4yo’s extreme behaviour – desperate for advice

[MilesJonesy]

My 4-year-old (well he turns 4 on Wednesday) son has always been a bit fiery, but since starting the new nursery term things have spiralled out of control. Last year he would occasionally hit out, but nothing like what’s happening now.

In the past few weeks he has:

• Flipped tables and turned the whole nursery room upside down (two or three times).
• Spat on toys and thrown food.
• Tried to hit staff, and last week scratched a teacher’s arm so hard it drew blood.
• Refused to let others share resources (like all the Play-Doh pots) and gone into full meltdown if asked to.

At home, it’s not much better. He’s wrecked his room in anger, smashed a glass candle jar, peed himself in protest during time out, poured water over his brother in the car, and regularly hits/spits at his sibling. He sometimes escalates so much I can’t leave him unattended even for a few minutes while cooking.

We’ve tried every sanction I can think of: time outs, no screen time, early bed, confiscating toys, putting him in his room, even withdrawing attention/not playing with him. He doesn’t seem to care about any of it – he just shrugs it off and carries on. Sometimes sanctions even backfire (e.g. peeing himself in protest or trashing things).

What makes it harder is that he can also be completely fine – affectionate, able to sit through long stories, build Lego, go for walks, or cuddle up quietly. And just this week he had two completely fine days at nursery where nothing bad happened at all. So I’m baffled as to how he can switch from that to such extreme behaviour.

We constantly reinforce “soft hands” and “kind words” at home. Nursery have been supportive – they’ve made referrals for speech and language and for a possible neurodevelopmental assessment, but the waiting list is about two years (Scotland). I’ve started looking into private options because I feel I can’t cope waiting that long.

Emotionally, I feel like I’m at breaking point. I’m stressed, anxious, and sometimes feel totally alone dealing with this. I have another child too, and it’s horrible watching him bear the brunt of the hitting/spitting.

Has anyone else had a child whose behaviour escalated like this around age 4? Does this sound like ADHD/autism/PDA, or something else? And what practical strategies actually made a difference in keeping everyone safe day-to-day?

Any advice or reassurance would mean the world right now. My eldest is 6.5 and has no problems whatsover at home or school except the odd bit of being silly or cheeky.

I believe children need to be allowed to backchat to their parent. I would not silence that completely by threats. Assuming it’s backchatting only, not violence or breaking things or such. I don’t like the mentality “you do not backchat to me”. I grew up with that and think it was damaging.

@Bananacherry I always found that approach better, although it's exhausting and friends and family can get a bit eye rolly (so now I am very selective with who I tell what).

We have had to lock a lot of things away or put then beyond reach, many many times over the years. Have duplicates of things. We stick to the type of game that DD can easily win (Uno) or accept that nothing will ever be finished or watched to the end. Have lowered our expectations around homework, organisation, sitting at the table. If it works, we do it, even if outsiders might find it strange.

The thing I will say is being a SEN parent is expensive and this compounds the stress. It's also very hard on adult relationships.

@BertieBotts I wanted to thank you for the Eddie Gallagher book recommendation. That really changed things for us.

OP, there is light at the end of the tunnel. My 12 year old is transformed from when she was 4, despite still having some challenges.

I agree with this. Once i started listening to what my "backchatting" child was saying, i realised he was actually pointing out illogical inconsistencies in what i was saying/doing/my expectations of him. Letting him "backchat" gives us the chance to discuss things and work out a way forward that respects everyone in the family.

Solidarity. I remember vividly when DS would pursue a messy/inconvenient/dangerous activity with an unshakeable focus, and I would feel completely helpless in the face of his determination. When I say 'completely helpless', I mean I would feel despairing, powerless, frustrated, furious and ill. My DS has PDA/ADHD, but we now work with a small team of people, both online and in real life, who have changed our lives. An insightful OT is a godsend in this situation. DS is now 11, and we face significant challenges, but life is so much better.

❤

That sounds really difficult. 💐 It could potentially be autism/ADHD/PDA. His behaviours didn't start suddenly after an illness or infection did they?
It may well not be this at all, but what you said about his behaviour reminded me of a friend's child who was eventually diagnosed with PANS/PANDAS. It's a condition that is triggered by an infection, usually strep, but can also be triggered by other infections. It often causes sudden, extreme behaviours, and it can sometimes be treated with antibiotics, so it may not fit your ds but if it did it could be worth looking into.

So the strange thing about all this is that the weekends have been pretty much smooth sailing even while his behaviour during the week, especially at nursery, have been challenging. Yesterday we had a family party, took the boys to the park, we were in the house in the afternoon, and the worst thing that happened was the kids had a fight in the car for five minutes before we distracted them with some music.

Before the summer my son's behaviour at nursery was fine, he just occasionally hit another child - but only rarely. All of this started when he went back in August. And the extreme behaviour there like hitting teachers and turning the place upside down - that hasn't been happening at home. There was just a brief period in July when it would escalate that far at home. So nursery specifically seems to be a big problem for him right now. It seems like he's becoming completely dysregulated there. One trigger was right after lunch, once he finished his meal, he would start running around the lunch hall and throwing things. (It was only the nursery in the hall). So the nursery started bringing him into the nursery classroom after lunch to eat his pudding in peace and quiet with one teacher who is in there tidying and he's absolutely fine doing that.

