Help for preschooler with anger issues and gross motor delay

[Anonymous]

Anonymous wrote:

Anonymous wrote:Get him a full evaluation by a developmental pediatrician or child psychologist and not just an evaluation for gross and fine motor issues which will be done by an OT. You need to know what the problem is first before you can address it. The anger issue can be from anxiety, ADHD, etc or nothing - the preschool can just be a bad fit but you won't know until you get a full evaluation.

Good luck!

While a full evaluation is a good idea, it could take up to 6 months to even get the appointment. You know what the behavior is so you can and should address it now. Regardless of what the evaluation shows, you're still going to have to experiment with several different wants to address the aggression, so that can start now with a visit to a child psychologist.

Also - since this is new behavior and a new school, you do have to consider whether or not it is something about the classroom that is causing the behavior. One thing you can do is get a psychologist to do a classroom observation.

We have wondered what it is about this classroom. Can anyone recommend a good child psychologist in the Rockville area?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get him a full evaluation by a developmental pediatrician or child psychologist and not just an evaluation for gross and fine motor issues which will be done by an OT. You need to know what the problem is first before you can address it. The anger issue can be from anxiety, ADHD, etc or nothing - the preschool can just be a bad fit but you won't know until you get a full evaluation.

Good luck!

While a full evaluation is a good idea, it could take up to 6 months to even get the appointment. You know what the behavior is so you can and should address it now. Regardless of what the evaluation shows, you're still going to have to experiment with several different wants to address the aggression, so that can start now with a visit to a child psychologist.

Also - since this is new behavior and a new school, you do have to consider whether or not it is something about the classroom that is causing the behavior. One thing you can do is get a psychologist to do a classroom observation.

We have wondered what it is about this classroom. Can anyone recommend a good child psychologist in the Rockville area?

I'm not sure about Rockville, but I think that Children's behavioral health outpatient clinic generally has shorter wait times than the developmental or neuropsych departments. And in fact, when I called over to Children's to ask for an appointment with developmental pediatrics, they told me that their policy is to send you to behavioral if the main issue is aggression and there is no underlying neurological condition.

[Anonymous]

I would not pick your son up from school if he acts out. That is likely a reward for him.

I would use the same tactic at school that you are using at home. If it is time out, then he gets a time out at school also.

I would also use a reward/behavior chart while he is at school. He gets a token for going to school, participating in each activity he is supposed to that day (art, circle, music etc), using gentle hands, gentle feet and for using his words. If he gets all of his tokens, he gets whatever it is he is working for that day.

Each day before drop off go through the rules for school. Use gentle hands, use gentle feet, use all your words etc.

Get on the waitlist now for a developmental pediatrician.

I would also meet with the teachers and see if there is a particular time of day these incidents occur (right before snack - he might be super hungry), or during transitions. I would try to determine if there is a trigger so you can teach him the appropriate response to that trigger.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get him a full evaluation by a developmental pediatrician or child psychologist and not just an evaluation for gross and fine motor issues which will be done by an OT. You need to know what the problem is first before you can address it. The anger issue can be from anxiety, ADHD, etc or nothing - the preschool can just be a bad fit but you won't know until you get a full evaluation.

Good luck!

While a full evaluation is a good idea, it could take up to 6 months to even get the appointment. You know what the behavior is so you can and should address it now. Regardless of what the evaluation shows, you're still going to have to experiment with several different wants to address the aggression, so that can start now with a visit to a child psychologist.

Also - since this is new behavior and a new school, you do have to consider whether or not it is something about the classroom that is causing the behavior. One thing you can do is get a psychologist to do a classroom observation.

We have wondered what it is about this classroom. Can anyone recommend a good child psychologist in the Rockville area?

I'm not sure about Rockville, but I think that Children's behavioral health outpatient clinic generally has shorter wait times than the developmental or neuropsych departments. And in fact, when I called over to Children's to ask for an appointment with developmental pediatrics, they told me that their policy is to send you to behavioral if the main issue is aggression and there is no underlying neurological condition.

Thank you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:With little kids installing zero tolerance policies when you have nothing to offer or help really doesn't work. It's a lot of you may not ever ever. Your child is upset and frustrated. The idea is not to forbid it, the idea is to help him. Be on his side. Don't make rules he can't possibly follow. A zero tolerance policy in your home? With what result? Expulsion?

Zero tolerance at home as in, you hit your sister, you're going to have a time out every single time it happens. We are on his side and we're not trying to make rules he can't follow, but don't hit or kick other people seem like pretty basic rules - and they're rules he has to follow in order to attend school.

Read Kazdin. While punishments have their place, the key is to develop and teach positive behaviors. At four years old, lecturs & time outs are not enough to teach positive behaviors.

Thanks, I'm going to pick this up later today.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get him a full evaluation by a developmental pediatrician or child psychologist and not just an evaluation for gross and fine motor issues which will be done by an OT. You need to know what the problem is first before you can address it. The anger issue can be from anxiety, ADHD, etc or nothing - the preschool can just be a bad fit but you won't know until you get a full evaluation.

