away or becomes stiff when I try to hug, unless my child wants something from me, in which case my child can be affectionate and engaging. - Ds1 only wants to be hugged strictly on his own terms.

My child has a large need to control everything. - Absolutely, as part of their autism.

My child does dangerous things such as runs away, jumps out of windows, or other potentially harmful actions. My child seems oblivious to the fact that my child may be hurt. - Yes. A lack of awareness of danger can be fairly common with autism.

My child deliberately breaks or ruins his things or other's things. - When angry, my ds has been known to break his own things.

My child doesn't seem to feel age-appropriate guilt when my child does something wrong. - Yes, again as part of their autism.

My child is impulsive. My child seems unable or unwilling to stop doing something my child wants to do. - Yes, being impulsive or having compulsions is common with autism.

My child doesn't seem to learn from mistakes, consequences, or punishments (my child continues the behavior despite the consequences). - Yes again.

My child seems not to experience pain when hurt, refusing to let anyone provide comfort. - Yes, ds1 feels little pain and has always been this way.

My child does not usually ask for things. My child demands things. - Yes again.

My child is quite bossy with other children and adults. - Yes again.

My child often does not make eye contact when adults want to make eye contract with my child. - Absolutely!

My child has extended temper tantrums. - Yes, for several hours at a time.

My child chatters non-stop, asks repeated questions about things that make no sense, mutters, or is hard to understand when talking. - Yes!

According to the checklist I should be worried about attachment disorder if I can tick five things. I've ticked twice that many without even finishing the list.

As I say though, I don't know your nephew's circumstances and they are none of my business. I'm just posting this to show you that there can be a big overlap between various types of SN.

Whatever the cause, I hope your nephew is able to get the help he needs and wish you all the best.

[coppertop]

I don't know about school counsellors but your sister could speak to the school nurse, her HV or the GP to ask about referrals etc.

They won't be able to diagnose anything but should hopefully be able to point your sister in the right direction.

[brandy77]

my 4.5 year old has so far been told he has an insecure attachment disorder by cahms and a private pyschiatrist said asd

havent got a clue if he has either of them or a bit of both, i know hes not normal and i hate saying that but he isnt and it is very hard trying to find out what is wrong with him. not that i want him labelled for any other reason than too understand whats going on in his head and so i can help him

[iamsoooangry]

Thank you, i feel very sad. Thank you /coppertop, I understand what you are trying to say. It sounds as if it is going to be a long journey to help dn.
Brandy do you feel able to describe your ds' symptoms in a few words? Sorry if i am prying and you don't want to speak any further. Thank you and all the best to your little ones.

[brandy77]

describe my son,well hes a dear little lad whos been through loads of hospital investigations (hence the attachment disorder suggestion). He is controlling, bossy, insecure, prefers home to going out, likes teenagers/adults more than children his own age,very straight faced and i spose lacking emotion in that respect,frigid... that sounds awful but compared to the loving attention from my eldest at that age, my youngest is quite happy sitting on his own watching t.v instead of snuggling up and will only really want a cuddle when he wants one. He loves his pets and is very kind to them (apparently attachment disorder children are cruel to animals!). hes extremely tidy and likes everything to be in its right place. He notices changes that shock me, tiny changes that other children wouldnt even think of mentioning.

He is a lovely looking little lad, but a lot of the time i feel like im just on auto pilot with him as he does seem quite distant, dont get me wrong we have our days of happiness where hes adorable but they are so few and far between that i write them on the calendar with a big red circle around to remind me of how nice he can be.

There, much more than a few words!

[magso]

Ds was originally assumed to have a degree of RAD (he had a lot of changes before he joined our family and became our much loved son). Indeed we espected it. We also espected sensory difficulties. We did all we could to build attachments using intensive interaction and play methods. His diagnosis of autism was delayed by barking up the wrong tree!
As I understand it ( am speaking only as a mum)those early months of learning from gentle touch, cooing, smells, soothing and rocking, the two and fro of reacting, etc are important in helping the young brain develop its sensory and emotional regulation. Genetics probably play a part too. Attachment disorder occurs when some of this development is a little shaky! There is a wide range of effects and severity.
In developmental disorders such as autism and ADHD the development is shaky for different reasons (genetic suseptability, brain damage caused by illness, toxins, sensitivities etc) something upsets the development. There is a wide range of effects and severity.
In the early years it can be difficult to distinguish between disorders because the clinical picture can be similar. I was told this (apologetically) by Ds Pyshiatrist when his ASD was diagnosed! I too suspect he has a bit of both! He is very gentle with animals - although he had to be taught - ie how to touch gently. He used to laugh (or cover his ears) at children crying but now understands this to be a sign of sadness and he is likely to try and help. His help may not be quite right though! He does not have the inate ability to guess other peoples feelings or desires so makes mistakes. He is not deliberatly unkind but in the early years when he could not distinguish between a laugh of delight and a cry of anger he made a lot of mistakes! He is learning the difference, - because he wants to.
HTH

[magso]

Ps the school edpsych can advise on stratagies (if asked to by both parent and school) to support your dn without a diagnosis.

[iamsoooangry]

Thank you for sharing this. I didn't realise there might be overlaps in conditions,but then of course it makes completely sense.

I will gently speak to my sister, I think she knows the boy is not quite right, but it is too hard to bear, but we have to help him. Thank you. I hope you have friends to support you because it sounds hard.

[iamsoooangry]

When does in your experience empathy develop? I suppose it varies in children, but when would you concerned that there is little empathy?

[brandy77]

hi iamsoooangry, i didnt think my son had much empathy towards others hurt etc. He can strike me or his brother very visciously and continue doing it till i hold him firmly or i would get beaten senseless by a 4 year old! When i speak to him after about it, he just doesnt seem to click that hitting hurts even though if his brother hits him back hes absolutely devasted but still doesnt understand.

But today, our pet rat died, and i honestly didnt think my son would be bothered and be quite matter of fact about it, but he was inconsolable, absolutely destroyed him, he cried and cried and cried and went on about the rat all afternoon and said he hated the animal doctor. But i was pleased in a warped way because it showed me that he does has feelings after all

[magso]

IASA - empathy can be seen in quite little children imho. So at 5 ( in a child otherwise developing well) I would be concerned. However you may need to work out if he really lacks empathy - or more lacks forthought, imagination or noticing skills. Once he knows he has really upset you does he show distress?
The problem with ds was that he did not realise that what he was about to do (hit/bite) was going to hurt another. Two reasons for this 1)lack of forthought (impulsive- acting almost reflexly) and 2) not being inately aware that what doesnt hurt him ( the biter) might hurt the recipient! He is also impaired in recognising signs of distress.
Sometimes you will see a tot hit another (not intending to hurt - they haven't got that far) but then crying when they see the other child cry ( empathy).
Ds was somewhat older before he would cry at another childs distress but only if there were unmissable indicators of injury such as blood and child lying screaming on the floor!. He also got upset at broken flowers ( still does). He too was inconsolable when next doors dog died when ds was 3.5 and later when his fish died. I was secretly pleased too Brandy! Sorry your ds is upset.
We have to exagerate our emotions, make extra fuss if hurt to teach ds to notice. However this will only help a child who does not want the fuss or to hurt. When ds was younger he would do things to get noise and reaction - any noise!

[iamsoooangry]

It all sounds so complicated.....thank you.