4 year old and violent outbursts

[MilesJonesy]

I originally posted about two months ago with concerns about my little boy. It was in the parenting thread and I got quite a bit of flack from some parents in there so I thought I'd post here instead.

My little boy is now 4 years 2 months. His behaviour is still extremely up and down, but there have been some significant developments:

1. Educational Psychologist involvement

The EP met with nursery and my husband last week. She said we’re doing all the right things at home (which was reassuring but not hugely helpful in terms of “what next”). She’s planning to observe him in nursery over the coming week. A follow-up meeting isn’t until three months from now, which feels like a lifetime.

1. Nursery changes

Nursery have reduced his hours to half days (9–12) on the EP’s recommendation, and my husband has reduced his work hours so he can pick him up every day. This seems to help him cope better overall — he had a good run of 7–8 settled days at nursery last week.

1. Speech & Language

He’s working with a private SALT on speech sounds and social communication. He definitely has a language delay, and this seems to make regulation harder. His receptive language is miles better than a few months ago, but expressing emotions and negotiating with peers is still shaky.

1. The incident yesterday at home

Yesterday was one of the worst days we’ve had:

– He smashed his brother’s Lego creation (an impulsive moment)
– Completely flipped into rage when I reacted
– Threw objects around the room
– Picked up a long hard stick/cane and hit me with it very hard
– Emptied planters, broke the cat flap, tried to throw lamps
– Had to be taken into the garden to calm down because it wasn’t safe

Then half an hour later he was calm, apologetic, and wanting hugs. He genuinely seems not to remember the hitting once he’s regulated again. The rest of the day his behaviour was good.

1. Consequences are landing a bit more

Yesterday I cancelled a birthday party he was supposed to attend and told him Daddy would do bedtime (my turn normally). These upset him more than anything else, so maybe that’s progress? But it still doesn’t stop the initial explosion.

1. He can be absolutely fine

This is what confuses me. In between these episodes, he can be lovely — affectionate, regulated, plays beautifully with his brother, follows rules, listens to stories, even took part in his football class today (with his dad shadowing him). It makes the extremes harder to understand.

1. CAMHS & ND referrals

He’s on the waiting list for CAMHS and the neurodevelopmental pathway but it’s 2+ years where we are (Scotland). We can’t sit in limbo for two years like this. Private neuro options are thousands of pounds, which we don't have.

Has anyone else had a 4-year-old with this mix of impulsive destruction, aggression, and then total normality in between?
Especially alongside a language delay?

How did you keep everyone safe at home?
What did nursery/school put in place?
Did things improve by age 5–6?

Any experiences or practical advice still very, very welcome.

He has an older brother, 6.5, who had had typical development and no issues at school or home.

You say he is language delayed and on a reduced timetable (presumably to reduce stressful time at nursery), what does he do that is not communication heavy that he enjoys?

For support with education, have you looked at Enquire?

Keeping a detailed diary to spot triggers will help. It will also help you to note down how you respond so you can see what doesn’t work. It is easier to prevent escalation than deescalate once DC have reached the point of no return.

Has DS had a home OT assessment? It can look at how to make the house safer and better meet DS’s needs.

Throwing can be a way of meeting sensory needs. Has DS had a sensory OT assessment? Do you have any sensory toys/equipment?

Do DS and his DB have separate bedrooms? If so, things like Lego creations go be moved to DB’s bedroom. Move things such as canes that can be used as weapons and things that can be thrown. It isn’t easy, but DS needs closer supervision to step in sooner. It really isn’t easy, but some DC need someone within arm’s reach all the time.

Unless the birthday party was yesterday and DS was too dysregulated to attend, I don’t think cancelling it is the right way to go. For most with SEN, the delay would be too long. And typical punishments don’t work for lots of DC with SEN. So, for many, punishing dysregulated behaviour in that way doesn’t work. Same for things like time out.

Has the SALT been into nursery?

Does DS communicate in other ways, e.g. PECs/AAC?

Some people find the books The Explosive Child and the Out of Sync Child helpful. Others find PDA strategies on non-violent resistance resources useful.

