Extreme and worrying behaviour in 4 year old. ODD or something else?

[TimesTable]

My DS, just 4, is displaying some extremely worrying behaviour at the moment. By way of background, about a year ago, we had some concerns about his social skills, he had a (private) multidisciplinary assessment at the time which ruled out autism but diagnosed pre-dyspraxic tendencies including low muscle tone and hypertonia. Over the last year, his social skills have improved enormously - he has a good group of friends and plays nicely with them. So I'm certain he doesn't have autism. He understands that other people have feelings and see things differently - at least he does when we look at scenarios in his books together.

However, his behaviour towards me and DH is becoming unmanageable:

He hits and spits in our face
He pulls my hair
He says things like, "I'm going to kill you,' 'I'm going to push you down the stairs'
He delights in defying us at every opportunity, laughing in our faces.
Time outs have no effect on him, he just laughs his way through them.
He will through things around the room/at us.

These are not done as part of a tantrum - he is deliberately doing them to make us cross, which he says he loves.

Honestly it is destroying me and making me wonder what on earth to do. I am going to go to GP tomorrow to ask for a referral to a psychiatrist.

Has any one on here dealt with behaviour like this and advice on how to present it to the GP? I know they will just think it's poor parenting and tell me to go away and use a star chart but I really think he needs to see a psychiatrist.

Never experienced this myself. Does he have a sibling? I have found it useful compairing my ds with his older brother so when I get the " your quite so maybe he's just shy like you?" I can use the " his big brother never shuts up, his big brother was talking at 12 months" if you get the "maybe it's parenting" comment?

Unless your spitting at your ds and telling him your going to push him down the stairs, it's not your parenting. Blaming parents is a easy option but don't worry about that. If you get brushed off keep going back. Write everything down and hand that over. Insist on a referral. I hope you don't need to insist

I have no idea how you put this across to ask for help because I'm in the same boat. DS is the same age and does all the things you mention. We've had him assessed and have been told there's no problem because he masks his difficulties in public. I have come to the conclusion that these things are caused by a combination of anxiety (specifically demand avoidance), worries, build up of frustration and sensory issues. DS seems to struggle hugely with uncertainty/unstructured time so building in breaks is something I'm trying to work on now as well as putting together a visual timetable.

Is your DS like this all the time/in all situations? I think the first port of call is always the parenting/behaviour but I believe parental instinct counts for a lot. Hopefully your GP will see you are concerned and give you the referral you seek. Best of luck

Thanks 2boys - his sister is only 1.5 but already v different from how he was at that age, v sociable, affectionate.

The behaviour has been particularly bad in the last few weeks and when he's in one of his 'naughty/aggressive' moods, it's like I can't get through to him at all, like he's not even there

x-post NiceCupof Tea - thanks for your supportive post although sorry to hear you are going through this. I like the idea of a visual timetable - I went to a parenting seminar recently which recommended making some rules with visual cues, like taking a photograph of them doing something and sticking it on the set of rules.

The trouble is i'm so worn down by it at the moment I am lacking the creative spark/flair to implement this sort of thing. I need to focus on it though.

Re. whether he's like it all the time - no, not all the time. I have seen him play nicely with other children and have had no reports from nursery although I haven't specifically asked them. He can be lovely one to one sometimes (but of course one to one, there are no pressures on him and he generally gets his way). I haven't identified any particular triggers for the behaviour but I will start keeping a diary.

Take a look at PDA! Children with this condition often dint meet all the criteria for Asd although it does fall under the Asd umbrella!!

Beware of the ODD diagnosis as it basically allows Proffs to blame the parents !!

PDA is caused by anxiety and the behaviour challenges usually occur when the child feels out of control!

Keep coming on here and also check out the PDA facebook pages.

Good luck

Thanks Ineedmorepatience - like your user name! Yes, it definitely is linked to control in my DS's case. He very much likes to be in control of everything and order everyone around! I will check out more on PDA. I suspect it might also be linked to the dyspraxia in some sense as I read somewhere that children with dyspraxia struggle to regulate themselves - ever since he was born he's been (for want of a better word) grumpy, easily frustrated and upset.

Not sure if you have any support groups in your area for general sen / disabilities. I go to one set up by parents. It's not specific to any particular diagnosis but it's very interesting to hear that so many things overlap.

