Behavioural problems with 4 year old, please help

[NinaManiana]

I am really struggling with my eldest son and hoping anyone can share any similar experiences or lessons learned.

He’s just turned 4 and his behavior is a nightmare. He is violent pretty much from the moment he wakes up in the morning - biting, hitting, scratching. His rate of doing as he’s asked is basically zero - all routines (morning, bath, leaving the house) are a nightmare, he won’t get dressed, won’t sit down. He can’t be left unattended for even a moment as he either attacks his brother (2 1/2) or smashes things. He is also extremely clingy and very frightened of being left alone. He is extremely hyperactive, bouncing around all the time and will not occupy himself independently for even short periods of time. Tantrums (explosive rages) can go on for over an hour at a time. Despite all this i adore him and he has the ability to be bright, witty and kind when he wants to.

He is at a private pre school, where they are struggling with his behaviour also. He has attacked the teachers and so on. They are talking about whether they can meet his needs, which i know in private school lingo pretty much means being expelled is on the cards. His younger brother’s nursery has raised concerns about abuse given the number of bite and scratch marks he has on his body.

Family time is an unrelenting nightmare of behaviour management, leaving us unable to rest or enjoy time together. Taking him for one to one time can help whilst its ongoing, as he wants the full attention of whichever adult he is with, but as soon as we’re back as a family unit he becomes dreadful again.

His younger brother is a much more ‘typical’ 2 1/2 year old. Has his good and bad days, but i can see his behaviour is more like other kids that age, where my eldest is like nothing i can compare to except a cousin of mine who has ADHD and Aspergers and was like this as a kid. Consequently he had no friends as he couldn’t socialise.

We’ve had him assessed by occupational therapists who say he isn’t on the spectrum (good eye contact, developed empathy, great language) and he doesn’t have ADHD as he is able to concentrate when he wants. So that leaves us with the conclusion he’s just naughty? Which i struggle with. Most of this started with the birth of his brother when he was 16 months old - maybe a coincidence or maybe attachment related i wonder.

He is pretty much sugar free, he gets 12 hours sleep most nights, has had a consistent routine since he was 6 weeks old, there are no bereavements, there’s no abuse and we are never physical with him. We are totally consistent on boundaries, it’s not like we ever let him ‘get away’ with hitting or anything though the weekends would be easier if we did. My husband and i and our nanny (we work full time so have a nanny for wrap around) are all consistent in our approaches. Up until a few months ago we did all the usual warnings, counting and naughty step. Down to his level, talking firmly, explaining. I tried the sarah ockwell smith gentle stuff a while back and gave up when i spent an hour and a half trying to reason with him not to flush his duvet down the toilet.

The last few months we’ve been trying a more gentle approach trying to explain positive behaviours, gently taking his brother away from situations where he’s being attacked and so on. Doesn’t seem to be doing any good.

After that massive essay I guess the things i’d love some ideas on are:

1. School. It’s a selective school so if kids are ‘naughty’ they just kick them out and select an easier one from their waiting list. We picked it as it has lovely facilities and got him in through the nursery so he bypassed the test but it seems it’s not a great fit. Other private schools in the area are also selective and he wouldn’t pass a test. But i worry in a comprehensive without a SEN diagnosis he’ll just end up being excluded from activities for being naughty? And in a bigger class his problems are likely to be even worse? Basically i’m not sure if a comp would be better as they’d have more provisions for dealing with kids who don’t fit the mold or worse. I’m not averse to comprehensive, i went to one myself.

2. Has anyone got experience of a kid like this? Did they grow out of it? My worry is he’ll end up labelled ‘the naughty kid’ and that label can stick as kids don’t get invited for playdates or parties etc.

3. If anyone has a child like this is there something i’m missing. Like... did anyone see big improvements from cutting out gluten or switching bedtimes or... i don’t know anything? Is there an SEN diagnosis maybe the people weren’t looking for?

I do feel for you as it does sound hard and it does seem to suggest that there is something going on, as like you suggested, his behavior does sound quite extreme. One thing to note is that an occupational therapist cannot asses a child for autism, they are nowhere near qualified. In addition the reason why he suggested that he can't be on the spectrum are common and naive myths; children with autism can have very good eye contact, excellent or even advance speech, be very socially motivated, be very warm and caring, can be every empathetic (sometime more than typically developing children), etc - these positive traits are not rare and commonly found in children with autism. Autism is a social communication disorder (not a speech disorder, or a social disorder, or a no-empathy disorder, etc) so an assessment will focus on social communication; is he able to read the invisible social cues in order to establish relationships, did he point to share interests (like a plane in the sky) by 18M old, did he show you things of interest that he found (like toys, big leaves that he found in the floor) by the age of 16M, does he show social referencing and did from an early age, does he seek praise when he is proud of something he does (and used to do it by 18M), etc - these are the areas that autism tends to really impair.

I would ask the GP for a referral. CAMHs probably have big waiting lists but the GP might be able to suggest a private therapist of some sort who could assess him and make suggestions.

Or psychologist. Hopefully the GP can tell you what's best.

@AladdinMum he did do all those things which also I guess is why it has been discounted as a diagnosis.

Though something which I should mention is there is a heavy bias towards asbergers in the men in my family. Funny they are all kind and empathetic and all the rest of it but I just assumed the occupational health person knew what they were talking about.

Thanks for your response.

@AladdinMum though now I think of it he has zero understanding of boundaries - like he'll kiss or lick people he likes even if he doesn't know them, hit people he doesn't etc

There is a lot going on and I think it would be wise for him to be seen either by a development pediatrician or a child psychologist - by observing him and performing certain tests they should be able to get a clearer picture. Apart from his behavior, has his school not raised other concerns around his development? things like, maybe, not listening, struggling academically, not establishing relationship, not understanding social cues or boundaries (like rules of games the other children play), etc, etc. The school will have a SENCO person and I would have though that way before exclusion is considered they would first be involved with him and even bring in specialists from outside (it's their duty to do so) to observe him at school (I am assuming this is in the UK).

@AladdinMum it's UK but a private school so they don't have a SENCO person because they openly don't cater to SEN. So that's why I'm thinking maybe he'd be better at a comprehensive who have those facilities, but what if he never gets a SEN diagnosis and he's just 'the naughty kid' but in a class twice the size.

Hi OP - sorry to resurrect an old thread but I ust wondering what the outcome was re your son? I’m in a very similar position myself.