ADHD almost 5 yr old is violent at home

[Anonymous]

Help! I am feeling totally out of my parents depths and looking for some parenting books/guidance. My middle child, almost 5, has been diagnosed with anxiety/selective mutism and in school she is well behaved but inattentive. We suspect inattentive ADHD but it has not yet been formally diagnosed. At home she is pretty typically loud and normally a sweet very happy go lucky girl but sometimes she just goes OFF and I’m at a loss.

She gets violent with her brother and parents over tiny things. We had a great day yesterday, went to the pool, had popsicles, all was well. She was definitely tired, so that couldn’t have helped. Last night, she wanted us to wait to read a bedtime story - I was waiting but her brother started reading aloud and she got angry and stomped on his back. I got upset and told her we do not hurt people (something she hears a lot) and I could see she was in a mood immediately and she tried to hit me, I wouldn’t allow her to, it escalated and she slammed the door. Baby was already sleeping so I was pissed and yelled at her not to slam the door; she promptly did it again so you can imagine how that went. I took a couple of her toys, and I did not want to do her bedtime. My husband took over and eventually she came to apologize after 10 min and we hugged and I told her I loved her but we can’t hurt people. Another example- this morning we were playing a game (flip two cards, higher card wins) and she “lost” and head butted her brother. I again told her that was not ok and my husband took her upstairs for a timeout but then she started absolutely losing it — I went up and let her out and told her to stomp her feet instead of hurt people and held her in my lap while she cried.

I read last night that negative punishment is not as effective as positive rewards, but I am not really sure how to even implement rewards for this type of thing — not being violent in the moment and instead training anger on a pillow or stomping feet. It’s rewarding an absence of violence rather than a specific action.

If anyone has experience with this and has some parenting strategies or books for young children they can point me to I would really appreciate. We have just started therapy but have been really focused on the anxiety side of it which I feel like I have a much better handle on. The violence - I am at a loss.

[Anonymous]

When she’s calm, teach her what to do with her body when she’s angry. Take deep breaths, go for a walk, blow some bubbles, draw a picture of her feelings.

You can create a “calm down corner” (look on Pinterest for ideas) and gently suggest she goes there when you anticipate her possible outburst.

And try and stay on top of sleep (ie no late bedtime on weekends. Some kids can handle it but maybe yours can’t) and hunger (protein, healthy fat. Not mindless grazing but more
Frequent meals)

[Anonymous]

We have a 7 year old with the same diagnosis. What has helped is ensuring she gets 12 hours of sleep. We are also keeping her engaged in the activities she enjoys not just being dragged to the next thing the entire family wants to do. She’s craving attention, it is hard to get when u have other siblings. My daughter has a high achieving older brother and it’s very hard on her. We are going to be doing OT again to help with mood regulation. She’s on adhd meds as well, but we have just added supplements because she’s not eating well.

[Anonymous]

ADHD is primarily a condition marked by dysregulation, including emotional dysregulation. My 8 year old DD was diagnosed last year and that's her primary symptom. She gets "big feelings" and has a very hard time managing them. She mostly becomes argumentative and obstinate and will yell and stomp her feet. She occasionally cries or throws a book or toy on the floor.

Some things that have worked for us so far:

--Medication. DD is able to calm herself down and use the tools she's learned to manage her feelings MUCH BETTER when she's on her meds. She still gets frustrated or upset, but she's much more rational and in control.

--DH and I have to stay calm in the storm. It gets worse when we react to DD's dysregulation. We acknowledge her feelings, give her options if possible, and explain why we can't let her say hurtful things/throw books/etc. It requires a huge amount of patience--more than I have at times. Sometimes I have to step away and calm myself down before I can respond to the situation. I think it helps my DD to see me calm myself down. It reinforces the tools she's learned (breathing exercises, stepping away to cool off) and that it's normal and ok to have these feelings.

--When she's calm, we talk to her about how she was feeling and what to do about it. Most of the time her anger or frustration is really something else--feeling left out, feeling embarrassed that she lost the game, feeling shame because she made a mistake. So we talk it through and identify what was actually going on, emphasizing that it's normal to feel that way, and what she can do the next time she feels that way.

