Has the time come to get help, and if so who from?

[whoshouldItalkto]

Originally posted this in behaviour, but thought maybe you ladies would have a better perspective. Hope that's OK.

My DD is 6 and in yr 1. She's always been a reasonably challenging child, but for the last 6 months or so she has seemed generally out of sorts and unhappy, and we have had problems with her behaviour, particularly:

Anger and tantrums. She gets angry at the slightest criticism or if things don't go her way. She has a major tantrum maybe once or twice a week. This only happens at home or with her family - never at school. We never give in to the trantrums, so gets nothing out of it. She can't seem to give any reasons why she's so unhappy, although she's clearly jealous of her sister (who we certainly do not favour, and is 3, so not a new addition). On the other hand she gets "over the top" excited about things - loud false laughter, shouting etc over something like me getting home.

She will not do as she is asked. Quite often she will just ignore the first few times, and then if I "threaten" a consequence (e.g.take a toy away, no television) she may comply. If she doesn't and I enforce the consequence she gets upset and angry, says it's not fair etc. It's like she wants us to get angry and punish her so she can say we don't care about her. It feels like I'm always on her case and threatening which is horrible.

Academically at schools she's fine. She is much less happy this year than last though. She has struggled a bit with expectations in terms of personal organisation, independence and concentration (her teacher has very high expectations of this and a number of children have struggled) but this is getting much better. Friendships I think are an issue - I think there is some friction beween her and her group of friends, but again it is really difficult to get to the bottom of this. If we have her friends round to tea individually she plays very well with them. The behaviour started before she went to this class though, so don't think this is the only reason.

I hate seeing her so angry and feel like I've failed. There have been no major changes in our family, and she is very much loved and gets plenty of attention. She eats a good diet and I supplement Omega oils. She struggles a bit going to sleep, and tiredness certainly exacerbates this behaviour, but I don't think it's the whole problem by any means. Is it time to ask for help and advice? I don't want to go through the school as wouldn't want her labelled - also as it's not really a problem at school don't think they'd do anything. Also reluctant to go through GP for same reason - some days are fine and I wonder why I'm worrying, then it all kicks off again. Am happy to go private, but who would I contact? Behavioural therapist? Play therapist?

Sorry it's long, and TIA.

This sounds exactly like my ds. He is also in yr1 and I could have written every word of your post.

I have been trying to figure out what is going on with him for the last two years and I do feel like we are making progress now. The 'label' that seems to fit ds exactly is Pathological Demand Avoidance. We have been referred to the community paediatrician (who agreed he showed features of PDA) and are due to go back at some vague and unspecified date in the future. It might be worth you reading up on that and see if any of it applies to your dd.

www.pdacontact.org.uk/frames/index.html
www.pdacontact.org.uk/frames/index.html

However, I have learnt over these last two years that a diagnosis is not going to help my ds and, because his difficulties are not that severe, there is little that the NHS can offer. There are far more challenged children around that rightly come first.

Luckily, there is lots and lots and lots you can do yourself to help your dd. Ds has been using behaviour balance supplement since last July and we've found that has had a hugely positive impact on his behaviour www.detoxpeople.eu/index.php?l=product_detail&p=2&gclid=COmI2caq5q4CFWwntAod1U4Zgg It doesn't work for everyone, but It's certainly worth a try.

You are doing the right thing with her diet and omega 3. Check your omega 3 is high in EPA as for a long time I was giving just DHA which is not really worth bothering with. There are quite a number of us who have been following the Brain Food Diet www.amazon.co.uk/That-My-Child-Brain-Food/dp/0753512955 which I would highly recommend. My ds was eating healthily but I upped his protein levels to fit with the Brain Food plan. It also includes specific exercises to do which have really helped our ds.

Have a read through the support thread here www.mumsnet.com/Talk/special_needs/1407629-Tinsley-House-Support-Thread?pg=1

I know that's an awful lot to take on board at this stage, I do hope I haven't overwhelmed you

Pop, many thanks for this. Interestingly I was actually lurking on the Tinsley House thread as some of the things people were saying rang true. She also has borderline convergence insufficiency according to the optician. I definately think I'll get the book. Yes, the omega is equizen, so high in EPA, but will also look into other supplements.

Pop, i've just looked at your pda links. They're very interesting and while there are particular attributes that ring true, the whole diagnostic criteria doesn't. She enjoys being with other children (and they seem to enjoy being with her) and doesn't seem to need to control them particularly. She also does have some sense of responsibility (particularly at school) and boundaries, again particularly at school and outside the family. Certainly no-one outside the home (including the school) would consider her "naughty." One thing I thought that really struck home was her emotions seem like an "act" - this describes it very well.

I said above that a diagnosis won't help my ds, but discovering PDA has been enormously helpful for me and dh (and the rest of our family) to see the motivation behind his behaviour. Now that we understand more what is going on in his head we have been able to deal with him so much more effectively and he is far happier as a result. We know PDA is the root of his problems, the only benefit of a professional diagnosis would be getting school to take his problems more seriously- it wouldn't help us at home.

However, there is nothing to lose by seeing your GP, outlining the problems and asking for a referral to the community paediatrician, but whatever issue may or may not be causing problems for your dd, I can only recommend that you read around as much as possible and explore lots of ideas- it will help you identify more clearly where the problems lie. Obviously, no one would attempt to diagnose over the internet but I can say that I have had infinitely more valuable advice from SN mumsnetters than I would get in a lifetime of appointments with health professionals.

Going back to the idea of PDA, sometimes girls present in a more subtle form than the boys (as in most things!). They are more skilled at 'social echolalia' and so can cover their difficulties more easily. Have a look at the notes from this presentation at the PDA conference 'Missed diagnosis or misdiagnosis? Women and girls with PDA' www.autism.org.uk/news-and-events/nas-conferences/previous-conferences/pda-london-2011.aspx Also, it's very common in PDA for children to behave better (sometimes even well) at school but 'make up for it' at home.

Thanks pop. I'm very reluctant to go to a GP, partly as her problems are relatively subtle, and partly as I don't really want her labelled as a "problem" at the moment. My GP isn't great at this sort of thing anyway. I keep swapping between thinking she's a normal but rather willful and highly strung little girl, and that she has a real problem. Will order the brain food diet book anyway - certainly wouldn't hurt. By the way, can I ask did your DS's issues come on relatively suddenly, or were there always signs there?

Looking back now there were the signs but back then it was more age appropriate iyswim. As he got older his behaviour broadly stayed the same but appeared to deteriorate when compared with how his peers matured.
I had toyed with the idea of there being 'something' behind the issues just before he started school but researching for myself on the spectrum I couldn't find anything that seemed to match exactly. What I learnt on here is that no one individual fits a diagnosis absolutely completely and exclusively, the 'spectrum' is exactly that- individuals will have their own unique pick'n'mix combination of particular features. By the time he was half way through reception I discovered PDA and that explained it all to me.

Thanks for your help. May well see you on the Tinsley House thread.