Is this tantrum concerning

[Anonymous]

Thank you so much for the Child Find suggestion, I hadn’t even thought of that. I did look it up though and as a PP says, services are done through the public school (at least in DC). We have her at a daycare we love and don’t plan to start public school until 4 or even kinder.

We are fortunate to have decent incomes so would not qualify for anything means tested. It’s just that what, $660 a month for sessions when we pay for insurance is just bananas. I can see my own mental health professional for $40 a session. The issue seems to be the lack of therapists for kids. There are some but they are in upper NW and we are on the hill. Probably a 3-4 hour outing every week.

As for the OT referrals, we did question that too when our Ped recommended it. She assured us it would be appropriate and the place also told us they have that kind of expertise. But now we are starting from scratch again.

[Anonymous]

At this age you need to see a developmental pediatrician. Kennedy Krieger takes insurance but there waitlists are forever. Get on it now and if you don’t need it you don’t have to go when you time comes. In the meantime, yes pay for a good pediatric therapist who will work with her AND you. The work with you is maybe more important than play therapy or whatever. You mostly need to ensure you are handling the tantrums inan appropriate way and doing reasonable things to prevent them. Often you can get partially reimbursed by your insurance. It’s worth it.

My Dd bit me during an epic tantrum to the point I have a scar. Thankfully she is a well adjusted and happy elementary school student now, despite her significant ADHD.

[Anonymous]

Anonymous wrote:This sounds like my daughter who has autism.

NOT dxing your kid, but affirming that those type of tantrums multiple times per week are outside of the typical toddler behavior.

Did you try your local child find? You shouldn't have to pay for services if she's found elibigle.

This reminds me of my niece. Her parents used to joke she was like the hulk - ripping off her clothes when she was angry. My niece was diagnosed with high functioning autism at 14. She has always struggled with emotional regulation. Also, not diagnosing your child. There are so many reasons for emotional disregulation. But it would have been better if my niece was diagnosed earlier. I would definitely go thru Child Find and see about figuring out these behaviors.

[Anonymous]

Anonymous wrote:Thank you so much for the Child Find suggestion, I hadn’t even thought of that. I did look it up though and as a PP says, services are done through the public school (at least in DC). We have her at a daycare we love and don’t plan to start public school until 4 or even kinder.

We are fortunate to have decent incomes so would not qualify for anything means tested. It’s just that what, $660 a month for sessions when we pay for insurance is just bananas. I can see my own mental health professional for $40 a session. The issue seems to be the lack of therapists for kids. There are some but they are in upper NW and we are on the hill. Probably a 3-4 hour outing every week.

As for the OT referrals, we did question that too when our Ped recommended it. She assured us it would be appropriate and the place also told us they have that kind of expertise. But now we are starting from scratch again.

Get on the waitlist for developmental pediatricians at Children’s and Kennedy Krieger while you are pursuing other therapies. The waitlists are long but you can try calling them every month to see if there are any cancellations.

[Anonymous]

I don't think OT was a wrong turn. What insurance do you have? Can find an in network provider with a $20-$30 copay for appointments? My son is now 5 and has a diagnosis, but I credit early intervention via OT for helping him learn to regulate emotionally.

[Anonymous]

I just saw that you are on the hill. Try My Kids Therapy in Greenbelt.

[Anonymous]

Hi op. Lots of kids do see ot for emotion regulation issues, it’s not that off base. It’s just that an OT isn’t going to give you any type of diagnosis it’s not what they are trained to do.

I will be honest with you, we pay a lot out of pocket to get to see the right people. It’s not easy (we are two feds so make a good combined income but not super high earning feds yet and definitely not crazy earners). So just want to share that unfortunate reality. Our mental health care system is just very flawed and it makes it hard for therapists to interact with the insurance system without drowning. So most are out of pocket then you’re out of network and get reimbursed if anything.

This all being said, I would not discount child find. While the services may be within schools I believe there is an evaluation component that might be helpful to you.

We started with just a regular therapist. Our pediatrician actually said the data for OT on things like sensory issues isn’t great so she didn’t recommend it (some people I’ve definitely heard success with it) but either way I think you need someone that can help you figure out the root before going to OT. Sensory issues usually are linked to something else, they don’t usually come by themselves so first figure out what the foundational piece is.

So for us, tantrums weren’t like you describe but there were outbursts at school with peers. We started with a psychologist (LCSW or LCPC is also great, not a psychiatrist they are only for meds) who has a lot of experience with anxiety and adhd which were the suspects for us. They have really helped us navigate this whole process, they can help with initial potential diagnoses (or diagnose, but at 3.5 ours held off on diagnosis in the beginning because it wasn’t totally clear). They understand all the different options - OT, neuropsych evals, child find, etc. It seems like you would really benefit from having someone help you understand the landscape, I know it’s greatly helped us.

I know it’s so hard. And it’s incredibly difficult when tantrums ARE normal for 3 year olds (or in our case, some biting or hitting can be normal) but what you describe is not typical. Like the other poster said it may just be that she feels deeply and needs time to learn more concrete regulation skills, and some changes to environment (for us it was shorter days at school, lots of 1:1 time with mom or dad without sibling etc, and us changing some of our responses), or it might be more going on. For us I think we’re probably going to land like the pp, probably some adhd going on but our interventions right now are helping. Good luck!

[Anonymous]

Anonymous wrote:We have three kids and none of mine have ever had a tantrum to that extreme - either in length or destruction.

Generally tantrums are about two minutes - a long one might be five? Four or five?

+1 three kids and I’ve never witnessed anything like what you describe

[Anonymous]

Woah I didn’t realize I wrote a nice sorry

[Anonymous]

Novel*