Best intervention for 3 year old with behavior challenges

[Anonymous]

Just adding my kid would back track on progress she had made when she was stressed. Feeding was her biggest issue and when she had a bad teacher one year who did a lot of shaming she really reverted and started only eating crackers and things again. Once we got her in a better situation she was able to make more progress on feeding.

[Anonymous]

Poor guy, it sounds like he has a lot going on. I suggest having some conversations with the daycare/preschool provider. If your kid is there 7-8 hours a day, maybe there is something going on there with the bathroom that spooked him. Too much pressure, an unkind comment from an employee, even a loud flush might be the culprit.

What happens when he really needs to pee? Have you just sat with him and read books or chatted and tried to take his mind off having to urinate? Maybe then he could relax enough to go. I used to distract my kid until he got so wrapped up in the story he would just relax and pee.

Good luck! I hope you find something that helps him!

[Anonymous]

I’m so sorry OP — this sounds so hard for you and your son.

We have an older child with encropesis and have been referred to this program by our ped GI: https://gbtherapy.org/inc...tinence-2/

No idea if it would be suitable for your son but thought I would share just in case.

Keep us updated, we are rooting for you! Hugs.

[Anonymous]

The doctor gave you many reasonable options. They all start with making an appointment. You are overwhelmed and don't know where to start. But you can do this. Kudos for coming to this board and asking people who have done this before for advice.

If possible, pick 2 or three options for providers based on recommendations and coverage. You don't have to worry about that for KKI or CNMC. Then, make a folder with all of the pertinent info you will need to make these appointments.

-Basic info: name, address, demographics, contact info
-Insurance card info
-Medications
-Prewritten statement/bullet points of your major concerns and why you are calling this doctor/practice/therapist.

Then pick a week to start your calls. Before dialing, make sure you have your work and home calendars handy and a paper for note taking. Also make sure you have enough time to sit on hold.

These appointments will have various wait times and next steps, so although it's a lot of calling in the beginning, the next steps will probably be more spaced out and easier to tackle.

I know this advice seems simplistic and common sense, and maybe you do it all already. But when I'm highly emotional and stressed, it's hard to get out of your own head and make a plan and get it going.

Good luck to you and your DC!!!

[Anonymous]

Op here. Thanks for the advice and suggestions. He’s in preschool during the day but it’s not been a good fit so far for him. It’s not the best program but we don’t have private school money and the other daycare options are very mixed, and some aren’t options because they don’t take 3 year olds who aren’t potty trained. Looking into other options is on my to do list for December on top of everything else I have to do because I think we need a different program next year and some of the programs have January application deadlines (but just thinking about that gives me a headache on top of everything else).

Regarding Child Find, I read up on it but it seems they only do evaluations in areas he would pass. His issues aren’t social, cognitive, communication, etc. but simply behavioral. He did qualify for services with MoCo Infants Toddlers at 2 but that was because we pushed hard - he passed their assessments with flying colors and it was only because his eating they could categorize him as atypical development that he was able to get services. That said, the whole process them was a ton of work, time, paperwork, and meetings for me and the benefit was really not much - a few meetings with an SLP who watched me with him and then gave me some generic suggestions and handouts. I have an education background and just felt like the process was very condescending and not beneficial for a whole lot of effort. Given that, I feel like Childfind would be similar to this, no?

I think the development pediatrician is likely where I’m going next, and then maybe OT. I’m not against a KKI eval but I just did one with my older kid and am coordinating behavioral psychological services for them on top of dealing with their diagnoses and challenges and that is about all I have capacity for.

I’m just really struggling, being the parent of two SNs kids is taking a tremendous toll on me and my husband and our marriage.

[Anonymous]

Anonymous wrote:Op here. Thanks for the advice and suggestions. He’s in preschool during the day but it’s not been a good fit so far for him. It’s not the best program but we don’t have private school money and the other daycare options are very mixed, and some aren’t options because they don’t take 3 year olds who aren’t potty trained. Looking into other options is on my to do list for December on top of everything else I have to do because I think we need a different program next year and some of the programs have January application deadlines (but just thinking about that gives me a headache on top of everything else).

Regarding Child Find, I read up on it but it seems they only do evaluations in areas he would pass. His issues aren’t social, cognitive, communication, etc. but simply behavioral. He did qualify for services with MoCo Infants Toddlers at 2 but that was because we pushed hard - he passed their assessments with flying colors and it was only because his eating they could categorize him as atypical development that he was able to get services. That said, the whole process them was a ton of work, time, paperwork, and meetings for me and the benefit was really not much - a few meetings with an SLP who watched me with him and then gave me some generic suggestions and handouts. I have an education background and just felt like the process was very condescending and not beneficial for a whole lot of effort. Given that, I feel like Childfind would be similar to this, no?

