4 year old hitting at nursery - feel totally lost

[endoftether89]

I have a 4 year old with a significant communication delay. He has been at a mainstream school nursery since September, he has a one to one there, and I understand that he will have a one to one when he goes to reception with his EHCP.

Since about age 2.5, we’ve had issues with him hitting. I have tried absolutely everything I can think of, I’ve read so many books and websites, I honestly don’t know what more I can do. I have always been a thoughtful parent, I put a lot of effort into having a calm home, I just have absolutely no idea where the hitting came from. I’ve just never been able to completely stop him doing it, though I do see progress now and then.

However, one thing that made me so hopeful and positive was that he did not display the behaviour at nursery. He was always so happy at nursery, and I just felt so hopeful.

However, last week nursery told me that he was hitting other children and pulling their hair quite a lot. The same the next day. We reasoned that it must be the heat, and I kept him off the other day that he was due to attend nursery that week because of the heat. I was really hoping that would be the end of it, but today nursery have again told me that he has been hitting and pulling hair “near constantly”. I just don’t know what to do. I feel so worried, upset, embarrassed. I was so desperate for him to make a friend but he’s not going to be able to if he’s constantly hitting everyone, is he?

Does anyone have any experience with an issue like this, and what happened? Is there a particular type of professional I can get involved eg is it something a private OT could help with? Or someone else? I really, truly cannot think what else I can do by myself because I have been trying and trying everything for years now. Nothing works. I did ask the paediatrician a few months ago, but she said it sounded normal to her - this was obviously before he started also hitting at nursery in fairness.

I just feel like I’ve been parenting on hard mode his whole life, I’ve thrown myself into it completely and really tried so hard for do everything right, but despite all that nothing works out anyway. I just want something to be easy and go well for him!

Has the school tracked the hitting? Either by a detailed diary, ABC chart, STAR analysis.

What support is in the EHCP?

What did the EP recommend?

OT can help. Both in terms of emotional regulation but also sometimes hitting and hair pulling can be related to sensory needs. If DS has an EHCP, was an OT assessment part of the EHCNA and is OT provision in F of the EHCP?

SALT can also help. Sometimes hitting and hair pulling is how frustration around communication difficulties presents. As above, was a SALT assessment part of the EHCNA and is SALT provision in F of the EHCP?

Is 1:1 detailed, specified and quantified in F of the EHCP? If so, is it actually being provided?

Thanks for replying @scoopofmintchocchipicecream x

No, nursery have not mentioned anything about tracking. That’s something I can ask tomorrow, thank you.

The EHCP is vague, and I’m now wondering if I should take steps about this. When I got the draft I asked why one to one wasn’t specified and the case officer gave some waffle about how they like to leave it up to the school but that the EHCP indicates a “high level of adult support”, and I heard via the school that the LA will be giving £19K of funding for him and school have said they will be hiring a TA for him. Though I have not yet any direct experience with the actual school rather than the nursery, I trust the school to act in his best interests as they have been really positive and helpful so far. Therefore I let it lie re EHCP wording as I was so exhausted from the fight of actually getting one. However I’m starting to wonder if I’ve been a bit of a mug and need to take steps re the EHCP?

We’ve never had any contact with occupational therapy, I have asked at various points but just been pointed to a helpline that only offers advice over the phone, no assessments or appointments. He did have private speech therapy for some time but it wasn’t helpful - I feel maybe the SALT was not a great fit/we weren’t a great fit for her. NHS speech assessment said they didn’t feel he needed support - anyone who even has one interaction with him would know that’s mad. Paediatrician has always described him as having a “severe communication delay”, and she has recently re-referred him to SALT so we will see what comes of that. There was a mention of following SALT recommendations in the EHCP, I will pull it up later this evening and find the exact bit. I think these may have been the recommendations following his NHS SALT assessment.

AFAIK, the EHCP assessment was essentially just based off the EP assessment and nursery’s comments. The advice from the EP was quite vague, none of it related to hitting because he wasn’t displaying that behaviour at nursery.

His current one to one at nursery has been funded via an LA grant - though I’m not sure what has happened with this since receiving the EHCP in late April. I don’t know whether his one to one is now funded from the EHCP and the grant has stopped?

