Does my kid need an evaluation or do I need a parenting coach?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That sounds tough. I think an eval AND a parenting coach in order-not because you are causing the issues but because kids with intense temperaments (and perhaps adhd, etc) can be really challenging and there is good evidence that specific parenting techniques can make a big difference. Id probably wait on a parenting classes/coaching till after an evaluation though so you have a better idea what of the nature of the issues. Good luck!

not a parenting coach. an actual trained behavioral psychologist who knows evidence-based methods to address disruptive behavior.

start out with reading Kazdin, Parenting the Defiant Child. https://alankazdin.com/

you can also seek out an evaluation, but evaluations a) take a long time and b) don't provide you any actual therapy, or even much insight into therapy. our aggressive DS actually did get an autism diagnosis in the middle of trying to figure out his behavioral issue, but the autism diagnosis was literally useless. it was one day with a psychologist who we never saw again. all she said was "get behavioral therapy for aggression and work on social skills." gee thanks!

if they wait for an evaluation, it will be another six months of letting these dysfunctional patterns escalate, and could get much, much worse. ask me how I know. especially with a smaller sib in the house, the aggression needs to be dealt with ASAP.

here's a starting place for therapy: http://www.pcit.org/

Also, I just wanted to address the notion that there's nothing that can be done until "you have a better idea of the nature of the issues." That's the single most harmful attitude we encountered when we started to deal with my DS's disruptive behaviors. OP already KNOWS the nature of the issues - her son is disruptive and physically aggressive, and she and her DH do not have parenting tools to deal with it. Sure there could be an underlying diagnosis, but that has nothing at all to do with the actual challenge, which is obvious.

The most effective techniques really do vary based on the nature of the issue-best parenting practices for autism spectrum vs incipient odd or dmdd (though he is too young for that diagnosis at this point) have overlap but it would absolutely help to know. And by parenting coach I did mean a skilled person a la kazdin method trained or even their parenting course not some part-time life coach but yes, good to be specific.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That sounds tough. I think an eval AND a parenting coach in order-not because you are causing the issues but because kids with intense temperaments (and perhaps adhd, etc) can be really challenging and there is good evidence that specific parenting techniques can make a big difference. Id probably wait on a parenting classes/coaching till after an evaluation though so you have a better idea what of the nature of the issues. Good luck!

not a parenting coach. an actual trained behavioral psychologist who knows evidence-based methods to address disruptive behavior.

start out with reading Kazdin, Parenting the Defiant Child. https://alankazdin.com/

you can also seek out an evaluation, but evaluations a) take a long time and b) don't provide you any actual therapy, or even much insight into therapy. our aggressive DS actually did get an autism diagnosis in the middle of trying to figure out his behavioral issue, but the autism diagnosis was literally useless. it was one day with a psychologist who we never saw again. all she said was "get behavioral therapy for aggression and work on social skills." gee thanks!

if they wait for an evaluation, it will be another six months of letting these dysfunctional patterns escalate, and could get much, much worse. ask me how I know. especially with a smaller sib in the house, the aggression needs to be dealt with ASAP.

here's a starting place for therapy: http://www.pcit.org/

Also, I just wanted to address the notion that there's nothing that can be done until "you have a better idea of the nature of the issues." That's the single most harmful attitude we encountered when we started to deal with my DS's disruptive behaviors. OP already KNOWS the nature of the issues - her son is disruptive and physically aggressive, and she and her DH do not have parenting tools to deal with it. Sure there could be an underlying diagnosis, but that has nothing at all to do with the actual challenge, which is obvious.

The most effective techniques really do vary based on the nature of the issue-best parenting practices for autism spectrum vs incipient odd or dmdd (though he is too young for that diagnosis at this point) have overlap but it would absolutely help to know. And by parenting coach I did mean a skilled person a la kazdin method trained or even their parenting course not some part-time life coach but yes, good to be specific.

No, they don't. Our behavioral therapist said she would use the same techniques regardless of the diagnosis. If they didn't work, then yes, she would have referred on to a specialist. It might "help" to know in the sense that more information can be helpful, but it is absolutely not helpful or necessary to refuse to take steps to help a child with his obvious challenges until you get the results of the mythical evaluation.

And again, no, a "skilled person" is not the answer. "A trained and well-supervised pyschologist" is the answer.

