How do you deal with aggressive/destructive outbursts?

[crunchy_mommy]

DS is 3.5 years. Sometimes I think there is nothing "wrong" with him, he's just a little... unique. Other times I feel like another child invaded my kid's body. The therapist suspects Aspergers + sensory issues and maybe a mood disorder... and I guess I agree, deep down inside, but I go through stages of denial or something. He can seem so mature and so connected and so... normal. But there are lots of little issues and a few big ones. We may be having him formally evaluated soon.

He has these outbursts. They are not tantrums -- and he's not necessarily angry. They come out of nowhere & he just seems completely out of control. They've been happening as long as I can remember but the past few weeks the frequency & intensity has substantially increased. He does things like knock down all the furniture, rip trim from the wall, hit, bite, put himself in danger (climb up a 7' high wall, tried to swallow a whole bottle of homeopathic pills, run into the street, jump into a pond)... When he is calm & "normal" he is not like that at all, he is generally very cautious, gentle, can follow rules (with help)... It's like a switch flips inside him and he just goes nuts all of a sudden. Sometimes he is laughing, but not in a happy way, and, sometimes he is screaming or crying, often it is a mix of what looks to be 'false' emotion, like it doesn't match up with what he's saying or doing or really feeling.

I am so torn up about this. I really don't know what to do when he is like that. I can't prevent it and I can't pinpoint a trigger (nothing environmental, nothing he's eating, not a response to anything obvious). I've tried all different ways of responding... rewards, consequences, reasoning, over-reacting, under-reacting, providing extra sensory input, removing as much sensory input as possible... nothing works. I can distract him a tiny bit but it just makes the whole thing last longer. I've resorted to just holding him until his body calms down (and it usually does, in 20-30mins) but he does not enjoy this and he bites, spits, etc. as I'm holding him. If I let him go he will hurt someone or himself or destroy the house. I can't believe I have to figure out how to safely & gently restrain my own son.

Afterwards he is totally back to himself again, just as abruptly as it started. He is very verbal but not so great about describing what is going on with himself physically/mentally/etc. What I've gathered from his is that he does not like these outbursts... he feels they are funny at first but then they aren't but he can't stop it. I think he feels out-of-control and scared. I just want to help him (and hopefully keep myself and my house intact in the process!)

Has anyone dealt with anything like this? I need support. I need someone to understand. I need ideas... both for preventing the outbursts and for dealing with them when they do happen. I am so, so exhausted.

[crunchy_mommy]

No one? Am I the only one dealing with something like this?

[NiteNicole]

My niece is like this.  She just has...outbursts.  She can't control herself.  She's not necessarily angry or upset, in fact sometimes she starts off happy and just goes bananas.  Sometimes she's laughing while banging her head against the walls, sometimes she's tearing down the curtains.  NOTHING puts an end to it, she just has to wear herself out.  At the same time, she's sweet.  She's not mean at all.  She just amps up and can't calm herself.

Her doctor mentioned a few things, and one of them was IED (Intermittent Explosive Disorder).  Her parents are trying a few meds, one at a time, because she also has other issues.  So far, things are going really well. She is her same sweet self and she's not "muted" in any way, she can just calm herself when she gets excited or upset without having to burn herself out being destructive and explosive.

Obviously, I'm not her parent and I'm not involved in everything that goes on, but I didn't want to leave you hanging.
 

[pattimomma]

Probably most people on this board have dealt with the melt downs. With my son I remind myself that he is having a hard time, he is not giving me a hard time. I also try not to have an emotional reaction. More later, my 1yr old is having a melt down!
 

[crunchy_mommy]

TY for the responses.

NiteNicole, DS does sound a lot like your niece. It is some comfort to know I am not the only one dealing with this, none of my friends understand and I've yet to come across anyone IRL who's dealt with it.

