How can I help my child to self regulate?! Desperately need help

[Garlicnaan]

Our child 8yo loses it over tiny things and will scream, swear, rage and hit (his brother or himself, not us) when he loses his temper. He's very anxious and fearful.

Examples will be: a game not going his way, food not being what he wanted, parent not coming quickly enough, brother saying something annoying, getting him to do anything he doesn't want to do.

Consequences don't seem to work. Afterwards he gets upset and says sorry and that he's an awful person. He is such a sweet and empathetic boy in so many ways.

We've been trying our best to stay calm and regulated when he's losing it. And trying to give him fairly low demand lifestyle. Our only demand really is that he goes to school, which he hates.

His brother however finds it so hard to be around and they clash all the time. To the point where I've considered moving out with one of them to keep them separated. It's really getting us down.

I am desperate to find ways to help him regulate - can anyone help me? Happy to pay for external help if that's what it takes.

When I try to talk to him about ways to stay calm or other ways to manage his emotions when he isn't in a state, he gets really angry.

And quite honestly the times when he's regulated are also so few and far between and usually when he's in a state of flow eg drawing, or watching TV, that I don't want to interrupt him during a rare moment of peace.

Our only demand really is that he goes to school, which he hates.

This may well be the problem. I am not saying you should home educate if you don’t want to. In fact, I personally wouldn’t. But, if education was easier for DS home life is likely to improve too. With that in mind what support is the school providing? Do they have anyone who can support Zones of Regulation work? Does DS have an EHCP? Has DS had SALT, OT, Ed Psych assessments?

The things you see as triggers may not be the true cause. DS may already be on the tipping point when e.g. the wrong food is served. Have you tried keeping a detailed diary to try to spot underlying triggers to help stop escalation in the first place.

Does your DS have a diagnosis/is he under any professionals/has he been referred for assessment?

What are DS’s sleep and eating like? Some find sensory equipment, trampoline, punch bag helps. Some people find The Explosive Child book helpful.

For your other DS, have you spoken to the local young carers service? Sibs can be supportive too.

Thank you for replying - no EHCP, SALT, OT or EdPsych involvement except to observe him for his autism assessment. We could go private but we are living in permanent fight or flight and overwhelm so would be grateful for an idea of where to start. Maybe OT?

He has an autism dx but was a borderline case and doesn't present that typically. He presents more like a girl does, typically. Masking, superficial friendships etc.

Pretty sure he's dyslexic too. HIs speech and reading are good, his writing and spelling are not, to put it mildly.

He is in a small nurture group at school, and can sit by himself if he wishes, and is offered ear defenders, but that's about it.

We've tried observing him and the only obvious triggers we can work out are hunger and thirst, and we could certainly get on top of that a bit more.

Aside from that it's his brother. He's ok 80% of the time when his brother isn't around. That flips to 80% not ok when he is. We have considered getting two houses, it's that bad! It's a vicious cycle with them triggering each other.

His sleep has been ok at times but was when younger and is currently awful. If he wakes in the night he shouts and screams in fear until we come. He's waking a lot.

He is fussy but eats ok. He soils himself frequently. We are looking into medical help for this.

We have a trampoline and had a lot of other sensory things but it's hit and miss if he'll engage with them. He's too scared to go on the trampoline by himself. He's too scared to be in a room by himself. The fear is awful and a big problem. His brother has wound him up trying to scare him which has made it a lot worse.

I would start by requesting an EHCNA. If the LA agrees to assess an EP assessment will be part of the needs assessment. OT, SALT and psychiatrist &/or clinical psychologist can also be part of it.

Alongside this I would request a referral to CAMHS, paeds and the continence service (if that isn’t who the medical help is via).

Play therapy sounds like it could help.

If writing is a problem has DS tried a laptop and assistive technology or a scribe?

Does DS take any medication to help with sleep? Do DSs have their own room or do they share?

Thanks, who do I go to for the referral to CAMHS, paeds, etc? I went to my GP when he was missing a lot of school and threatening to kill himself and they were quite dismissive. So are the school although we are getting a new SENCO soon so I might get some better help.

School have let him use a laptop occasionally and we are trying to do touch typing with him at home but he won't really engage much.

He has his own room, and no nothing to help him sleep. He is so much better than he was when younger that we just suck it up. He takes around 20-60 minutes to drop off but can wake several times on a bad day. On better days he will wake much less or occasionally sleep through - but only if we are in bed with him.

For an EHCNA you can’t make the request yourself. On their website, IPSEA has a model letter you can use to send to the LA.

For the continence service and CAMHS, in some areas you can self refer. If you can’t, go back to the GP and school. If they still won’t refer, complain, but also try the school nursing service. The school nursing service will be able to refer to the continence service at least. The GP will be able to refer to paeds. In some areas the school would be able to too. If they all refuse to refer to paeds complain again. You could also request a referral to a sleep clinic, the GP will be able to do that.

If touch typing isn’t working, what about speech to text software?

Thanks I really appreciate all the help.

What would the paeds do? That the other services wouldn't?

I was thinking paeds to rule out a medical reason for the soiling. They can also help with sleep medication.