what am I doing wrong?

[lolaismyfavouriteandmybest]

Also posted in Behav/Dev but posting here for the SN perspective. Hope someone can help!

dd is 4 (has dubious diagnosis of ASD) and has tantrums, usually at bed time. Always triggered by her ignoring clear warnings that she is behaving in a way that is unacceptable and there being a consequence.

For example, she would not keep still while I was cleaning her teeth tonight. so I warned her I would stop cleaning them if she didn't co-operate, she didn't so I stopped. Cue wailing and throwing herself around demanding that I finish cleaning her teeth (she'd cleaned them, I give them a brush round afterwards to check them so they were pretty much fine) I told her calmly that she'd missed her chance but she could still have some stories read to her if she calmed down. Then we had meltdown.

She needs routine and predictable consequences so when she starts shouting and screaming I go downstairs to remove the attention that she feeds off. I try not to shout at her. I make noise to reassure her that I'm still there but I will not go back until she has stopped shouting/screaming/stamping/throwing all her things around. But she doens't seem to get this and screamed Mummy I need you for at least half an hour tonight. I try to be quick to reward when the screaming stops but three times as I went to her, she got worked up again and it set her off worse. she just gets so worked up she can't get herself out of it. She knows she has to be quiet to get me to come to her but can't see why standing on the landing screaming "I AM BEING QUIET MUMMY" doens't have the desired effect (she is bright as a button when she's not tantrumming and we've talked about it when she's calm to try to help her to understand why shouting and screaming that she is quiet is not working for her)

She loves chosing a toy to take to bed (along with her comfort items) so I have tried removing this privelige. (I never make her have nothing) I have also tried confiscating toys and making her earn them back with good behaviour. but when she gets the red mist cause and effect have no meaning to her.

When she trantrums in public it's worse as I can't remove my attention so it lasts even longer and she gets very violent.

I need a better coping strategy but what?

Hi there,
First of all when you say "dubious diagnosis of ASD" what do you mean? Do you mean you dont agree with it?
Secondly, maybe it would be helpful to write down what happens just before a meltdown and afterwards to see if there is a pattern.
Does she have sensory issues?

Dd3[8] who is being assessed for a posible asd used to get worked up like this if we left her to calm down by herself. She would just get more and more upset. The same happened when we tried to introduce time out as a consequence for inappropriate behaviour.

She would get so worked up that it would take me half and hour or more to calm her down after a 3 minute time out!!

We stopped using time out, I have always found the only way to calm Dd3 is to hold her quite firmly and sit quietly with her reassuring her.If she has flipped she is really not in control and needs help to calm down.

I think sometimes removing privilages that are part of a routine is setting yourself up for a meltdown, especially at bedtime when everyone is tired.

Is there anyway you can turn it round to be more positive?? May be say if you are quick to get to bed without any fuss you can choose 2 toys. Or if you brush your teeth nicely you can have an extra story.

I know its hard but if you can turn difficult things in to more positive things everyone feels more relaxed and hopefully the tantrums become less

Good luck .

Re diagnosis - She is partially sighted and definitely has sensory issues. her diagnosis of ASD hinges purely on her not making eye contact (Which to me makes it flawed) I'm partially sighted too so she hasn't learned anything about eye contact from interaction with me.... she has social and communication difficulties but poor vision explains things perfectly. CDC seem to like to see ASD and have diagnosed accordingly despite saying in the letter of diagnosis that her problems are consistent with poor vision and that it is impossible to say if her vision or ASD are the root cause of her problems. But they felt she needed another label and a few more doctors appointments.......

There is a pattern before her melt downs and I'm guessing it is sensory. When we are out it's pretty much always to do with holding hands. (I'm pretty much blind and she runs off. Therefore she must hold my hand when it's just the two of us. I cannot negotiate on that one. she's OK until she has to queue or wait for more than a milisecond then BANG we have meltdown.

With the teeth brushing I have to put my hand on her head to feel which way she is pointing as she wriggles around and I'm as likely to get an ear as a tooth. She doen't like this but I cannot brush her teeth any other way. I explain, she gets cross, I warn that I will stop unless she puts up with it, she does not......

I've tried holding her when she tantrums (and that's how I calm her once she has began to get back under control) but if I try when she is starting up she fights me and tries to hurt me.

She also reacts very badly to positive praise. If you praise good behavour she stops straight away and is delibaratly naughty. I've posted before about this and the feeling is she sees through the praise to the control implied and it makes her angry. But any warning of possibly consequence is like waving a red rag to a bull and rather than warning her off it triggers the event I am trying to avoid and much more....

I try to offer rewards but she seems to think that she can say she is being good, get the reward and then be a horror. I'm explaining that she has to do the good thing first but I'm not getting through. she'll take an age eating or getting dressed but insist she is being quick and that she deserves her treat. even if I set her a time she'll insist she's met the targets even if she's still naked when her getting dressed timer beeps!

Time outs do work a little as she gets distracted by her books and calms down, then we can talk about why I'm asking her to stop/do certain things. I try to pick my battles but there are certain things that trigger time and time again that I can't avoid.

Thanks for the responses. I know we have to make things more positive, it's working out how when we are all tired and stressed.....
and I need to help her learn how to get her temper under control but I don't know where to start!

Poor you and DD. You seem to be doing a very good job, but without much reward. Could you get some professional input? Would the GP refer DD for a behavioural assessment?

This is far too simple, but...
Don't brush her teeth at bedtime. Do it earlier, perhaps when she's watching TV. Yes, it might mean there's a little bedtime milk or whatever left on her teeth, but you can avoid dodgy snacks after toothbrushing.

I think your sanity and her learning not to tantrum so much is more important (we've abandoned morning facewashing for the same reason)

my dd3 has a vi amongst other things and has huge sensory issues, it's hardly surprising really is it! Have you seen an OT as part of the asd dx and filled in a sensory questionnaire to find out exactly what the issues are? Do you get much input from the sensory impairment team, what does her qtvi think?

we did see and OT they said she was fine. thb I'm not impressed with anyone we saw as part of the asd assessment. I'm SO dissapointed that they have a huge wait for apointments and can't make us jump through their hoops again until April.... The last thing I'm inclined to do is recruit any more specialists. we are under 6 consultants as it is.(and we were been seen at 4 different hospitals from Newcastle to Great ormond st until I got militant and did a cull :) I was spending all my annual leave on trains visiting doctors!)

The VI service used to be great but since she started school she has a new VI teacher who I have neer met and who doesn't respond directly to my queries. They think she is coping fine in school (which is good) and does not have any regular support. I think they see me as a fuss pot. (which I probably am. her vision is good compared to most of the children that they help yet I ask alot of questions)

I've tried to have an objective look at the lead up to the tantrums and I've come to the conclusion I'm as bad as she is. I get frustrated and she reacts badly. (we have a lot going on at home at the moment so keeping my cool is difficult) But over the few days I've tried harder to be kinder and I've diffused a few situations before meltdown and turned a blind eye to some more harmless stuff. I'm still just as clueless as to what to do when meltdown hits but I hope it will be less often if I can be a little more thoughtful and considerate.

I just need to get dh on board as he thinks I am being too soft and he blames poor discipline for her tantrums.