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Hi all,

I am hoping someone will be able to tell me I'm overreacting...

My 3yo DD2 has really awful tantrums. DD1 did not, so this is new territory for us, but I think we're doing all the best things for her and it's only getting worse. I joke privately that she has Seinfeld tantrums because they are about nothing. I don't mean that they are about something that just I think is nothing -- they are really about NOTHING. She will find something frustrating, we'll offer an alternative she might like, and then she's off on a miserable screaming fit. We ask what is upsetting her, and she won't answer (or she'll answer with either "NO" or "EHHHHH"). We ask if she wants something, and she won't answer. We ask her if she'd like us to sit quietly and wait until she's done being angry, and she'll usually say NO, but the other choices we give (does she want to be alone for a few minutes? does she want a hug?) are also met with "NO."

This would all seem like typical three-year-old stuff if it weren't for the part that just totally wigs me out: the self-injury. The ONLY way she exits the tantrum is by hurting herself. She will eventually either bang her head on the floor (or another hard surface), kick her bare feet so hard that she bruises them, or, in one dramatic and terrifying tantrum, claw at her face with her nails and rip a big gash in her forehead. Once she is HURT, she will start crying "Owie owie owie," and then she'll allow us to pick her up and comfort her. At that point, I ask, "Are you all done being angry? Can we talk about it?" and she'll say yes, but she is never able to articulate what she wanted in the first place.

This even happens in the absence of all stimuli, like in the middle of the night (she sleeps in her own bed). She will wake up just RAGING, and cannot tell us what she needs. It follows the same pattern -- 10-40 minutes of rage, followed by some kind of self-injury, after which we can get close enough to comfort her and she'll go back to sleep.

Would this worry you enough to wonder if it was more than a developmental stage? I have a call into our pediatrician (after yesterday's tantrum, her forehead looks like someone went at her with a hammer), but I don't know if I should be seeking therapy for her, waiting it out, or having her evaluated for some kind of emotional issue.

TIA for any ideas.
 

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I don't have experience with this. But I wanted to send you a hug, and bump you, so that someone who does have more experience can offer you some guidance. I have a rather calm 4 yo that was never prone to tantrums. I also have a 2 yo who tantrums so badly, with unbelievable hate and rage, and is like an elephant, will be pissed off for half an hour just to get her way and still remember who or what she is supposed to be pissed about..... but she always has a reason (whether I agree it is rational or not). And she doesn't harm herself, except for a short period at about 15 months where she banged her head a bit too much. In my opinion, self-injury is not normal. Maybe she needs the release for some reason? I hope you can find out why and how you can help her.
 

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I would probably seek out help just to get a professional opinion and learn some strategies to help her through the tantrums. I have spent a lot of time around young kids (used to be a teacher), and while 3 and 4 year olds can have intense tantrums, the self injury takes it to a new level.
 

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The pediatrician sounds like a good start. My dd tried to hurt me in those ways, but never herself. It was something I worried about, though, as violent as her tantrums got. I could protect myself from her but I wasn't sure how I would protect her from herself. I would have called the Ped. to start with too, in case she felt we needed a referral to a psychologist or something to get past that.

 

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I would definitely seek professional help. I have workedin behavioral health and have seen these behaviors before I have never worked with someone so young. I'm sending you
because I can imagine how hard and scary it must be to watch your little baby do that to herself and not be able to help her. Good luck mamma!
 

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Definitely seek an eval. Tantrums in a 4 year old wouldn't worry me. Tantrums where she can only exit by causing herself injury would!

I'd also suggest reading: Sensational Kids and The Out of Sync Child. This sounds like it might be partly sensory based. She becomes dysregulated and then can't re-regulate herself.

http://www.sensory-processing-disorder.com/
http://www.kid-power.org/sid.html
http://www.spdfoundation.net/

An occupational therapist might be just what you need. But she needs to be evaluated to see whether this is physically based, neurologically based or whatever.
 

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Discussion Starter · #7 ·
Thank you all for your very thoughtful responses. I took at look at some of that SPD stuff and some of it resonates, while most of it does not. For example -- she is not bothered by textures much (likes to play with sand, likes to knead bread dough, play with flour, play with playdough, etc.), she doesn't seem irritated by chaos or loud noise, she is affectionate but not clingy, she eats lots of different foods and even tries more new things than her older sister, she loves swinging and baths, no issues with tags on clothes or anything like that, etc. If anything, she seeks out more stimulation than I'd expect -- she has a CD player on at bedtime, and she also has a little musical aquarium attached to her bed that plays music, and sometimes after I turn on her CD player, I notice she will turn her aquarium on too -- so there are two things with music playing as she falls asleep.

What DID resonate is that she is a huge risk taker; very physical; is obviously very hard to calm when she's upset; when I ask her to look me in the eye during a serious talk, she seems unable to do it for more than a few seconds (but she'll do it when she's happy and playing); she doesn't transition well; she sleeps poorly.