[Anonymous]

Anonymous wrote:Sorry OP again- how do I find such a person? Ask pediatrician for recommendations? Is Children's Hospital good?

Are you in DC or VA? I suggest heading over to the Special Needs forum and asking for recommendations. Children's is good but notoriously hard to schedule. They do have a behavioral therapy clinic, but it's located in a far-flung suburb.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sorry OP again- how do I find such a person? Ask pediatrician for recommendations? Is Children's Hospital good?

Are you in DC or VA? I suggest heading over to the Special Needs forum and asking for recommendations. Children's is good but notoriously hard to schedule. They do have a behavioral therapy clinic, but it's located in a far-flung suburb.

... although come to think of it, it's possible it's all much easier to access now with telehealth! our therapist worked almost exclusively with the parents. she only saw our DS one time, and that was more for her to see him in person and get a brief sense of how we interact with him. so it could be very feasible to do the parenting therapy entirely online.


If you went with the full-on Parent-Child Interaction Therapy, I think this could be done online as well, but not sure. There is a significant component where they coach you on interacting with your child in real time. We didn't end up doing it because we did therapy "backwards" because we had to work on extinguishing dangerous behaviors right away, which is more focused on the parents.

[Anonymous]

Anonymous wrote:OP here- thanks all, appreciate the suggestions.

He gets lot of outside time- at daycare during the week and then on the weekends. Sometimes we do additional outside time after daycare but he plays hard and already seems exhausted. We rarely allow screen time during the week- occasionally in the morning but the evening routine is short playime, dinner, books, bed by 730pm. I don't want to take away books as punishment, so I'm always at a loss over punishment for hitting besides a time out. Sometime I think he does need an even earlier bedtime but I struggle to get the 1yo down before 7. My book time with him is after this. I will try harder though- maybe we skip playtime and go straight to dinner.

But yeah, clearly we do not have the tools to parent him so i'll look for the psychologist for some help. Thanks again.

Guess what we ended up having to do? Giving him regular screen time in the evenings so it could be taken away as a consequence! It worked like a charm. At the age when we started therapy, screen time was pretty much the only privilege that was important enough to him to make a difference. All it takes is say one show every night to do the trick.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That sounds tough. I think an eval AND a parenting coach in order-not because you are causing the issues but because kids with intense temperaments (and perhaps adhd, etc) can be really challenging and there is good evidence that specific parenting techniques can make a big difference. Id probably wait on a parenting classes/coaching till after an evaluation though so you have a better idea what of the nature of the issues. Good luck!

not a parenting coach. an actual trained behavioral psychologist who knows evidence-based methods to address disruptive behavior.

start out with reading Kazdin, Parenting the Defiant Child. https://alankazdin.com/

you can also seek out an evaluation, but evaluations a) take a long time and b) don't provide you any actual therapy, or even much insight into therapy. our aggressive DS actually did get an autism diagnosis in the middle of trying to figure out his behavioral issue, but the autism diagnosis was literally useless. it was one day with a psychologist who we never saw again. all she said was "get behavioral therapy for aggression and work on social skills." gee thanks!

if they wait for an evaluation, it will be another six months of letting these dysfunctional patterns escalate, and could get much, much worse. ask me how I know. especially with a smaller sib in the house, the aggression needs to be dealt with ASAP.

here's a starting place for therapy: http://www.pcit.org/

Also, I just wanted to address the notion that there's nothing that can be done until "you have a better idea of the nature of the issues." That's the single most harmful attitude we encountered when we started to deal with my DS's disruptive behaviors. OP already KNOWS the nature of the issues - her son is disruptive and physically aggressive, and she and her DH do not have parenting tools to deal with it. Sure there could be an underlying diagnosis, but that has nothing at all to do with the actual challenge, which is obvious.

The most effective techniques really do vary based on the nature of the issue-best parenting practices for autism spectrum vs incipient odd or dmdd (though he is too young for that diagnosis at this point) have overlap but it would absolutely help to know. And by parenting coach I did mean a skilled person a la kazdin method trained or even their parenting course not some part-time life coach but yes, good to be specific.

