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3 year old with aggressive rages: To evaluate or not?

post #1 of 4
Thread Starter 
This post is primarily directed toward parents of children who are intensely spirited who have considered or gone down the path of an evaluation. (Please note, we are not a family who will use any physical means of consequences/punishment. To date, we have not tried any token reinforcement systems such as a star chart, sticker chart, etc. though if need be, we are not opposed to it.)

I am trying to determine if I should take my three year old child in for an evaluation. This level of aggressive behavior has been present for about two months.

My son can go from zero to sixty over situations such as requests to wash his hands, use the bathroom, etc. Basically, non-preferred requests. His rages involve a great degree of physical aggression (directed mostly toward me or my husband) and, while the actions are not hard - that is, they do not really hurt - they are very directed. When he rages it looks like the following: Pre-warning of request is made: "In 5 minutes, it will be time to use the bathroom". Time reminders are delivered in a non-emotional voice at three and one minute's time. When the five minutes are up he is given the choice to walk by himself or with me/my husband. (Even if we have tried to assist the transition by helping him find "safe" places for his current project, talking about the next fun activity that will follow the non-preferred task the following scenario will still occur.) This is when he screams and comes at me/my husband - hitting, kicking and spitting. He is permitted to take a break should he not desire to engage in the request but once aggressions have occurred he is instructed to take a time-out in his room. He will usually go to his room (a positive) but will continue to rage (screaming, kicking furniture) for 15 minutes to an hour. No amount of talking helps at this point. He has demonstrated he needs the space to "rage" until he is done. At which point, me/my husband goes in a checks in with him. We talk about what happened, what a safer choice would have been and practice calming techniques. We always model the following language, "When you hurt someone, you can say 'I'm sorry.' or 'Are you okay?' He usually chooses one of the phrases but apologies are never required.

On a good day, he usually has two episodes and on a bad, closer to six. I taught in early intervention rooms prior to obtaining my teaching license and taught a primary (K-2) behavior classroom for years before having my own children. I have read many a book and think my approach is solid and grounded. (Not that I am perfect but I feel like the manner in which I am addressing his needs is not the heart of the issue.) I provide clear boundaries, an appropriate level of choice, positive redirection, lots of cuddle time, etc.

We have had no big changes that have triggered this behavior. HOWEVER he did stop napping consistently around the time of the increased rages but I have tried everything possible to make naps happen and it is not working or worth it. Any quiet time or nap time is now met with more raging - lasting one hour typically. He has very developed linguistic skills. His diet contains a very limited amount of sugar. For example, he is allowed three vegan fig newtons per day if he remembers to ask. We get outside a lot and spend the majority of the day outside if possible. He has always been an intensely spirited child who has gone through three other phases of aggression. This one is more intense (perhaps because he is three?) in the degree of aggressions - approximately 20-25 on a bad day - and the duration that the episodes last. When he did attend daycare for a short while he did display similar intense behaviors yet not the level of aggression as that was not at the time he was in an aggressive phase.

Although this has been a very long post, I know as a specialist I would still have many clarifying questions. Here is my question: What would you do? Would you seek an Early Intervention evaluation? Would you look at diet? Would you just wait it out and appreciate that this could just be an intense child learning where the boundaries lie? Please advise.
post #2 of 4
Based on what you wrote, I'd call my pediatrician and ask for advice.

Good luck.
post #3 of 4
The thing that stands out to me is that you give him 3 warnings and then you go do something. For a 3 year old, this is just way too much, IMO. The concept of 5 min, 3 min, 1 min... It's like threatening and then not doing it. So it seems to him like you keep saying you will do something and then you don't, so he thinks he won't have to do it, then he gets upset when he finally does have to.

So, my suggestion is to give one warning and then count down until you go or set a timer and then do the thing when it "dings" or just one warning anyway, and I think you will have less rages. I know that with my kids, being mindful of just telling them things once and then getting to them right away really helps (not necessarily instantly - I try to be understanding of interrupting their play/train of thought... but I often will wait until I see a break in what they are doing to interrupt, so then I don't give "notice").

HTH

Tjej

ETA: For the timeout in his room - have you tried other things? A sit-in where you physically restrain him so he doesn't hit you but you hold him gently? I don't know if that describes it properly, but my kids will sometimes be upset and really just want/need snuggles to calm down. If I don't snuggle then they can pitch a nasty long fit.

As far as doing evaluations or not, I'd personally try my "less warnings" tactic first, and if that doesn't help then I'd do a food journal, then I'd seek consultation with a professional.
post #4 of 4
If you think he needs the transition warnings, and in line with what the pp said, try a visual timer - set for five minutes (or whatever they go up to 60)and it will show red - the red slowly disappears as the time goes down...just say I'm setting the timer for five minutes then you need to ______

Ask yourself what you think the purpose/function of the rages might be? If he gets a time-out and he really hates those tasks then his rages might be designed to delay or escape the task? In which case the time out is getting him exactly that? In general, other possible functions of behaviors are attention (could it be that?) sensory - which is possible and would be soemthing an OT could evaluate? or a tangible (doesn't see likely here)

It seems to me that his behaviors are a bit extreme for what you are asking, go to bathroom, wash hands? (and I have my own very spritied, strong willed and controlling dd, now 6.5) An evaluation can't hurt. But if he is three he is technically too old for early intervention (the free evals for birth to three - not available after third birthday) But that's not to say you can't still get an eval through your ped's referral....

Given all that you have said and you seem so knowledgeable and seem to have some really strong parenting skills I'm even more inclined to get the eval.
good luck
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