I spoke with her pediatrician, who I like very much and has been with us, listening well, through many very difficult medical issues with DD2 (all resolved now -- had to do with a congenital heart problem for which she had surgery at 14 months). The ped said it sounded like it was all behavioral, these tantrums, and that the best thing to do was ignore the tantrum as soon as it's obvious that my presence is not helping. She suggested that I walk away without announcing that I was giving up -- but to simply give up, let her have her anger, and be ready to give love when it's over. She promised that DD2 would not hurt herself badly, that I should rescue her from real serious harm, but that my continuing to engage in the tantrum by asking what's wrong and what I can do is what is feeding her rage.

The pediatrician also said that the night time rages are totally separate -- she believes they are night terrors, and said that we should try patting and comforting her back to sleep for no more than 10 minutes, and if she won't calm down and go back to sleep, we should attempt to wake her all the way up by turning on the lights and even using a damp washcloth on her face. She said that even if DD2 responds to something we say, she may actually be asleep, like a sleepwalker. It never occurred to me!

I asked the pediatrician what would have to be happening for her (the ped) to be worried about all of this. She said it would have to happen without me or DH around -- like at school, or with a sitter, or with friends or family. She said the fact that DD2 holds it together for other people indicates for her that this is behavioral.

I also talked to DD2's preschool yesterday. The director has a son with serious special needs, and she gave me some tips for tantrum aversion that she learned from his OT and PT, so I'll try those. And DD2's wonderful teacher read the class a book today called "If You're Angry and You Know It" which gives kids ideas of things to do when they're angry. DD2 was excited about the book and borrowed it to read at home. Hopefully we can work on some of that.

What do all of you think? Would you pursue this further, or see what happens? It's easy for me to want to wait and see today -- since it was a day without tantrums, the first in weeks! (and coincidentally followed the first full night's sleep in weeks too)

TIA, all of you.
 

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Quote:

Originally Posted by fiddledebi View Post
If anything, she seeks out more stimulation than I'd expect -- she has a CD player on at bedtime, and she also has a little musical aquarium attached to her bed that plays music, and sometimes after I turn on her CD player, I notice she will turn her aquarium on too -- so there are two things with music playing as she falls asleep.

What DID resonate is that she is a huge risk taker; very physical; is obviously very hard to calm when she's upset; when I ask her to look me in the eye during a serious talk, she seems unable to do it for more than a few seconds (but she'll do it when she's happy and playing); she doesn't transition well; she sleeps poorly.
These are signs of a sensory seeker -- I'm not saying that your dd has SPD, but before you dismiss it, look at the information about sensory seeking. These are kids who don't get enough feedback from their neurological systems, and as a result are very physical, seek out stimulation and noise.

And it's important to note that not everyone is going to have every symptom.

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Originally Posted by fiddledebi View Post
I asked the pediatrician what would have to be happening for her (the ped) to be worried about all of this. She said it would have to happen without me or DH around -- like at school, or with a sitter, or with friends or family. She said the fact that DD2 holds it together for other people indicates for her that this is behavioral.
See, I disagree with that. ADHD presents like that (symptoms must be present in several environments), but SPD doesn't always. Our ds held it together beautifully in school and not at home. Other kinds of things are like this too.

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Originally Posted by fiddledebi View Post
What do all of you think? Would you pursue this further, or see what happens? It's easy for me to want to wait and see today -- since it was a day without tantrums, the first in weeks! (and coincidentally followed the first full night's sleep in weeks too)
I would say that if the typical behavioral solutions that your ped/preschool suggested don't work, then it's time to look elsewhere.

The sleep piece is key -- if she's consistently overtired, then her behavior is going to be off. Period.
 

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I'm not totally sure on the self-injury thing, although my DS has done that from time to time, but he had a lot of tantrums when he was 3-4ish... We had some talks (at a non-tantrum time) about hwo everybody feels angry sometimes, and it's ok to feel angry, but it's not ok to hurt people (including self) or to hurt things (throwing/breaking/etc). Then we found a long list of things that were ok to do to express the anger/aggression/frustraton. He would punch his pillow, play with clay, go outside and yell or run around, jump up and down, turn on some loud music and dance wildly, throw stuffed animals around his room (we concluded that those were safe), etc. Anytime he got upset and started to do something that was not acceptable, we would remind him that it's ok to feel angry, but not ok to hurt people or things....it was very effective for him to feel like it was still ok to go a little nuts, and that it was definitely ok to feel angry...he was validated in his feelings, and found healthier ways to channel them.

