What is wrong with my child

[Hortuslover]

Good morning all,

I am starting this thread in pure desperation.
I am really struggling with my near 5 year old boy.
I don’t even know where to start so I’ll bullet point the daily struggles;

• he is aggressive to me, his dad and siblings and thinks nothing of punching kicking us all.
• he has an atrocious temper but can switch it on and off when ever it suits but can fly off the handle so easily
• screams over us when we try and discipline him
• no amount of discipline works, he just doesn’t care
• some days he can walk into school without a problem but then just decide he’s not going in and has to be physically taken in by teachers, this morning he threw his water bottle into the bushes, threw his coat and bag and ran off. We make a fuss when he does go in fine and reward him with small treats
• he is very set in his ways, say if he gets something new, he has to leave them in the packet for example a new pair of socks, he kicks off when he has to wear them as he wants to keep them in the packet so as something as easy as getting him to get dressed is a chore as he just refuses sometime because he wants to keep things new and clean
• thinks nothing of waking every one when ever he wants to get up. Youngest ds is still in with us but he deems it acceptable to come in to our room and just switch lights on and doesn’t care when we try to explain to him that he can’t do that
• I don’t think he’s sleeping very well and looks exhausted, he has bad dreams which results in refusal to go back to bed in the middle of the night and screams until he get his own way, in the middle of the night we don’t even know what else to do
• in general he’s just so loud and dominant

There’s probably so much more but I’m conscious of it being too long.
I’ve considered going to my health visitor, she seems nice enough but I feel just a little uncomfortable around her (it’s probably me) but I don’t feel I could sit and relay my worries to her.

Not sure taking him to the gp would help?

For context, I can’t seem to think there’s been anything to create this behaviour from him, he’s 1 of 4 and none of the others are like him. I am worried though that his younger brothers will start copying his behaviour. We do deal with him immediately, he gets lots of 1:1 time, plenty of outdoor time, goes to bed early enough with a regular bedtime routine.

I am at my wits end.
Maybe these things aren’t too bad? I just don’t know anymore.

I’m open to further questions if there’s crucial things I’ve missed out and I’d appreciate anyone’s advice or suggestions.

Not sure taking him to the gp would help?

The GP is the person who can refer you to more specialist services for a full assessment. I would start there.

I agree that this needs investigating. Have you spoken to his teacher?

It is probably worth talking to your health visitor and the GP.

Have the school made any comment on his behaviour? How long does he take to settle on the days when he has to be carried in? Does he behave in class and cooperate with the other children?

How is his speech? Is he able to articulate himself well?

How is his eating? Does he have any particular behaviours around food the way he has around keeping things new?

I ask these questions as sometimes as parents we can't see the wood for the trees, and these things IME are the things a GP would be interested in to give a more overall picture.

If you have concerns then school and GP are definitely avenues worth persuing.

I have briefly mentioned my concerns to school and told them just how bad his behaviour can be but they say he’s fine at school and they don’t seem to take it any more seriously than that really.

With having 4 children, I have made quite a few gp appointments probably over a short period of time due to eczema, ear problems and general illness so was getting worried about frequent visits. I know this isn’t an issue but with having anxiety and depression, it makes me reluctant to go back again, like I’m looking for things to be wrong.

With regards to my anxiety and depression, it is now well under control after having counselling and being compliant with meds, but despite my recovery, he is the one major factor that affects my low mood in a massive way.

Just yesterday when he kicked off going into school, they rang my half an hour later to say he’s been giggling and talking and settled right down pretty much straight away. He started just this September and I do think he’s absolutely exhausted, but he’s sleep seems to be suffering too.

You’re right, I really can’t see the wood for the trees.

He is very articulate, can express his feelings very well. He’s actually quite clever, Nursery mentioned that he was really clever quite early on.

There’s no issues around food that I can think of, eats really well, in fact we struggle to fill him up, he can eat all day.

Nursery never had any problems with him at all. Was friendly and popular and behaved well.