I have always felt really, really positive about his nursery. They have always been so switched-on, caring, and kind. Very interested in doing what is best for him - they have previously said, and I agreed, that having a one to one was necessary but that he needs to develop some social independence and therefore his one to one should hang back a little to allow him space to interact. But maybe this is something that needs to change now

I definitely agree that frustration re inability to communicate could be causing the aggression, that makes sense, but on the other hand he is now actually perfectly able to express, albeit in an unusual way, eg “I want that toy” or “move” - I feel more like the hitting is a manifestation of lack of impulse control or emotional overwhelm. When I’ve seen the hitting at home, it seems as though his brain leaps to hitting before even bothering to consider communicating. Eg at home he has been saying things like “X (nursery child) had a book, I loved X’s book, I wanted it a lot” and then in a sort of separate part of the ‘conversation’ will reveal “I hit X”. Does that make sense? He can formulate words to describe that he wants it, but he has gone to hitting before even thinking about anything else

I bet the LA said that. Err, no, the EHCP absolutely should not leave it for the school to decide.

High level adult support is rubbish. What is a high level? What support? What adult? Think about who (including training, qualifications and experience), what, where, when, how long for, how frequently…

Even when you have a good relationship with a school, the EHCP needs to be lawfully written.

If 1:1 isn’t detailed, specified and quantified in F of the EHCP, it doesn’t have to be provided and it is likely DS isn’t actually receiving full time 1:1. Even if 1:1 is provided, it will mean when other staff are absent &/or needed elsewhere, they will steal the member of staff providing 1:1 for DS in order to comply with ratios/other EHCPs/randomly e.g. for trips. Then add in the times the person providing 1:1 s actually helping another child in the class. I suspect DS isn’t receiving as much 1:1 as you think right now and that may well be contributing to the situations leading to hitting and hair pulling.

Don’t fall for the common line that 1:1 leads to dependence. That isn’t the case. A well trained 1:1 deployed correctly does not.

When was the EHCP finalised? Do you still have the right of appeal?

The EHCP sounds rubbish more generally too. DS needs SALT and OT input. SALT and OT needs to be in F of the EHCP. Then DS doesn’t need to sit on the normal NHS waiting lists, and he isn’t limited to what is typically provided via the NHS.

What you describe with hitting before communicating can still be communication difficulties. Communication is about more than just the physical ability to speak. Especially once you add in other factors, such as the nursery environment and the emotional dysregulation. DS may not be able to communicate at that specific moment in time

Have the other kids been allowed to retaliate and hit him back? He may just not realise that it hurts.

I disagree that hitting is the answer to teaching a child with SEN no hitting.

I cannot thank you enough for your comment re appeal window @scoopofmintchocchipicecream - like an idiot I didn’t check this. I had it in my head there was no time limit for appeals after a finalised EHCP, I don’t know why. But yesterday was actually the last day of the 2 month window, so after reading your comment last night I emailed the mediator company. I’m hoping this will be sufficient, as looking up the relevant legislation it just says I have to “contact” the mediation people within the two month limit, and I do now have the email with the time stamp proving I did.

Am I right in my understanding that there will be a review after he starts reception, and therefore another opportunity to appeal?

@wisbech I can’t imagine the nursery are actively allowing other children to hit in retaliation. They haven’t commented on whether anyone has retaliated so I don’t know. The last time I remember anyone hitting back was at a soft play approx age 2, an older child gave him a good whack after he hit her first. He thought this was cracking great fun, he seemed to think it was a game. At that stage, he wasn’t really hitting in anger - he would do it when overwhelmed either negatively or positively. So in the case of the soft play incident I just gave, he was happy and very excited at the time, a child running past him made him laugh and then he hit another child who was closest to him.

He doesn’t hit when excited anymore. These days it is definitely to express anger or sadness. I suppose he learnt it gets a reaction. I am very consistent with consequences but they just don’t work with him - it seems to very quickly become a mental “routine” to him. Even though the consequence is a negative one, the fact he can predict what comes after the hitting seems to comfort him and after he does it he will immediately ask to do whatever consequence we are currently using.

Contacting the mediation service is enough. You will then have a month from the date of the mediation certificate to submit the appeal, or because that is likely to fall within August, you will have up to the first working day of September, so the 1st September this year.

An annual review (AR) must be held at least every 12 months. Because DS is under 5, it should be considered every 3-6 months. However, this is a should rather than a must. The law only mandates annually. Following ARs, you get the right of appeal. You can also request an early review. Although the LA may not agree to hold an early review.