ETA--as for night waking, I'd look into night terrors. DS has had those too (he's 8 now) he'll just wake up shaking and bawling and be totally inconsolable. He can't explain what's wrong, he just is freaking out. They seem to come in clusters, then none for months and months, then a few together again. they happen most when he's stressed--such as when daddy has to be out of town for a week or something like that. So maybe see if there are other things which are creating a stressful environment for your dd? If you can calm any of that, it might help her.
 

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My daughter is sensory-seeking, and really that kind of fits in with the self-injury thing. Maybe she needs a sensory experience to bring her out of it? Maybe if she has something to rock on and some variously textured things to touch and hold when she has a tantrum that would help? Also, adding sensory play things (various doughs, soap suds, anything gooey or whatever) to her day might help her.

AND I think kids are pretty good at holding on till they get home as far as anything goes. Maybe she feels off all day, and then she gets home to you where she's safe and it falls apart.
 

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Quote:

Originally Posted by fiddledebi View Post

I asked the pediatrician what would have to be happening for her (the ped) to be worried about all of this. She said it would have to happen without me or DH around -- like at school, or with a sitter, or with friends or family. She said the fact that DD2 holds it together for other people indicates for her that this is behavioral.
I strongly disagree with this. It is actually very common for kids who have real problems to work very hard to hold it together at school/away from mom and day, and only exhibit their very difficult behavior with their parents. I have heard this (that kids with actual, real problems often hold it together at school and fall apart with mom and dad) from more than one professional, and experienced this myself. It is simply not always true that if a child can hold it together at school it means their problems are caused by parenting.

I second the recommendations for an evaluation if the recommendations you've been given don't lead to improvements. It can't hurt, and might help. At the very least I think you need another opinion beyond that of your pediatrician.

And I also agree with Lynn that if your child's sleep is disrupted frequently, she isn't getting enough good quality sleep and that can most definitely lead to difficult daytime behavior. A thought-is her nighttime raging happening at around the same time every night? If it is, waking her a bit before she typically begins screaming might help--for our dd who did this, it sometimes worked. Sometimes not so much.
 

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Originally Posted by fiddledebi View Post
The pediatrician also said that the night time rages are totally separate -- she believes they are night terrors, and said that we should try patting and comforting her back to sleep for no more than 10 minutes, and if she won't calm down and go back to sleep, we should attempt to wake her all the way up by turning on the lights and even using a damp washcloth on her face. She said that even if DD2 responds to something we say, she may actually be asleep, like a sleepwalker. It never occurred to me!
My ds has been having night freakouts too.

I just borrowed "Solve Your Child's Sleep Problems" (didn't care for it but some info is relevant) and the section on Sudden Partial Wakings explains that toddlers may cry, scream and trash for up to 40 minutes and rarely up to an hour.

It's often called night or sleep terrors but that's actually misleading since they are not actually scared.

The book says it generally doesn't mean much, physically or emotionnally (for kids under 5 or 6 anyway). It's developmental.

They think that the child doesn't fully come out of Stage IV non-REM sleep before starting the next sleep cycle and is left in a mixed state, neither asleep or awake.

The advice given is different than what your ped suggested. It says to avoid waking your child and keep your distance during the episode then let her go back to sleep. You probably want to be in the room to ensure she doesn't hurt herself tho. It also says not to talk to your kid about it because since she doesn't remember any of it, it could make her anxious.
 

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nak

I have a diff. take on this. Only because of what I have experienced with my 2 dds.

My dds exhibited very similar beahaviours that turned out to be due to food intolerances (gluten--dx celiac---and dairy). Take those out and we get our girls back. Add it back in even in small amounts and we have girls who are raging, out of control, aggressive, sad, tantrum-y and weepy for "no reason" --there really was no rhyme or reason to it. My older dd could 'lock in' for HOURS at a time, even after she got whatever it was she 'wanted'. She would/could not respond, her eyes would glaze over, often she\d hide behind smthg (couch, table, etc.), put her hair in her face and her body would be very tense. It looked like a temper tantrum/inabillity to express herself but I knew something was 'off; because she was/is very articulate..

anyway just smthg to think about,,does she have dark circles and/or wrinkles under her eyes? That is just one indication of possible food inttolerance.
Read Is This Your Child? by doris Rapp, excellent book and talks a lot about the behavioural aspect of allergies.

HTH!
 

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Quote:

Originally Posted by fiddledebi View Post
I asked the pediatrician what would have to be happening for her (the ped) to be worried about all of this. She said it would have to happen without me or DH around -- like at school, or with a sitter, or with friends or family. She said the fact that DD2 holds it together for other people indicates for her that this is behavioral.
Your pediatrician may be fine, but as so many pp have mentioned, this is not logical. My DS has slight sensory issues (tags in clothes, seams in socks... ) and he will suck it up in daycare, at other peoples houses... but will tell me how his socks are on the wrong way when we are at home. Kids feel safe and comfortable with their parents, and that gives them the confidence to act as they really want to - love, tears, joy, hatred, kindness, tantrums and all. In other environments, they know there are other rules, and they often feel the need to "behave" and conform.
 