No, they don't. Our behavioral therapist said she would use the same techniques regardless of the diagnosis. If they didn't work, then yes, she would have referred on to a specialist. It might "help" to know in the sense that more information can be helpful, but it is absolutely not helpful or necessary to refuse to take steps to help a child with his obvious challenges until you get the results of the mythical evaluation.

And again, no, a "skilled person" is not the answer. "A trained and well-supervised pyschologist" is the answer.

There is overlap in techniques but it it’s absolutely false that it’s one size fits all-that’s absurd. Source-I am a mental health professional.

[Anonymous]

http://rachel-bailey.com/

Rachel Bailey has a podcast and YouTube page and Facebook page for the podcast where you can sometimes ask questions. Or schedule a Zoom with her directly. She is extremely helpful at understanding behavior and also used to be an ADHD coach and has some kind of positive discipline credential.

You can also join her academy for more support. I would try something with her while you are also pursuing other avenues. She will have things for you to try but is also not shy about recommending other experts if needed. She has extremely practical tips.

[Anonymous]

How much does he nap? It could be a simple as being tired, which you already observed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That sounds tough. I think an eval AND a parenting coach in order-not because you are causing the issues but because kids with intense temperaments (and perhaps adhd, etc) can be really challenging and there is good evidence that specific parenting techniques can make a big difference. Id probably wait on a parenting classes/coaching till after an evaluation though so you have a better idea what of the nature of the issues. Good luck!

not a parenting coach. an actual trained behavioral psychologist who knows evidence-based methods to address disruptive behavior.

start out with reading Kazdin, Parenting the Defiant Child. https://alankazdin.com/

you can also seek out an evaluation, but evaluations a) take a long time and b) don't provide you any actual therapy, or even much insight into therapy. our aggressive DS actually did get an autism diagnosis in the middle of trying to figure out his behavioral issue, but the autism diagnosis was literally useless. it was one day with a psychologist who we never saw again. all she said was "get behavioral therapy for aggression and work on social skills." gee thanks!

if they wait for an evaluation, it will be another six months of letting these dysfunctional patterns escalate, and could get much, much worse. ask me how I know. especially with a smaller sib in the house, the aggression needs to be dealt with ASAP.

here's a starting place for therapy: http://www.pcit.org/

Also, I just wanted to address the notion that there's nothing that can be done until "you have a better idea of the nature of the issues." That's the single most harmful attitude we encountered when we started to deal with my DS's disruptive behaviors. OP already KNOWS the nature of the issues - her son is disruptive and physically aggressive, and she and her DH do not have parenting tools to deal with it. Sure there could be an underlying diagnosis, but that has nothing at all to do with the actual challenge, which is obvious.

The most effective techniques really do vary based on the nature of the issue-best parenting practices for autism spectrum vs incipient odd or dmdd (though he is too young for that diagnosis at this point) have overlap but it would absolutely help to know. And by parenting coach I did mean a skilled person a la kazdin method trained or even their parenting course not some part-time life coach but yes, good to be specific.

No, they don't. Our behavioral therapist said she would use the same techniques regardless of the diagnosis. If they didn't work, then yes, she would have referred on to a specialist. It might "help" to know in the sense that more information can be helpful, but it is absolutely not helpful or necessary to refuse to take steps to help a child with his obvious challenges until you get the results of the mythical evaluation.

And again, no, a "skilled person" is not the answer. "A trained and well-supervised pyschologist" is the answer.

There is overlap in techniques but it it’s absolutely false that it’s one size fits all-that’s absurd. Source-I am a mental health professional.

are you trained in PCIT or other specific behavioral modification therapies to address distruptive behaviors?

it’s not one size fits all, but from OP’s description, any well trained behavioral therapist will be able to help.

[Anonymous]

Anonymous wrote:http://rachel-bailey.com/

Rachel Bailey has a podcast and YouTube page and Facebook page for the podcast where you can sometimes ask questions. Or schedule a Zoom with her directly. She is extremely helpful at understanding behavior and also used to be an ADHD coach and has some kind of positive discipline credential.

You can also join her academy for more support. I would try something with her while you are also pursuing other avenues. She will have things for you to try but is also not shy about recommending other experts if needed. She has extremely practical tips.