--Sleep is critical. She needs a consistent 8-9 hours. We have a consistent bedtime and routine.

--We limit screen time. No screens during the week. On weekends, we try to limit screens to 30 minutes at a time. Anything more than 30 minutes at a stretch causes her to get cranky, disagreeable, and argumentative. So we just break it up by doing other things throughout the day.

--How to Train Your Angry Dragon is a book that might help. My DD liked it a lot.

--Keep an eye on whether food/hunger plays a role. My DD doesn't seem to be as affected when she's hungry (unlike me and our other child) but keep an eye out to see if this is a factor for your child.

[Anonymous]

She is masking at school, so she's having restraint collapse at home. You need a better school setting.

[Anonymous]

Just a note to say thank you for this post. We have a 8 year old DD who exhibits extreme frustration intolerance and emotional dysregulation at home. I often feel at my wits end for how to help. I’m very calm by nature and try modeling and channeling that as much as I can —just operating in a lower key so I’m not flashing back at her. I’m not sure it does a whole lot of good in terms of helping her lasso her feelings. At school her teachers were pretty shocked to hear about our struggles with temper flares and physical outbursts. She keeps it together during the day (and she’s an excellent student and engaged participant) and talks of trying to get someone to pay or hurt as revenge for her feelings. She hits me a lot less than she did a couple years ago but it occasionally will happen. ADD has not been formally diagnosed but everything I’ve read about it fits. I’d love advice on where to start with that and OT. She’s about to start talking to a counselor at school but here we are at the end of the school year. I’d love to keep this going. Thanks everyone for the community.

[Anonymous]

Op, assuming your are seeing a therapist for the selective mutism - what do they say about the behavior you are describing?

I have a child (8 yo) with anxiety and ADHD. Medication and CBT have been life changing. Started medicating at age 6. I also did parent coaching. The therapist DC sees for anxiety helped with setting up positive reinforcement strategies (like every day your DD manages to not hit she gets a sticker and at 5 stickers she gets a prize - something where getting a prize takes some work but not too hard), as did the parent training - it was largely troubleshooting problem situations and teaching calming strategies.

[Anonymous]

Regarding rewards: You never offer a reward in a meltdown stage. You target desirable behavior. Set goals that will improve the livability at your house, like your child being in charge of getting herself ready for bed calmly. Then you reward that nightly with something that is logically connected to the behavior you want to see. Maybe your child picks out the bedtime story book or gets five extra minutes of being read to. It’s ok to have consequences along with rewards. The book Parenting with Love and Logic explains this well.

You also try to “catch your child being good” in day-to-day activities. This doesn’t require reward, just verbal praise. Be specific in what you praise: “Wow, I noticed you dressed yourself and were ready to go to school early today,” “Thanks for being so careful with the dishes when you helped to clear the table,” “You were very kind when you were playing with your brother earlier,” etc.

[Anonymous]

in my experience, 9 times out of 10 when a kid is struggling with significant emotional regulation or frustration tolerance it is actually that they are on the spectrum rather than adhd as it is currently dx. I actually think both of them are terribly categorized, but ultimately as of right now that rigidity/ inflexibility, inability to accept losing a game, inability to wait your turn, and greater aggression that is typical are all hallmark signs. it could be a mixture of h/i adhd and asd also. A lot of parents say 'oh anxiety' but as our therapist and psych say over and over, anxiety in kids is rarely hidden and disguised as other things.
what you should do is get into parent training and get her a therapist who can help her label and recognize her feelings. That will help her to cope better at school which will help with the after school restraint collapse.

[Anonymous]

I would get one of Kazdin's books--great strategies for reinforcing the positive opposite (keeping your body gentle when upset in your case) through practice and earning points toward small prizes. Basically, you identify when the negative behavior occurs, role play frustrating situations, give her points for practicing, and have a system for earning points in real life (playing a game with her brother for X minutes and keep her body calm is 2 points or whatever). When she can do a short amount of time consistently, you make the amount of time longer. Or focus on bedtime if that's an issue and then work on dinner time, for example. Staying calm is also important. Hang in there.