Pattimomma, I guess I am looking for more... how can I keep DS safe, keep myself safe, and keep my home somewhat intact? I can keep myself calm(ish) but I can't physically deal with constantly being hit, bitten, trying to keep furniture from flipping over, etc.

[pattimomma]

Sorry for cutting it short earlier, my baby did not want me to be on the computer. It's my 12yr old son who is on the spectrum, ADHD and has an adjustment disorder (mood disorder). His bedroom has a bed, a dresser, and a desk. That's it because we get him to go in there if he has a full on melt down. We had to reduce it to a laundry basket and a bed when he was younger and more likely to try to push the dresser around.

Can you wet some wash cloths, fold them up and freeze them? He can work on unfolding the frozen wash cloth when he feels destructive. What about a punching bag? Cardboard boxes he can tear up? Are there things he could bite? An OT usually has some types of 'chewies'. Of course the question is how to redirect him to the appropriate outlet. We discussed the options with our DS when he was in a good mood and then tried to remind him of them when he would lose it (doesn't always work). I found just trying to get him to stop won't work. He needs to get it out physically.

Baby wants me again so more later.
 

[mamarhu]

My heart goes out to you, Crunchy. I have BTDT, and it ain't fun.

2 or 3 suggestions; you may have already considered, but here goes anyway...

Can you get training in how to safely restrain a child? Your needs will change as he grows, and it is important to be able to keep him (and you) safe, whether at home or in the community. There are safer ways to do it; employees at children's mental health facilities are carefully trained. This training is not easy to find or access for the general public, but might be a good idea. If you are interested, I can suggest how to find such training in your area.

I would rush the formal evaluation if I were you. I don't generally put too much stock in diagnoses for young kids - they change all the time, with developmental stages, different practitioners, the kid's mood on evaluation day. But a diagnosis may open the door to services and supports that you wouldn't otherwise be able to access. I don't know what kind of insurance you have, or what services are available in your area. But a diagnosis is often a required step one. Occupational therapists can generally start without a specific diagnosis (just a referral from your pediatrician), and can address specific problems before there is an official "reason". Sensory issues are the foundation of some pretty extreme behaviors in some kids, and are sometimes surprisingly easy to address.

Last is a sort of philosophical point. All behavior is communication. Your son is trying to tell you something in his most extreme moments. It may well be that he spirals out of control, but it starts with a need to communicate. I don't pretend to have a clue what your child is trying to say in his rages (or whatever - that doesn't sound like quite the right word). But with time, maturity, and help, he can learn to communicate in better (safer and more effective) ways.

All kids do well when they can. With help from you, and possibly professionals, he will learn the skills. Hang in there; it really does get better.

[kathymuggle]

One of my nephews is like this. He is classically autistic.   It is like a switch flips and something goes off. He is very aggressive and he bites, head bangs, tried to eat glass once….Once the outburst is over he is done, and back to his happy self.

We do know there is a reason for his outbursts, even if we are unable to decipher it. 

In my nephews case the most common cause is:

a) physical.  He may have problems with his bowels - his poops are smears (he is 10) and he smears many times a day.   There is some speculation this might cause intermittent gas - thus the explosiveness.  He is on fibre to try and bulk things up, and it has worked (somewhat) and cut down on the outbursts - somewhat.

b)  Not being able to get what he wants the moment he sees it.  In some ways this is very tricky as you cannot always predict what he will want, therefore you cannot always avoid the situation.  A lot of the time, you cannot figure out until after the fit what set him off.  It is like detective work.

Nephew is on Risperdol.  It helps somewhat.  My sister does not restrain him in a fit if she can avoid it at all- if he is home, she leads him to his bed, and he has his fit there.  When he sees his bed he will literally throw himself on it and rage there.  It works for him that he has a safe place to rage.

I would argue for getting a diagnosis sooner rather than later as well.  What has happened over time is that my sister is decreasingly able to find sitters of any sort (an aggressive 10 year old is not something most people can handle).  You cannot bring him to most places due to his issues.  He now goes to respite one weekend or so a month.  This would not be possible without a diagnosis, and my sister has needed respite so she can have a decent quality of life and refill her well, so to speak, and be a better parent.