Good luck!

While a full evaluation is a good idea, it could take up to 6 months to even get the appointment. You know what the behavior is so you can and should address it now. Regardless of what the evaluation shows, you're still going to have to experiment with several different wants to address the aggression, so that can start now with a visit to a child psychologist.

Also - since this is new behavior and a new school, you do have to consider whether or not it is something about the classroom that is causing the behavior. One thing you can do is get a psychologist to do a classroom observation.

We have wondered what it is about this classroom. Can anyone recommend a good child psychologist in the Rockville area?

I'm not sure about Rockville, but I think that Children's behavioral health outpatient clinic generally has shorter wait times than the developmental or neuropsych departments. And in fact, when I called over to Children's to ask for an appointment with developmental pediatrics, they told me that their policy is to send you to behavioral if the main issue is aggression and there is no underlying neurological condition.

Thank you.

no problem I hope it helps to know that this mama understands what you are going through - our boys sound very similar!

[Anonymous]

Anonymous wrote:I would not pick your son up from school if he acts out. That is likely a reward for him.

I would use the same tactic at school that you are using at home. If it is time out, then he gets a time out at school also.

I would also use a reward/behavior chart while he is at school. He gets a token for going to school, participating in each activity he is supposed to that day (art, circle, music etc), using gentle hands, gentle feet and for using his words. If he gets all of his tokens, he gets whatever it is he is working for that day.

Each day before drop off go through the rules for school. Use gentle hands, use gentle feet, use all your words etc.

Get on the waitlist now for a developmental pediatrician.

I would also meet with the teachers and see if there is a particular time of day these incidents occur (right before snack - he might be super hungry), or during transitions. I would try to determine if there is a trigger so you can teach him the appropriate response to that trigger.

Re: the picking him up - it may well be serving as a reward, but my thought was to try to stop what's happening at school. I don't want him to hurt other kids.

We've tried the behavior chart, both at school and at home, and we do the rules for school. There doesn't seem to be a single clear trigger, though transitions seems to be a common one - but it is not the only one.

I think part of the problem is what's happening at school when he has an incident - I don't think the teacher does react in the same way we do at home and while we've had multiple meetings to get on the same page, I think she at the very least talks more than we do at home. We try to keep things to a simple "we don't do x, I can't let you do x, etc." kind of thing.

I appreciate everyone's feedback - I've been replying but not saying I'm the OP. I really appreciate all of your feedback and advice, minus the vote for threatening and hitting him.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get him a full evaluation by a developmental pediatrician or child psychologist and not just an evaluation for gross and fine motor issues which will be done by an OT. You need to know what the problem is first before you can address it. The anger issue can be from anxiety, ADHD, etc or nothing - the preschool can just be a bad fit but you won't know until you get a full evaluation.

Good luck!

While a full evaluation is a good idea, it could take up to 6 months to even get the appointment. You know what the behavior is so you can and should address it now. Regardless of what the evaluation shows, you're still going to have to experiment with several different wants to address the aggression, so that can start now with a visit to a child psychologist.

Also - since this is new behavior and a new school, you do have to consider whether or not it is something about the classroom that is causing the behavior. One thing you can do is get a psychologist to do a classroom observation.

We have wondered what it is about this classroom. Can anyone recommend a good child psychologist in the Rockville area?

I'm not sure about Rockville, but I think that Children's behavioral health outpatient clinic generally has shorter wait times than the developmental or neuropsych departments. And in fact, when I called over to Children's to ask for an appointment with developmental pediatrics, they told me that their policy is to send you to behavioral if the main issue is aggression and there is no underlying neurological condition.

Thank you.

no problem I hope it helps to know that this mama understands what you are going through - our boys sound very similar!

It really does help - thank you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would think picking him up from school early is rewarding the behavior.

We don't do fun things when he comes home early - I worried about that too but school liked the idea and said they have done it before. My thought was if he is hurting others, removing him from the situation would be the best way to stop it.

We used to have this. Does he like school?

I thought that picking my son up early was totally counter productive.

On her other hand, an eval and IEP with services were helpful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would not pick your son up from school if he acts out. That is likely a reward for him.

I would use the same tactic at school that you are using at home. If it is time out, then he gets a time out at school also.

I would also use a reward/behavior chart while he is at school. He gets a token for going to school, participating in each activity he is supposed to that day (art, circle, music etc), using gentle hands, gentle feet and for using his words. If he gets all of his tokens, he gets whatever it is he is working for that day.

Each day before drop off go through the rules for school. Use gentle hands, use gentle feet, use all your words etc.

Get on the waitlist now for a developmental pediatrician.

I would also meet with the teachers and see if there is a particular time of day these incidents occur (right before snack - he might be super hungry), or during transitions. I would try to determine if there is a trigger so you can teach him the appropriate response to that trigger.