I think the development pediatrician is likely where I’m going next, and then maybe OT. I’m not against a KKI eval but I just did one with my older kid and am coordinating behavioral psychological services for them on top of dealing with their diagnoses and challenges and that is about all I have capacity for.

I’m just really struggling, being the parent of two SNs kids is taking a tremendous toll on me and my husband and our marriage.

Are you in MoCo? I’d look into Karasik for daycare. They are inclusive and my ASD kid is really thriving there. If you have an IEP you will get priority on the waitlist.

[Anonymous]

Try a Board Certified Behavior Analyst. https://www.bacb.com/

[Anonymous]

Anonymous wrote:Op here. Thanks for the advice and suggestions. He’s in preschool during the day but it’s not been a good fit so far for him. It’s not the best program but we don’t have private school money and the other daycare options are very mixed, and some aren’t options because they don’t take 3 year olds who aren’t potty trained. Looking into other options is on my to do list for December on top of everything else I have to do because I think we need a different program next year and some of the programs have January application deadlines (but just thinking about that gives me a headache on top of everything else).

Regarding Child Find, I read up on it but it seems they only do evaluations in areas he would pass. His issues aren’t social, cognitive, communication, etc. but simply behavioral. He did qualify for services with MoCo Infants Toddlers at 2 but that was because we pushed hard - he passed their assessments with flying colors and it was only because his eating they could categorize him as atypical development that he was able to get services. That said, the whole process them was a ton of work, time, paperwork, and meetings for me and the benefit was really not much - a few meetings with an SLP who watched me with him and then gave me some generic suggestions and handouts. I have an education background and just felt like the process was very condescending and not beneficial for a whole lot of effort. Given that, I feel like Childfind would be similar to this, no?

I think the development pediatrician is likely where I’m going next, and then maybe OT. I’m not against a KKI eval but I just did one with my older kid and am coordinating behavioral psychological services for them on top of dealing with their diagnoses and challenges and that is about all I have capacity for.

I’m just really struggling, being the parent of two SNs kids is taking a tremendous toll on me and my husband and our marriage.

Please reconsider child find. I am not sure where you are but in MCPS sit was wonderful. My child literally had perfect scores on every measure during their assessment but because of the difficulty noted by the teachers with regard to behavior they agreed to do an in person observation. Behavioral issues (including anything that makes it difficult to get through the school day) can be considered in the purview of ChildFind. It was really good for us and we were able to enter kindergarten with a strong IEP. It was also fairly easy as far as administrative burden.

[Anonymous]

OP, I’m sorry you are dealing with all this. I don’t know you but I am cheering for you. You are not alone.

[Anonymous]

OP, I'm going to give you a list so it's easier to read. All of these suggestions come from my life.

1) Do you have to work? Do you have to work as much? Can you afford a nanny? Day care/school can be incredibly stressful for SN kids and create /exacerbate problems. 

2) The eating thing sounds like it could be ARFID. Unless your kid is not eating enough calories to survive, feed him what he eats and forget food therapy right now. Literally cookies for breakfast if that is what it takes. If he has a crappy diet, he will need the miralax. If he is not eliminating, he is not going to be hungry no matter what you do. Forget potty training, make sure he's cleaned out, not impacted, and just try to get him peeing and pooping without a fight again. Ironically, the best way to help him might be to just keep giving him Miralax and liquids but otherwise not mentioning it at all.  

3) If reducing demands doesn't get him eliminating, you need a child therapist. I think the specific person matters more than their background. Someone who deals with toileting, and someone who can do home and child care observations. We used a psychologist for something similar but I don't live near you so I can't recommend. Maybe an OT could work, too, or a behavior analyst as long as you got a good one and not one that was really rigid and focused on "control". I think that might be a personality mismatch for your guy.

4) Make a developmental pediatrician or CHOP appointment for a full eval. There will be a wait so this will just get you on a list. You can decide later if you want to go now, or wait.

It will get better. Your kid is 3. That is little, and I suspect since he is articulate he may be "tricking" adults into thinking he is more developed than he is. His emotion regulation just hasn't caught up to his smart little verbal brain yet, but it will. I really think reducing some demands and stress will help.