angry 4yr old
I'm so sorry, PeacefulSeams. This is so hard. I'm glad you're pursuing psychiatric help because this sounds serious. Can you get to a major university or other excellent psych department? We've had our son evaluated by local doctors and see a huge difference between them in the accuracy and value of information we've received from the really good experts at larger clinics and a teaching hospital in our state.
Our 3-year-old is not able to verbalize things like yours because he also has some cognitive challenges and delays, but he is angry, explosive and violent. Our situation is a little different because we adopted him through foster care and know some history that damaged his brain and probably caused this (Fetal Alcohol Syndrome, trauma to his body as a fetus, communication delays that make it hard to express himself, and a parent with intermittent explosive disorder/bipolar/other serious psychiatric issues).
Our son sounds like yours in that he gets ticked off at the slightest thing (like if we don't refill his sippy cup fast enough or he can't have an object) and starts biting like a pit bull, hitting and kicking. He bangs his own head and throws his body to the ground. Yesterday he was pissed because I dared to leave the room he was in and he threw his bottle at my face, causing me a swollen, bloody, split lip.
It sounds like you're going to have to make some choices that might not be what you dreamed of when you had a child. I know that's the case for me anyway. I am very conservative about using medications, yet my son is on three behavior medications — one of which is at quite a high dose and he's only 3. I hate that it has to be this way, but it does for everyone's sake or things would be even worse. I don't know what's in store for you and your son, but I am rooting for you and hoping for the best possible outcome and wisdom to make the hard choices.
Regarding discipline, I wish I knew what to say. I use gentle loving guidance with my older children, yet it depends on the child understanding what you're saying and wanting to please as most children do. Early On offered to send a school social worker to my house twice to give me some tips based on Love and Logic. I took them up on the offer and there were some helpful things, but some things don't apply when you're dealing with a child for whom the logic part doesn't seem to work. Consistency is the one thing that has helped. I've had to really simplify it for my son. "You hit, you sit," for example.
Will you let me know how things turn out?
I took my son to his pediatrician and he referred me to the mental health center. We met with a counselor and she is sending my DS to be evaluated at the Neuropsych hospital. She is thinking Autism, TBI or maybe even some schizophrenia. I have to call them on Monday.
But after doing research on all of those, he has more classic behaviors of Autism. I have noticed that he is very ritualistic. As soon as he wakes up, he needs to get dressed, eat oatmeal or rice krispies and watch Wild Krattz. At bedtime, he has to hear the same 3 bedtime stories in the same order and wear the same PJ's. He lines things up. When he uses the restroom, he needs to take off his clothes and line them up in order: shoes, pants, underwear, shirt, socks...and then he will go to the BR. If anything varies in his routine, that is a trigger. I have also noticed that he is very sensitive to loud noises. They make him angry.
I just hope we figure this out so I can get him the help he needs :)
I'm so glad you're closer to getting some answers. I mentioned my 3-year-old before, but I also have a 4-year-old and he is classically autistic. The behaviors you describe sure do sound like autistic traits. I would encourage you to keep learning about autism while you wait to find out. Our 4-year-old is very rigid in what he wants. When he wants something, he wants it now. It does sound like what you describe. It couldn't hurt to learn more about it, even if you find out it's something else later. I hope it works out well.
As a mom of three with autism who has read voraciously on the subject since their diagnosis 4 years ago I have to say that as far as I know, being autistic, in itself, would not account for the level of violence and obsession with hurting and death that your son is exhibiting. Autism is frequently co-morbid with other disorders and the one that comes to mind most from reading your post is bipolar. Autistic kids can be violent, but it usually stems from extreme frustration intolerance and anxiety-based rigidity. I think you are looking at a complex diagnosis and the best place to get that is a neuropsychiatric hospital. That was a good call by the doctor. It might be a good idea to admit him while they do the whole work-up and start medications. Medications, while life-saving and liberating for kids with problems such as this, can also trigger negative behaviors. You want him in a safe place while you do this in case a med makes him more violent or disinhibited. One of my sons (who has Aspergers, ADHD, and Bipolar NOS) needed hospitalization twice for behavior and medication management and it was a good experience for us, as stressful as it felt at the time. So if that is something that is recommended, please don't fear it. In fact, in your case I would ask about it for his safety and yours. I can tell in your post there is some fear there, and its best to be honest about that with those who evaluate him. I am glad you are getting help! Please update when you can!
I feel like I could have posted this myself. My son is also 4 and behaves nearly the same way. Not quite as violent/morbid but almost. We are at the very beginning of our journey. *hugs* to you mama. I just want you to know you are not alone. Reading this brought tears to my eyes just realizing that someone else out there knows what its like to be me. Its bittersweet. God Bless.