Good luck, mama.   

[noahblakemommy2]

My oldest son is the same way. Has been since he was about your sons age. My son is now 11. He has since been diagnosed with ADHD, bipolar, and autism. He has spent nine months in a residential treatment facility. Prior to that, multiple acute stays at mental facilities, one week at a time. He has had two pending charges, one for busting the lip of his old principal, and one for kicking a girl in the face and her parents filed charges.

He has been extremely violent since preschool. He terrorized his class by running around, pushing the class in the corner, and tipping desks. Same thing happened in kindergarten. It progressed there though with being violent towards other kids by getting physical with them. That's when I first had to take him to a facility. It broke my heart. I cried when I had to leave him. A couple more stays that year and then first grade came....nothing changed, it got worse. That's when we did the testing for autism and he was also given the classification emotional disability. Therefore, he was put into a self-contained classroom. Three teachers, four other students besides him, structured schedule, and an isolation room if needed. In the end while he was in third grade, he got worse and in that classroom is where he got his first charge.

The whole time, he's been getting therapy, wrap-around services, case management, the works. I ended up having him move in with his dad after he came home from residential and the school year was over. I was told if I didn't change something, I would have a son diagnosed with schizophrenia soon. Now his dad has him, has taken him off his meds except one, and only goes to therapy once a month where he is afraid to tell her anything cuz she tells his dad and stepmom and he gets in trouble. I'm trying to get him back but that may take a while. His dad promised to keep all services in place when he got him. That's why everything was packaged and transfered. But he lied.

I know what you are going through. It is not easy. I put my life on hold for many years. Had to move in with my parents and leave my job. I'm just now getting to where I'm ready to job hunt again. I wish u luck hun.

[Eyelet]

My son is very similar to this and we deal with his aggression in a similar fashion. My son is 15 with classic autism/nonverbal. My son can be very aggressive and being that he's 5 8' and 190 pounds, we can't pussyfoot around with solutions.. What helps curb is agression is medications (risperidone, kolonipin), many sensory breaks, and a PECS schedule. We also learned how to safely restrain him with CPI training (http://www.crisisprevention.com/). My son attends a special needs school that hosted a CPI workshop for parents, which is where we learned it. Maybe check the website about training? I also know youtube has many videos on training, as well. 

I also agree about getting a full evaluation and diagnosis. With an official diagnosis he will have legal rights to services and help streamline his therapies/treatments. 

Originally Posted by kathymuggle 

One of my nephews is like this. He is classically autistic.   It is like a switch flips and something goes off. He is very aggressive and he bites, head bangs, tried to eat glass once….Once the outburst is over he is done, and back to his happy self.

We do know there is a reason for his outbursts, even if we are unable to decipher it. 

In my nephews case the most common cause is:

a) physical.  He may have problems with his bowels - his poops are smears (he is 10) and he smears many times a day.   There is some speculation this might cause intermittent gas - thus the explosiveness.  He is on fibre to try and bulk things up, and it has worked (somewhat) and cut down on the outbursts - somewhat.

b)  Not being able to get what he wants the moment he sees it.  In some ways this is very tricky as you cannot always predict what he will want, therefore you cannot always avoid the situation.  A lot of the time, you cannot figure out until after the fit what set him off.  It is like detective work.

Nephew is on Risperdol.  It helps somewhat.  My sister does not restrain him in a fit if she can avoid it at all- if he is home, she leads him to his bed, and he has his fit there.  When he sees his bed he will literally throw himself on it and rage there.  It works for him that he has a safe place to rage.

I would argue for getting a diagnosis sooner rather than later as well.  What has happened over time is that my sister is decreasingly able to find sitters of any sort (an aggressive 10 year old is not something most people can handle).  You cannot bring him to most places due to his issues.  He now goes to respite one weekend or so a month.  This would not be possible without a diagnosis, and my sister has needed respite so she can have a decent quality of life and refill her well, so to speak, and be a better parent.