My ds has dyspraxia, I suspect that's not all he has. He can be explosive. He has stopped being as bad as he once was after a really bad afternoon. I don't confront him, he gets overloaded at school and we do things differently now. Took a while to see the connection, I get very minimal help so it was a lightbulb moment.

Keep a diary. If he can hold it together for other people maybe he's letting it out as your safe. My ds is model behaved at school - but takes things out on his brother.

Just a thought, you may have to go via your pead. Also I saw a phycologist via a monthly drop in session! I didn't know that service existed. It's not advertised. I only find out as she was at a portage stay and play and approached a early years worker and got her to ask me to phone up.

Do you see early years? Do you still have a nhs pead? Do you have a half decent sure start centre near you?

There is more help for under fives, but once they turn six or start year one it really isn't as good.

Thanks so much for your replies. I really appreciate your support. I will take a look at all the resources you suggest. We don't have an NHS paed as we had the multidisciplinary assessment privately.

Today he said he wanted to be a baddie so that he could hurt people and take their love away.

Should I say that to the GP? I have no idea where he gets these ideas from . I am just distraught this evening, just don't know how I can keep on parenting him

When you do go to the GP you dont need to take him, just take a list of your concerns and a diary if you manage to keep one. Make a note of his challenging behaviours/issues/difficulties, what causes them(if you know) and how you deal with them.

He is probably voiceing the the fears that he has. If he is feels bad inside he will say bad things!

You can be a good enough parent for him, he doesnt need you to be perfect, its ok to get it wrong and its also ok to parent him in the way he needs you too, that may not be the conventional way!

Read the Ross Greene book I am sure it will help you.

Good luck

I know where you're at with lack of creative flair/time with another child to think of. I've had the explosive child and a number of other relevant books for ages now and not had a chance to read them. By the time the DCs are in bed I only have enough energy to sit in front of the TV!

I've just been taking pictures of DS doing the things he needs to do (wipe face, get dressed, clean teeth etc) and I will at some point print them and make a chart of the things that we do every day for him to check what comes next. I hope this will ease the anxiety of 1) feeling like life is out of control and not knowing what's coming next and 2) the anxiety he seems to experience when someone is asking him to do something.

I'm in a similar position to you. DS is 4.3 and was assessed (nhs) last year. We were told he 'couldn't possibly' be on the asd spectrum because he only showed alarming/significant behaviours in our company and not in nursery (only occasionally in public if there has been no suitable outlet in private) - but I have done a LOT of reading about this and I know that's just not true. Many children on the spectrum 'mask' in public. personally I think my instincts are correct and yours probably are too but in the meantime I'd kind of like to reassure you that the agression and "I want to kill you" type comments are not just coming from your 4-year-old. I think the concept of life/death is very prominent at this age and our DC are just exploring that. I'm pretty sure when they say "I'm going to kill you" what they actually mean is "I'm really angry" or "I'm struggling right now" - I believe many of DS's more unsavoury behaviours are caused by anxiety and I'm sure yours are too.

It may be worth looking into PDA although I'm not sure whether these behaviours would be present whenever a demand is placed on a person? There must be someone on here who can tell you. DS only seems to display demand avoidance and many other of the more challenging asd behaviours when under stress so my gut feeling is that it's an ASD with demand avoidance rather than actual PDA.

I don't know if you have support groups nearby but I feel that would be a good place to gather information and meet others in a similar position. All I can find near me is groups for those with a diagnosis and having had an assessment and been told it's just our imagination/parenting I'd feel a bit of a fraud

Just wanted to revisit this thread to say thank you SO much for the support you gave me last weekend! I looked up the Ross Greene book on Amazon and bought it but in doing so came across two other books - 'Transforming the Difficult Child' by Howard Glasser and 'Attachment Play' by Aletha Solter.

I have implemented the first stages of transforming the difficult child (basically an extremely intense and positive focus on anything and everything he does right), together with doing a lot more attachment play with DS and we are already seeing v good results! I honestly can't believe how successful it is already being. Reading those books, the penny really dropped that he feeds off the negative energy of the power struggles we were having and no punishment was ever going to be big enough for him as he would keep on pushing to see what would really make a 'big bang'

Tbh, I feel almost evangelical about it, I really feel we've been given new hope as a family, and DS has been given new hope of how to channel his intensity in positive ways. It's early stages so far but the difference in a week is incredible.

Yay!! So happy for you

Glad something is working. Those books sound interesting I might have a look too

Yay - always good when something works!

Yiur sounding so much op more positive too which is fab.