I am still waiting to get into the doctor. It took forever for the referral to be processed. I am just hoping the appointment doesn't take as long. In the meantime, his therapist told me to wrap a blanket around him when he starts to hurt himself or others. I tried that and it just made him angrier...although he wasn't able to harm anyone.
I just wanted to offer my opinion on the previous suggestion that it sounds like bipolar disorder. To me, it does not sound like it fits the criteria for bipolar disorder. My son was diagnosed with bipolar disorder at age 7 after being symptomatic since age 3. He is currently almost 13 so I have been dealing with this for awhile. The fits of rage do sound similar to what we dealt with but your updated description that he will go and sit until he is calm is definitely not indicative of a bipolar rage. During a bipolar rage the child truly cannot control themselves. I still vividly remember those rages (which thankfully we haven't seen in a long time as my son is stable on meds for quite some time now) and it doesn't sound like what you are dealing with. Also the main part of bipolar is exactly how it sounds in the name of the disorder - bipolar mood swings. You didn't mention any bouts of severe depression, which is necessary for a diagnosis of bipolar disorder. It seems lately that any time a person hears of a child with violent anger they assume bipolar but that really is just one facet of the condition. I hope that you are able to get your son help soon, I know how hard it is not knowing how to help your child.
After being ok for a little while now and having almost no episodes, he had one this evening. He was stomping and screaming and throwing things. Not as bad as before but not calm either like he has been lately. There is nothing new so I don't know what caused it.
The dr is referring him for an eval so I hope it happens soon.
My heart goes out to you.
I agree with earthmama4 that it doesn't sound like autism in terms of the violence, etc. Now my HFA son did "rage" and was often physically aggressive to others, but he was not into violence (couldn't handle scary movies - even Disney stuff, for example). The relationship between autism and violence in his case was that there is a lot of frustration that come with autism (dealing with other people, sensory issues, lack of social understanding) and it tends to create "rages" or "meltdowns" which are just intense releases of emotion. But they don't tend to be focused (like he would just hit whoever happened to be there, whether they had anything to do with the situation or not) and there was no malice or ill intent behind it. (now, mind you, my DD would use some very vengeful language when she misunderstood another child's intentions, she would get a "hate on" for certain kids; but she would never act on it and she grew out of it fairly quickly when she realized that she was not understanding what was going on).
I second the recommendation that you get a good mental health professional to take a look at him. I don't know how your health system works but here we just need to tell our GP that we have concerns and we get referred. The fact that your kid isn't in school and thus can't get a referral is total bullshit, pardon my language. I really hope you get some help, soon. You must be so worried and stressed by this! (hugs)
I totally had that 4yo and he was also reactive to dairy. We were looking at bipolar, ODD and he already had a spectrum diagnosis. It was absolutely horrifying. I panicked pretty regularly that someone would see enough of it to call us in to cps. His rages often spilled out of the house (we also homeschool) and I'm sure we were "that family". He said the most hateful things (and more about him dying than him killing anyone).
Ultimately, it was a rather severe blood sugar dysregulation problem. Test this out--it's not all that hard. And yes--I know how insane it sounds that it could be something so simple, but I have BEEN where you are completely.
Any time he eats anything made with flour, fruit, sugar or sweetener, starch of any kind (any kind of grain--rice, oats, etc.) make sure he eats a load of fat beforehand. If he's not allergic to peanut butter, that's been our lifesaver for a long time. If you can, remove as many of those things as possible for a bit. We lived on veggies, meat, guacamole, hummus and coconut yogurt for a while. Smoothies had half of an avocado in it (it picks up the taste of what's around it so put it in with some blueberries or whatever).
And keep a detailed log on him. If you pm me, I can send you the one we use so you can print it out. It has instructions.
Last, fish oil was huge for resolving sleep in ours (you note he's up at night). We did label dosing of Nordic Naturals Omega 3-6-9 liquid (NOT kids version). We saw a rather profound change in about 10 days in his sleep patterns.
Oh--and if you know he's dairy reactive, there's 80-85% chance he is also soy reactive... even if the tests come up clean. You'd be surprised, but yeah--food reactions can do this. That is the bulk of my career now. Mine is dairy, soy, gluten (gluten is processed by the same enzyme as dairy protein so they often go together) and a few other things that are off limits. And when we slack on his diet, he is right back to looking like a nightmare. But now he's bigger (turning 10 soon).
Hugs, mama. You're in a scary place. Nothing I'm suggesting to you will take too long to effect change. Less than a month. WELL worth the effort.