This sounds just like my DS at his age. He has settled down so much in the last few years, but we are having him assessed for asd/adhd. Please see your gp to get a referral. Ask for a referral to occupational therapy who will assess whether there are underlying sensory needs, and a paediatrician who can assess for asd/adhd. We can see that there is some neurological basis to our sons difficulties as he matures and continues to struggle with various things.

Things I wish I'd known /done when he was your age

• parent positively as much as you can. We have a jar full of tiny stones, my kids get stones liberally granted throughout the day for the smallest of things (eating sensibly, showing kindness, low voices when people are sleeping, putting coat on straight away). Don't use these to coax, bribe or threaten ("come on, or you won't get your stone"), and don't remove them for bad behaviour. Do use them to encourage ("let's get our coats on, then we can put a stone in the jar"). If they are unresponsive or combative ("I don't want a stone anyway") just ignore it and find another opportunity to give them. The purpose of this is to help build a positive relationship with your child, which you both desperately need.

• take more responsibility for your responses to him than you do for his behaviour. I spent so long focussing on everything my son was doing (and it was bad!) that I was totally unable to see how I would often behave just as badly in response. I became a person I hated, and I wish I'd seen it earlier. I still feel deep sadness and regret when I look back at those times. By all means think about how you can help him (to stay calm, make good choices, use his words etc) but spend more time thinking about how you're going to keep your cool in the moment.

• by all means put consequences in place, but think carefully about them and don't do it in the heat of the moment. Or if you do, don't be afraid to say "I was angry, and it was silly of me to say you've lost TV for a week. Now I've thought about it, I'd actually like you to sit down with me and think about 3 ways we can stay calm when we're cross. We're going to do that while your brothers watch TV, but you can watch as normal tomorrow." IMO, consequences (according to reasonable, modified expectations) are appropriate for children even when there is a neurological basis for the behaviour, but they need to be geared towards helping the child mature rather than solely disincentivising behaviour through punishment.

Hope this helps

He reminds me a little of my 8yo who we've found out has dyslexia and dyspraxia and is on a waiting list for ASD investigations. (He is very sensory).

At 5, we still felt like we were in the terrible twos, and it probably did escalate a bit from starting school compared to being at nursery. He's a delight at school, but all the tension of trying to be good and keeping up with difficult things like reading and writing means it explodes out of him at home. He had had intervention for a speech delay age 3-5. He needs a lot of quiet time to unwind, and being well fed and watered. He escalates towards the end of term and has a termly cycle of meltdowns, with bonus points for adapting to changes/ pressures such as SATs, supply teachers, holidays.

It is worth going to the GP. If nothing else, it establishes a paper trail if there is more to go on in the future. I went with a great mind map filled with my concerns and DS's quirks. School has been good for the literacy side of his difficulties, but don't see his emotional struggles.

Sorry I should add that when the jar is filled up with stones (family jar, it's considered a team effort so no chance of anyone coming last!) it can be exchanged for a big treat like the cinema or soft play. And if you feel they need it, you can put marks on the jar and offer smaller/cheap/free treats (family movie night, sweets from corner shop, later bedtime) to celebrate achievement along the way. I don't just give my kids tiny stones as a reward for good behaviour

I'd definitely start with the GP and see if you can have a chat with someone at the school regarding his behaviour at home.

Has this always been a thing, or has it escalated since he started school? A lot of my friends with kids that have just started primary have said that the vast majority of the time they are just an absolute nightmare to deal with, particularly as were coming to the end of the term. I definitely recall my DSS being very temperamental around this time and probably until he was 6, that first year of school is really tough on them.

@dustyphoenix makes good points.

I'm handling DS better since I accepted that there is something ND about DS.

Some flashpoints, I've eased off on. I brush his teeth for him as it is too much of a sensory/ co-ordination conflict for him to do. I'm better at seeing what is genuinely hard and what's being bloody awkward (which he can be too).