Good luck, mama.   

Edited by Eyelet - 10/4/12 at 9:48am

[kohlby]

3 years old was a VERY rough year for my oldest child.  I am certain he would have been diagnosed with SPD but my old ped was clueless so we toughed through it.  We got through it - but it wasn't pretty.  What helped the most was finding safe ways for him to get his mad out.  He had to get his emotions out.  He really wanted to be good, but he was impusive and couldn't control his behaviors.  We came up with safe things to do - like he was allowed to punch the couch cushions and throw the pillows.  I actually gave positive reinforcement when he was destroying the right things!  He wanted to be good, so just knowing there were safe ways to be destructive helped him.  I let him know it was okay to have those feelings.  His feelings of anger were valid - but how he was dealing with it was the issue.  With him, we used his bedroom as a safe place when he was totally out of control.  At 3, he would have at least 3 tantrums a day that lasted over an hour long each.  He got through it- 4 still had tantrums, but they were down to 30 minutes max and he learned safer ways to get his mad out.  He continued to improve from there on out.  So, I just wanted to give you a little hope that it's not always a long term problem.  But I also wanted to say to get your child help.  My oldest was a struggle since birth, but 3 was the peak.  Even with a positive case of it improving, I wish I had known to get him help.  He's now 9 and still has some sensory quirks but has learned to handle them.  But he is not violent at all.  He knows how to keep his aggression in check.   

[kamsmama]

It could be related to diet. Quickest way to see the myriad of things it could be caused by is to look up the failsafe diet--for my son it seems to be oxalates. :(

[deminc]

Hi crunchy mummy,

The part where you said it was as though someone else invaded your son's body - I could really relate to that. The difference between our sons was I could track the start of his outbursts quite clearly - school related - but it also kind of mark the start of a prolonged period when he would get excited and spiral out of control. My MIL wanted to pray over him, my mum gave me a talisman from the priest, so you can imagine. The psychologist said his outbursts stemmed from extreme anxiety and suggested separation anxiety (which didn't make sense to me), and also had him evaluated for SPD.

He is eight now and doing well. I have learned that his anxieties/violent episodes stemmed from vision/school related issues, and he struggled with the scale of his emotions. During that period he would hit and self harm. He also has sensory issues and needs heavy work to calm him down. Just physical activities like running, jumping will not cut it and makes him all hyped up and extremely reckless. He needs to climb - and yes, he often tries to climb the walls at home. Apparently it is calming, but we don't approve. Instead DH has agreed to take him rock climbing. Swimming laps and music therapy have also been beneficial to self regulation. He is also asking for a punching bag, but for now, he has taken to punching at the wall through a thin mattress when he feels the need to...well, just hit something.

Four, five, six were hard, and we did a lot of activities that were in line with what the OT recommended. His mood swings were wild and erratic, and I worried about bipolar and other scary conditions. We discussed emotions, and I placed a lot of emphasis on anger management, developing empathy, basically using his cognitive strengths to help him check and restrain his emotions and behavior. This year has been a good year, he seemed to suddenly mature a lot and was able to hold it together a lot more and maintain an even keel. I do still apply the brakes when I see him starting to spiral out of control, but it has been way less than before. I observe that he is also becoming more attuned to his physical needs,or at least he starts anticipating his needs, and that helps him self regulate. Previously, he may not realize when he is hungry or tired or cold etc until it really hit him and he overreacts.

I know many mothers here have much more challenging situations than mine, and frankly, I would have been really scared if I have read this thread some years ago. As it was, i was freaked out enough to get professional help, and in my case, the psychologist was not keen to label at such a young age, but instead took an emotional and SPD angle. She was also experienced with gifted kids and their early emotional issues.

I hope you find something helpful soon.