Re: the picking him up - it may well be serving as a reward, but my thought was to try to stop what's happening at school. I don't want him to hurt other kids.

We've tried the behavior chart, both at school and at home, and we do the rules for school. There doesn't seem to be a single clear trigger, though transitions seems to be a common one - but it is not the only one.

I think part of the problem is what's happening at school when he has an incident - I don't think the teacher does react in the same way we do at home and while we've had multiple meetings to get on the same page, I think she at the very least talks more than we do at home. We try to keep things to a simple "we don't do x, I can't let you do x, etc." kind of thing.

I appreciate everyone's feedback - I've been replying but not saying I'm the OP. I really appreciate all of your feedback and advice, minus the vote for threatening and hitting him.

You are doing a great job!! All of the tactics are hard to implement if the teacher is not on the same page 100%.. I had the little boy that hit and kicked also so just wanted to tell you to hang in there.

[Anonymous]

Why are people recommending an evaluation with an OT for a kid with GROSS motor delays? OP should have an evaluation by a physiatrist. Sarah Evans at CNMC is excellent and will refer you to PT if needed. The PT practice most people recommend in MoCo is Early Intervention Associates.

As for school currently, have you considered using a rewards chart? My kid has behavior issues too. At school he has a daily sheet for behavior/compliance and he needs to earn stickers for each activity in order to earn a small reward at the end of the day. It's working well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would not pick your son up from school if he acts out. That is likely a reward for him.

I would use the same tactic at school that you are using at home. If it is time out, then he gets a time out at school also.

I would also use a reward/behavior chart while he is at school. He gets a token for going to school, participating in each activity he is supposed to that day (art, circle, music etc), using gentle hands, gentle feet and for using his words. If he gets all of his tokens, he gets whatever it is he is working for that day.

Each day before drop off go through the rules for school. Use gentle hands, use gentle feet, use all your words etc.

Get on the waitlist now for a developmental pediatrician.

I would also meet with the teachers and see if there is a particular time of day these incidents occur (right before snack - he might be super hungry), or during transitions. I would try to determine if there is a trigger so you can teach him the appropriate response to that trigger.

Re: the picking him up - it may well be serving as a reward, but my thought was to try to stop what's happening at school. I don't want him to hurt other kids.

We've tried the behavior chart, both at school and at home, and we do the rules for school. There doesn't seem to be a single clear trigger, though transitions seems to be a common one - but it is not the only one.

I think part of the problem is what's happening at school when he has an incident - I don't think the teacher does react in the same way we do at home and while we've had multiple meetings to get on the same page, I think she at the very least talks more than we do at home. We try to keep things to a simple "we don't do x, I can't let you do x, etc." kind of thing.

I appreciate everyone's feedback - I've been replying but not saying I'm the OP. I really appreciate all of your feedback and advice, minus the vote for threatening and hitting him.

You are doing a great job!! All of the tactics are hard to implement if the teacher is not on the same page 100%.. I had the little boy that hit and kicked also so just wanted to tell you to hang in there.

Thank you. Everyone has been really helpful - I think this is the best advice I've ever read on DCUM.

[Anonymous]

How many kids are in the classroom and how much structure is there?

My child had aggressive behavior in pre k. She wanted to engage with the other kids but didn't know how. Plus, the school, by design, was uunstructured and let kids take the lead on activities and interactions. This stressed her out, but she didn't have the emotional vocabulary to tell us. When we got her in a more structured supportive school, the aggression completely disappeared.

For a psychologist, I recommend Paula Elitov. She will observe at school and make recommendations. For us, we also had her evaluate and make a provisional diagnosis, which worked well until we got a neuropsych a few years later.

[Anonymous]

Anonymous wrote:Why are people recommending an evaluation with an OT for a kid with GROSS motor delays? OP should have an evaluation by a physiatrist. Sarah Evans at CNMC is excellent and will refer you to PT if needed. The PT practice most people recommend in MoCo is Early Intervention Associates.

As for school currently, have you considered using a rewards chart? My kid has behavior issues too. At school he has a daily sheet for behavior/compliance and he needs to earn stickers for each activity in order to earn a small reward at the end of the day. It's working well.

Thanks for that recommendation. We have tried reward charts with no luck.

[Anonymous]

Anonymous wrote:How many kids are in the classroom and how much structure is there?

My child had aggressive behavior in pre k. She wanted to engage with the other kids but didn't know how. Plus, the school, by design, was uunstructured and let kids take the lead on activities and interactions. This stressed her out, but she didn't have the emotional vocabulary to tell us. When we got her in a more structured supportive school, the aggression completely disappeared.

For a psychologist, I recommend Paula Elitov. She will observe at school and make recommendations. For us, we also had her evaluate and make a provisional diagnosis, which worked well until we got a neuropsych a few years later.

Thanks for the recommendation. He is in a class of 10 with one lead and one assistant teacher. There is structure to the day but it isn't as rigid a structure as some other schools.