I do wonder if some of it's his speech delay, and the instructions throughout the day, his peers having conversations that he can't join in, and the weight of having to process everything all day.

Asking him why isn't going to get you anywhere. He's 3. He doesn't know.

Discipline is only half the battle. If a child's behaviour is this bad it's because of some important unmet needs and increasing discipline without finding out what those unmet needs are just tells the child his needs are not important.

There may be be neurodiversity or sensory issues here, he may find the nursery environment difficult or he may just not be coping with separation from mum. It's impossible to guess. Can you get him some sessions with a play therapist who might help to identify what's wrong with some play-based exploration of emotions.

Hi OP,

Sorry you’re going through this. You’ll get posters who say be firm blah blah blah completely ignoring the fact that you are a more than competent parent and actually that’s not working. Ignore them. They don’t know wtf they are talking about (I am also a primary teacher with two ND children who worked in challenging schools and had exceptional behaviour management skills).

Look into PAN/PANDAS - might not be but the change in behaviour sounds quite sudden.

Other than that he definitely sounds ND….could be PDA which is tricky as you may try typical ASD strategies that make things worse.

i would read up on PAN/PANDAS and also PDA see if anything rings true.

my youngest is 6 and has behaviours like your youngest. The dysregulation has many triggers. It’s too much to write here but I would recommend reading When the naughty step makes things worse. Also how to talk so little kids will listen.

Sounds like some kind of neurodiversity. He is probably overwhelmed with a new environment. Maybe there is a chance to move him to a smaller setting?

I think you said you'd secured some speech therapy - when does that start? It does seem likely that you and the rest of the family can understand what he wants to communicate more easily than nursery staff/outside kids.

Play therapy was helpful to our daughter. I don't know if schools and nurseries can access it in Scotland (we had to find and pay for it ourself) but I did find this interesting link:

Our Story - withkids.org.uk https://share.google/J6Pl64oDfFsmEnEeN

He's been in the same nursery class since January though, it's only after summer that this happened. And I think there are able 12 kids there spread across two rooms and with a free flow area to go to outside.

Demand build up over time. A well regulated child who doesn't have many demands on him might find that if the demand build up and up, he's unable to cope and becomes dysregulated .Maybe nursery have higher expectations of him now he's that bit older. Think of all the demands on a 4 year old before he even gets to nursery - get up, eat breakfast, get dressed, do your teeth, comb your hair, get your shoes on, come here, stop playing with that, get in the car, get out of the car, come here, do this, walk nicely - that's before he's even got in the door. Then he goes into nursery which can be a stressful environment for some children and has another pile of demands on him. Something we don't really think of as a demand, such as come and sit here in this noisy room with 11 other children and eat your lunch nicely, could be the thing that tips him over.

The fact he was taken to a quiet room to eat and he's fine now does strongly suggest a sensory issue. The fact he's fine at home over the summer holiday where his environment is safe and predictable, but unable to cope at nursery, except when they accomodate him is indicative that it's not behavioral but sensory. It's good that nursery has recognized he needs a quiet place to eat. They need to do the same with other triggers too. And some days he might be fine eating with everyone else. Some days it might be too much for him - they need to be flexible and adaptable but it sounds like they're willing to make accommodations which is great. Have a look at declarative language as well - we find it very helpful with our children.

I know the dysregulation can point towards Autism but when I look at the NHS symptoms:

• not responding to their name
• avoiding eye contact
• not smiling when you smile at them
• getting very upset if they do not like a certain taste, smell or sound
• repetitive movements, such as flapping their hands, flicking their fingers or rocking their body
• not talking as much as other children
• not doing as much pretend play
• repeating the same phrases

The only ones he fits are that it took him longer to talk (but he talks loads now). And sometimes he says things are too noisy. He is very sociable and actively reaches out to hug people, share things and talk to them. He'll also eat anything, unlike his big brother. He doesn't have any repetitive movements, he loves pretend play and he has back and forth conversations.

It could be PDA presentation of autism (my daughter doesn't tick any of those boxes but is diagnosed AuDHD), or maybe you're barking up the wrong tree - time will tell. What does the GP think? Any chance of referral to a paediatrician?

The paediatrician said in her assessment report that while DD's speech and language was very good, she didn't really respond to or pick up what others were saying one to one. It's subtle but it's there. Even at 12, it's like she's always set to broadcast, not receive. I get quite a shock talking to friends' kids sometimes when they actually respond to what I said, rather than simply responding.

I agree that PDA presentation tends to be different, or even AuDHD. When DS3 is medicated for DS3 his autistic behaviours are a lot more notiecable. He was diagnosed with ASD aged 3 and the clincians noted his subtle presentation. ADHD was diagnosed around 7. The gap widened signficantly between him and his peers so what was subtle at 3, was not by 7.

It's hard not to get bogged down into is he/isn't he, but for now you do know he is struggling at home and nursery and the typical behaviour management methods aren't working for him. So I'd press on with requesting assessments and looking into the PDA type support strategies

Clearly you have NT children!