Home Start may be able to support you.

So while his language is delayed, he can play imaginary games with his brother and take turns doing his. He loves lego and hot wheels. Going to the park. Going for wee walks (he calls them adventures). His language problems are more around talking about things in the past, consequences, his speech is hesitant and sometimes difficult to understand.

I'm not sure how to arrange an OT assessment? Would these be available through the NHS?

In my experience (2 children with very different communication difficulties) people tend to address difficulties by making communication central to every activity. Really what I think helps is (a lot) of things that don’t need communication so heavily but still use a persons brain. Most people find it VERY challenging to dumb down the language but retain the level of intelligence needed for the task. AS a results of this deficit in those around them, many language or communication limited people are expected to spend large amounts of their day doing things that are well below their intellectual level. My position has always been that being intolerably bored is likely to lead to poor concentration, attention, achievement and behaviour. So I would suggest rather than looking for ways to control his poor behaviour you look for ways to engage him more productively.

OT can be accessed via the NHS. Although not all areas commission sensory OT on the NHS and even when they so, it is often limited.

As a basic starting pointing, you could look at the Occuplaytional therapist’s resources, some of the ideas in this booklet and on this website.

What has been said about a possible diagnosis? Like have they suggested they suspect a diagnosis of something?

wht do you think?

my advice would be pay for private.

nhs are overrun. Nursery staff have zero training. Good one for reducing hours!!

I have ND girls, not boys but I do know about ND boys from working in SEND schools.

consequences do not work for ND meltdowns, at this age he will not understand and you cannot punish what they cannot help. It is much more beneficial for you to speak to him gently about your feelings ‘you hurt mummy and that made me sad’. Afterwards when he is calm and you can cuddle him.

dont rely on everything being ok when he gets to school and school being the magic wand.

you need to work out his triggers for meltdowns. If he is better for less hours at playschool then overstimulation could be one. Is he sensory?

you said about bedtime routine you not putting him to bed as a punishment. That is his routine and stability and would very much put him out - as I say consequences do not work for ND. It is a whole different ball game. Any specific questions just ask

Thank you — this is really helpful to read and I really appreciate you taking the time to reply. ❤️

Just to answer a few points:

• No, the EP hasn’t suggested any diagnosis at all yet.
She was very neutral and said they need to observe him over time before even commenting. So at the moment we genuinely don’t know whether this is sensory, emotional regulation, language-related, ND, or a mix of things.

• I completely agree that consequences don’t work the way they would for a neurotypical child.
We’ve actually moved away from anything harsh. What does help him is a very neutral tone, short sentences, and giving him space to calm down. Once he’s regulated again he’s very affectionate and remorseful and that’s when we can talk things through gently.

• He does have speech/language delay (he’s under a private SLT) and the EP did mention overstimulation and communication load as possible factors. So that absolutely fits with what you’re saying.

• Regarding bedtime — that’s noted.
I only swapped parents that evening because he’d actually hurt me physically and I genuinely needed the break for safety and calm. But normally bedtime is very consistent and predictable for him.

We are looking seriously into private assessments because the NHS wait here is over two years and his behaviour is affecting nursery, home, and siblings.

I don't really know if he's sensory. He's fine with textures, sounds, light, food etc. He likes rubbing my hair on his face to self soothe though, and when he's becoming overstimulated he likes to throw or scatter small things. Also he can spend an hour jumping around our living room to music.

Thank you again — it’s reassuring to hear from someone with ND experience. If you’ve got any suggestions for managing sensory overload or supporting emotional regulation in the moment, I’d be really grateful.

I got home from work today and my MIL had had the boys. Basically every single thing in my eldest boy's room had been thrown down the stairs and a lot of it was broken. Youngest had attacked her too. I don't even know what to do.

DC2 really needs closer supervision. It isn’t easy, but it is necessary.

Depending on DS’s level of understanding, is the nursery supporting Zones of Regulation work? That will help at nursery and at home.

The EP can’t diagnose, but they should be making recommendations.

SALT and OT can also help with emotional regulation.