He's usually lashing out because there is something he can't express more appropriately. He's sent to calm down and given a small snack (particularly if simering after school) and drink. His behaviour and any consequences are discussed when he is calm. Sometimes it make take a few attempts to get to that stage (our pb is 4 hours)

Be specific. "Tidy your room" or even "put your clothes in a basket" overwhelms him. "Put 10 items in the basket" works better.

I find routines tough, but trying to set up predictable patterns helps. DS likes incentives. Mornings were always a battle for us. DS now knows that if he gets dressed TO HIS SOCKS (important as I do not want him going back up into the abyss to spend 15 mins getting socks ) then gets tech time until breakfast when the rest of the routine continues. Splitting his tech allowence so he has something for nothing and doubling it as a reward also works for him.

@dustyphoenix the stones as a reward made me laugh. DS would love it if I regularly gave him a stone or a stick

have you ever heard of pda (pathological demand avoidance)? I would have a read up of that and of sensory processing difficulties and see if any of that rings a bell

Thank you very everyones input.
I know I can definitely adapt my responses to him.

Can children with asd/adhd switch it on and off?

I’d say he has always been quite highly strung but he’s definitely ramped it up since starting school. I make sure he gets quiet time after school as I know he needs his downtime quite a lot.
He saps that much energy out of me physically and mentally that I’ve nothing left for any of the others, I just seem to get through the day, just.
We both work, husband works shifts so has 4 days a week off. I work around husbands shifts, some weeks part time, some weeks more. So combined with work, other children and him, I sometimes feel like giving up and just letting him do what he wants. I know this isn’t the answer and we never let it get to that but I don’t know how much more I can take. How our day goes all depends on what mood he’s in.

Never heard of pda, will look that up now.

Oh and also, wherever possible, try and use non-verbal (and therefore less demanding/confrontational cues) for things you'd like them to do. We use a variety of lists peppered around the house to help with understanding expectations for various things (what's required when we get dressed/clear the table/tidy up/get ready for bed). This helps with independence and responsibility and, in turn, self-esteem and confidence. Or if he's just finishing up a game before we leave the house, I'll not ask him to change his shoes but will grab them and put them next to him so he can easily make the transition from game to leaving successfully.

I'd be interested to know whether anyone else feels/felt like this, but I used to really struggle with the idea of making these sorts of adaptations for DS. I'd feel like I "shouldn't have to" do these things in order for him to behave and do what was needed. And the truth is that, for many kids, you don't have to, and doing so would be mollycoddling. But as I've come to understand him more, I see now that he really needs these adaptations in order to succeed in life, and its my job as his mum to help him succeed, particularly in things he struggles with. Just thought I'd add that in case it struck a chord!

Yes that definitely struck a chord dusty, thank you. It makes a lot of sense.

Can children with asd/adhd switch it on and off?

Not at will, no, you will notiv#ce a fluctuation, but it's not a conscious one on their part.

No, the "bad" behaviour happens when they are out of their comfort zone. It's caused by heightened anxiety usually at a change in situation (transitions) or something being different to how they expected it to be, or a sensory stimulus that's overwhelming.
The times when you don't notice any untoward behaviour are the times the child has nothing in their environment to trigger them.

Good info on sensory behaviour
www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/Making%20Sense%20of%20Sensory%20Behaviour.pdf?v=201507131117

Loads of articles online about kids with ASD being fine at school so school aren't supportive because they "see nothing" (look up masking) then armageddon happens at hometime or if they can hang on a bit longer, when they get home. That's because they've dealt with a cumulative assault on their senses all day and are overwhelmed and have to let it go in a comfortable and nurturing environment.

I'd second that you read up on PDA too.

If he is assessed and has ASD or other condition(s) or whilst you're trying to make sense of his behaviours, please try not to think there's something wrong with him, try to think that differences aren't deficits. Different isn't wrong, different can be equally as good as ordinary.

Blank, your post has made me feel quite emotional. I’m not sure why, but not in a bad way. It all makes perfect sense that I’ve not been able to see and completely unsure and how to deal with it.