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For my kids, "behavioral" problems were in fact health problems. My son's got mild sensory things going on, my daughter's actually the one who would tantrum and get all wound up and have a really hard time calming down but she doesn't have the sensory stuff my son does. For us, identifying problematic food was the first step, but not enough. I am working on my daughter's gut health--no gluten and dairy were a start, but her gut needs more support than that. Our underlying issues are heavy metals from my fillings--not saying that's it for you, but I mention it cause it wasn't in my reality 2 years ago, and now it explains so much (for my health history and for the kids). I think your pediatrician is wrong (about behavioral vs health, I mean), but there are a lot of avenues to explore to figure out what's going on with your kiddo.
 

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I second the food interance thing. Ds did a 360 when we did the feingold program. Also take a honest look at things at home and school which maybe bothering her. Even something that is irrelavent to you maybe triggering her. Also if it continues it wouls not hurt to get a second opinion, or to seek out a therapist. It's best to address these things when they are young.
 

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I would pursue it further. I agree with everyone who said that kids can hold it together at school, at friend's homes, etc, but act differently at home.

I have also come to learn that pediatricians specialize in the physical health and well being of children - not the emotional or behavioral health. They can be a good starting point if you have questions about basic behaviors, but when they are more complicated, you need someone who specializes in that specifically. We have a wonderful pediatrician who "everyone" in town goes to, is affiliated with a top university, is compassionate and loving and all the rest. But, we have had some complicated issues surrounding sleep, and what I am now coming to figure out, sensory issues. We have had a great dialog going for years around many of these issues and more than once, he has said, "I read a book on this 10 years ago" or "We touch on this in our training, but it isn't the specialty of a general practice pediatrician". I really appreciate his honesty and ability to admit that he doesn't have as much knowledge as I need. I would totally and completely trust him if my son had a physical illness or injury. But, I use him simply as a starting point for behavioral issues.

Also, how does she know your child won't hurt herself seriously? I am not saying your child would, but there are children who do hurt themselves seriously. Without really evaluating your child's behaviors, why she is doing it, etc, I don't know how she can make that promise.
 

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My daughter did similar at 3 and never quite grew out of the tantrums and hurting herself. She is now 11. She also had night terrors, which are different, but I think may be related. She only acted up at home and around us--never at school or with grandparents.

After starting school she was diagnosed with auditory processing disorder, and a few years later Asperger's Syndrome.

I don't agree with your physician at all. We had a physician that basically rationalized all of our daughter's behaviors as well (telling us to ignore, which we tried for many years)---and I believe this delayed getting her services that could have helped. I think tantruming at three very severely until hand banging or self injury points to symptoms outside of the range of normal. Something else is going on, and she may need help with it.

Good luck,
Lisa
 

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Originally Posted by mamadebug View Post
I have also come to learn that pediatricians specialize in the physical health and well being of children - not the emotional or behavioral health. They can be a good starting point if you have questions about basic behaviors, but when they are more complicated, you need someone who specializes in that specifically.
I agree and have found the exact same to be true.
 

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Sensory processing disorder covers a whole spectrum of disorders. Think of the category, "mood disorders." It covers depression, anxiety, generalized anxiety, phobias, obsessive-compulsive disorder, etc. You get my point. I am sure many of the sensory processing disorder categories didn't resonate. But bear in mind just because your daughter doesn't react to textures or refuse to touch shaving cream, etc. (i.e. is NOT tactile defensive) does NOT mean that she doesn't struggle with other types of sensory processing disorder.

My daughter has sensory modulation disorder, a type of sensory processing disorder. She has problems regulating emotionally. A very small incident or seemingly nothing can trigger a cascade of extreme emotions, and like a snowball, escalate rapidly.

Sure, any child's tantrum is extreme. But my daughter's tantrums are in a whole different category. They are qualitatively different. I think the traditional advice to "ignore a tantrum" may work with the usual's child tantrum, and may be appropriate in those instances. But for a child whose tantrum is so qualitatively different -- as with my daughter's and seemingly yours -- I think ignoring the tantrum is inappropriate if not harmful. My daughter CANNOT calm herself at those times. She does NOT have the resources to keep from getting to that level of upset and she does NOT have the resources to bring herself down from it. She NEEDS my help (and others) to help her regulate. My daughter desperately needs me at those times, and feels very abandoned if I'm not present, and escalates in upset.

I would encourage you to have an occupational therapist skilled in sensory processing disorders and sensory modulation disorder evaluate your daughter. What do you have to lose? An hour of your time? Maybe you'll get some very helpful insights and a useful diagnosis. My daughter has been in occupational therapy for 2 years. Her emotional regulation has improved so much. I still expect that we will have times where she will regress, but she has improved a lot.
 
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