[Anonymous]

Anonymous wrote:in my experience, 9 times out of 10 when a kid is struggling with significant emotional regulation or frustration tolerance it is actually that they are on the spectrum rather than adhd as it is currently dx. I actually think both of them are terribly categorized, but ultimately as of right now that rigidity/ inflexibility, inability to accept losing a game, inability to wait your turn, and greater aggression that is typical are all hallmark signs. it could be a mixture of h/i adhd and asd also. A lot of parents say 'oh anxiety' but as our therapist and psych say over and over, anxiety in kids is rarely hidden and disguised as other things.
what you should do is get into parent training and get her a therapist who can help her label and recognize her feelings. That will help her to cope better at school which will help with the after school restraint collapse.

Agreed 100%

[Anonymous]

We had a formal neuropsych and they saw minimal evidence of ASD although I wondered that too. However, she doesn’t have trouble adapting to changes in routine that she doesn’t have control over, like her schedule. So if I tell her we don’t have gymnastics this week she is really wholly unbothered. Maybe disappointed and She might ask why a few times but accepts the explanation. Or if the pool is closed she’s ok with it. It’s more like - when she decides something in her mind and someone goes against it, then she’s angry.

Although we’ve had visitors the last couple of days and they’re close family so I don’t think she is at all “masking” around them and she’s been very happy and not at all like she had been when I wrote this. So I don’t know.

To the poster that asked what the therapist said, I’ve described this to like 3 or 4 different therapists and they have all said it can be related to anxiety. So go figure. I’m actually realizing now in all the reading I’ve been doing that her older brother likely has some anxiety as well. Not nearly as impactful, but he does from time to time have meltdowns that I think stem from anxiety.

[Anonymous]

You need to better protect the brother. In both your instances he was gaining parental attention and she attacked him. After her brief punishment she got more attention. Even a hug!

Did you stop playing with the brother to do all of this discipline? Then she has gotten what she wanted, your attention redirected to her. Don’t think of it as evil or anything, she is 6, but change your behavior and level of attention.

[Anonymous]

The ADHD dude posted about this recently. The part I took away was having a place to get the anger out, like pillows to punch. For our kiddo the ot said around that age it was ok to set up a smashing corner in the yard.

And agree with all the rest! I have a few ASD in my family and the anger comes out as an explosion from things not being as they should/rigidity whereas ADHD spouse & kid it's more of a nervous system overwhelm.

[Anonymous]

Anonymous wrote:We had a formal neuropsych and they saw minimal evidence of ASD although I wondered that too. However, she doesn’t have trouble adapting to changes in routine that she doesn’t have control over, like her schedule. So if I tell her we don’t have gymnastics this week she is really wholly unbothered. Maybe disappointed and She might ask why a few times but accepts the explanation. Or if the pool is closed she’s ok with it. It’s more like - when she decides something in her mind and someone goes against it, then she’s angry.

Although we’ve had visitors the last couple of days and they’re close family so I don’t think she is at all “masking” around them and she’s been very happy and not at all like she had been when I wrote this. So I don’t know.

To the poster that asked what the therapist said, I’ve described this to like 3 or 4 different therapists and they have all said it can be related to anxiety. So go figure. I’m actually realizing now in all the reading I’ve been doing that her older brother likely has some anxiety as well. Not nearly as impactful, but he does from time to time have meltdowns that I think stem from anxiety.

These things also wouldn’t bother my dc and he also doesn’t mask.
What does upset him is if he can’t do what he decided he was going to do or wanted to do. So if that’s winning a game or playing instead of reading etc etc - then he would get upset or angry. Mine also had no asd found at first eval but second at age 7 it was described as ‘traits’ but enough to get him the dx.
I’m not saying hey go panic this is the new dx. I’m just flagging that what you do tend to see with asd is that fundamental challenge with cognitive flexibility and recognizing/ processing emotions and perspectives and those of others than mainly are just things to know and work on in and of themselves at this point (I am of the school that we are getting to a little bit of a crazy tipping point with diagnoses but the language has given me a community I will admit)