I actually said to dh the other week that I think he’s a very anxious little boy and it kills us knowing he’s struggling, we just feel so sorry for him. He’s such a funny, caring little boy who is very well liked and loved by everyone around him. Think I’ve just got to a point where I can’t let this carry on anymore, for our sakes but more importantly his.

Might be a silly question, but do I take him to the gp with me?

He fits pda to a tee, I can’t actually believe it.

He absolutely loves football, we signed him up to a 5 week training course with his younger brother.
He refused to join in until 10 minutes towards the end despite his brother joining in. I just knew he’d love it once he started but he just wouldn’t start. We stopped going in the end as it was getting too stressful for him.

Yeah go to a go. Sounds like he could have ASD or autism or something.

we were all in your situation at one time, knew there was something, but not sure what it was. I'm a lot further down the road than you, my dd is adult now. You're lucky your husband is on the same page - lots aren't - plus you have the advantage of having other children so when some clown tries to infer it's your parenting that's causing your son's behaviour, (they will !) you have the experience and plenty examples to know that's not true.

The NAS has the procedure for asking for an assessment pretty well explained www.autism.org.uk/about/diagnosis/children.aspx
I'd initially see the GP on your own with at least as much info about your son as you've written here and anything else that 'shouts' when you read about ASD, PDA, Sensory Processing etc.
One more thing to bear in mind is kids with AN can often be emotionally immature, often emotional age is about two thirds their chronological age, so some expectations about they should be able to cope with X at this age need a fair bit of leeway.

Sounds like he could have ASD or autism or something.

ASD is autism, they're not two different things. ASD stands for Autism Spectrum Disorder.

It's so hard, isn't it Hortus. It can be a vicious circle - there's things you know will help him (like football) but it's so hard to facilitate them because of the very difficulties you face. I can say with confidence that DS is such a different child at 7 than he was at 4. You won't always be facing the same challenges.

It just jumped out to me that you said that you have a good or bad day depending on what he's like. We had (and still do occasionally, when we lose perspective) that same situation, it felt like DS was the emotional leader in our home, and that's not a good place to be. That's why I suggest spending some decent time (perhaps you and your DH together if you can) talking about strategies to help you both manage your responses, aswell as strategies to help your DS. It's taken some really conscious effort on our part to keep reminding ourselves that we set the emotional tone in the family, and that bad behaviour won't shift that.

re. the GP, I personally wouldn't have wanted to take DS - he gets really anxious and dysregulated when people talk about him, and he'd also feel horrible hearing a list of his challenging behaviours. I'd try and get a phone-call in advance and explain you'd rather speak directly, because you're dealing at home with the outworkings of the challenging behaviour caused by the very anxiety the appointment might induce!

Sorry to keep hopping on and replying, hope thats ok - I just know what it's like to be in your shoes!

I spent years working in learning disabilities-T.A &then residential units ..I would absolutely insist on a gp for an eventual referral...his behaviour sounds like its having an adverse effect on the entire family&some of the things you mention regarding his triggers were especially telling.Be persistent as many of the families i liased with had struggled for years to be heard &taken seriously.Good luck.

Kind of rings a bell with me too.

My little girl is 6. Fine at school with friends etc and doing well although occasionally complains of a sore tummy which I think is anxiety.

At home though or with me and her dad - it's so unpredictable. She has her wee ways. Likes her clothes piled in a certain way, socks have to be just right, blanket pulled over her a certain way, hair tightly pulled into a ponytail with 4 bobbles, two roots of the car horn when she's left off at school - everything has to be just so or the tantrum melt down is epic. She's been like this since ages 2.

Last week I took her swimming and bought her swim socks as she has just got a verruca. The lines on the bottom of the swim socks bugged the hell out of her - she couldn't physically restrain herself from pulling them off.

Sometimes she's grand and sometimes she's suddenly having a random melt down because her hair isn't right.

I don't know.