I don't know what to do anymore

[codenameduchess]

Dd is 4, and an absolute nightmare. I've reached the point where I don't want to be around her.

She screams, hits, punches, kicks, bites, throws herself around and flails about if she's even asked to do something simple. putting shoes on to go out can take 40 minutes.
She can be lovely, but flips so quickly over nothing I can't face taking her out because its embarrassing as she won't respond to anything and it can take an hour to calm her down.

about an hour and a half ago I asked if we could cut her toenails, they've needed to be done for a week and she's not wanted to but it's at the stage now where they can't be left any longer. They still aren't cut and she's been screaming nonstop at me the whole time, she's throwing herself over and attacking me. I've had to walk away and just sat in the garden crying (dh was there to keep an eye on her).

She doesn't respond to rewards, punishments, positive or negative reinforcement or any method we've tried. She just doesn't care, and it's worse when I'm around - she's barely any trouble for her grandma or nursery. I've found myself shouting at her more recently, I always try to stay calm and keep my voice level but it's just not always possible when she's screaming and punching me and i can't stop it.

It hasn't always been like this, she's had her moments and we've had phases where her behaviour has been bad but never this bad and to the point I just don't see a way out.

I'm 20 weeks pregnant with our second and honestly I don't know what I'll do when there's 2 of them. I can see her getting worse when there's a baby too.

What do I do?

Has she had any ear sinus or throat infections ever or been checked for enlarged tonsils or adenoids?

My DD can switch mood very quickly. What we have figured out is that she has a plan in her mind of what's going to happen, she hasn't communicated that plan but if we go off track it sets her off, she gets upset and so frustrated she can't explain why she's upset.

Have you tried explaining what's going to happen, just little snippets like:

'ok xxxxxx we're going to have breakfast and then I need to do your nails. After that we'll get dressed and go to the shops' let her process that for a couple of minutes then ask her to tell you what the plan is, then do it.

We also find that the day goes better if she gets a few minutes in the morning of quiet, cuddle time. Just 2 minutes of sitting together, saying good morning, no interruptions or distractions makes for a smoother start.

Ear, nose, throat, tonsils all fine- she's asthmatic (controlled, never had an attack and no current issues) and has had all manner of checks as she was constantly ill when she was little.

I ask things like cutting nails, brushing hair etc as we are teaching her about body autonomy and permission/consent- that she's in control of her own body, and that includes me and dh so I'd never just grab her. I know that sounds a bit much for a 4 year old but it's easier to teach the concept from a young age.

She likes to know what's happening so every morning we go through the days plan 'we'll eat breakfast, then get dressed then it will be time for nursery and after nursery we'll do x, y, z'. I try to offer choices so feels like there's some control, like 'do you want to get dressed or brush your hair first?' - both things need to happen, she's just choosing the order. Some days it works, others she screams and insists she's going to nursery naked.

For what it’s worth I completely agree with the bodily autonomy, it’s really important.

I was going to suggest you read about PDA as well. It is a bit of a myth that special needs will be equally obvious in all situations, many children "mask" behaviours in situations they don't feel as comfortable in and then it all explodes out when they feel safe which is often at home with the main carer. The key is that the behaviours must be present in at least two settings, which might be at home with mum/out with mum, or when around other children vs when alone, or with mum/dad.

It sounds utterly exhausting, my son was extremely difficult to cope with at 4 as well. He's 10 now and does have ADHD though not a hyperactive type. We had no idea at that age but looking back his behaviour was outside the boundaries of normal small child stuff and I wish I'd sought help with it rather than just assuming it was me who was crap. Honestly I think my failure to do this really affected our relationship in the long run which is so devastating. I had nothing to compare his behaviour to as he was an only child but now I've had another baby I can see how different he was even from a very young age. It's ok to admit that it's not normal,especially if that's the key to you finding more support. Is she due to start school in September?

One thing I think which will be helpful if it does turn out to be a kind of SN issue - you must be a very caring and respectful parent to do the bodily autonomy thing at this age even when it makes things more difficult for you. Having that kind of nature means that you'll probably be great at learning about parenting in a "non-standard" way and learning to understand and work with your child as they are rather than as you would hope they will be. Nobody finds that kind of thing easy, but some people find it harder than others. You sound like someone who is interested in learning and taking on new ideas which is a very useful trait.

OP.. that sounds so hard!! One thing don't blame yourself, she does not hate you, the reason anger frustration and misbehaves mainly with you is because your the closest to her so she feels like she can take it out on you. Doing the right thing walking away, not shouting which can be very difficult at times when your out of ideas and exhausted! Your DD sounds like a very clever and passionate young girl who knows exactly how to get her own way and it sounds like you've nurtured her independence and own choices which will pay off greatly in future.
I'm inclined to agree that if it was good colourings then it would be constant at nursery etc.. unless her diet is very different at home than at other places, more treats at home more sugar. Always worth having in mind. Personally I would say take a breath and keep things very simple, you've said she doesn't respond to rewards positive and negative reinforcements.. the rewards you've tried is it things like if you cut your nails you will get a treat tomorrow? I'm just wondering maybe try a reward straight away once she's done what she's supposed to, for example her favourite treat chocolate or whatever on table and say you can have that once you've done your nails or favourite book, you can read that with mummy after you've cut your nails. Then she can see what she gets once she's done what she's told, also don't ask just say mummy needs you to sit down and do nails now so there's no choice. Then it's just a battle of wills on who can hold out longest. Really hard but don't lose faith things will get better.

As a mental health nurse its a myth that conditions such as ADHD /ASD will show up across all environments.

Especially in girls . Some children unconsciously adjust their behaviour to the environment they are in - its a survival strategy the brain uses so that children continue to receive care & safety.

Speak to GP / HV whichever you have the best relationship with and discuss a referral to Paeds.

PS - my daughter was often like this ... I luckily had a fab relationship with my HV who told me her brain was frustrated as she could think beyond her years but emotionally she was still tiny.
I thought HV was giving me flannel & was convinced my DD had ADHD.
She didn't... it turned out my HV was right & DD is the light of my life .

Children this age can often get so frightened by their own feelings... i agree body autonomy is important but she is still tiny & above all craves to feel safe when she is having strong emotions. At these times she needs physical boundaries to feel safe - I literally use to hold my DD until she had finished thrashing around & screaming.

It allowed her to release her emotions whilst feeling safe - dont fall into the trap of treating her older than she is . Be careful with the body autonomy stuff it can be very confusing & frightening for them - ( iv worked as a MH nurse with young children so have seen this first hand ) .

And absolutely choose your battles- ignore as much negative behaviour as possible & give praise for the tiniest thing.