I would not waste money or time on this. There are many well trained therapists with experience treating disruptive behaviors.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That sounds tough. I think an eval AND a parenting coach in order-not because you are causing the issues but because kids with intense temperaments (and perhaps adhd, etc) can be really challenging and there is good evidence that specific parenting techniques can make a big difference. Id probably wait on a parenting classes/coaching till after an evaluation though so you have a better idea what of the nature of the issues. Good luck!

not a parenting coach. an actual trained behavioral psychologist who knows evidence-based methods to address disruptive behavior.

start out with reading Kazdin, Parenting the Defiant Child. https://alankazdin.com/

you can also seek out an evaluation, but evaluations a) take a long time and b) don't provide you any actual therapy, or even much insight into therapy. our aggressive DS actually did get an autism diagnosis in the middle of trying to figure out his behavioral issue, but the autism diagnosis was literally useless. it was one day with a psychologist who we never saw again. all she said was "get behavioral therapy for aggression and work on social skills." gee thanks!

if they wait for an evaluation, it will be another six months of letting these dysfunctional patterns escalate, and could get much, much worse. ask me how I know. especially with a smaller sib in the house, the aggression needs to be dealt with ASAP.

here's a starting place for therapy: http://www.pcit.org/

Also, I just wanted to address the notion that there's nothing that can be done until "you have a better idea of the nature of the issues." That's the single most harmful attitude we encountered when we started to deal with my DS's disruptive behaviors. OP already KNOWS the nature of the issues - her son is disruptive and physically aggressive, and she and her DH do not have parenting tools to deal with it. Sure there could be an underlying diagnosis, but that has nothing at all to do with the actual challenge, which is obvious.

The most effective techniques really do vary based on the nature of the issue-best parenting practices for autism spectrum vs incipient odd or dmdd (though he is too young for that diagnosis at this point) have overlap but it would absolutely help to know. And by parenting coach I did mean a skilled person a la kazdin method trained or even their parenting course not some part-time life coach but yes, good to be specific.

No, they don't. Our behavioral therapist said she would use the same techniques regardless of the diagnosis. If they didn't work, then yes, she would have referred on to a specialist. It might "help" to know in the sense that more information can be helpful, but it is absolutely not helpful or necessary to refuse to take steps to help a child with his obvious challenges until you get the results of the mythical evaluation.

And again, no, a "skilled person" is not the answer. "A trained and well-supervised pyschologist" is the answer.

There is overlap in techniques but it it’s absolutely false that it’s one size fits all-that’s absurd. Source-I am a mental health professional.

are you trained in PCIT or other specific behavioral modification therapies to address distruptive behaviors?

it’s not one size fits all, but from OP’s description, any well trained behavioral therapist will be able to help.

It seems behavioral therapy has been helpful to your family-that’s great iand t’s a good fit for many patients and for specific disorders but it’s not remotely the best only legitimate treatment for behavioral issues in early childhood and if your child’s therapist says it is they need to be better trained. But it IS great that it seems to have worked for your family.

[Anonymous]

Sounds like he has to keep it together all day long/make good choices all day at preschool, so then when he gets into the comfort of being at home he can let it all out.

Plus, it could be a combo of the above plus seeking your undivided attention. Negative attention (you yelling at him, time outs, etc) is still better than no attention (ie 1:1 time together; no younger sibling in the way) from you.

Does he nap at preschool? If so, he might be re-energized. Do you have outlets for him? Are there any triggers that cause tantrums (transitions, needing a snack, etc.)?

[Anonymous]

Anonymous wrote:

Anonymous wrote:http://rachel-bailey.com/

Rachel Bailey has a podcast and YouTube page and Facebook page for the podcast where you can sometimes ask questions. Or schedule a Zoom with her directly. She is extremely helpful at understanding behavior and also used to be an ADHD coach and has some kind of positive discipline credential.

You can also join her academy for more support. I would try something with her while you are also pursuing other avenues. She will have things for you to try but is also not shy about recommending other experts if needed. She has extremely practical tips.

I would not waste money or time on this. There are many well trained therapists with experience treating disruptive behaviors.

I posted about Rachel Bailey. I'm curious why you think seeing her would be wasting time or money. She is phenomenal. She is also trained as a therapist, for that matter. I only posted about some of her free resources so OP could get an idea of how she presents things, but I have also met with her individually and in the academy. We did try therapy before finding her. For us, that therapist was the wasted money.

[Anonymous]

My 4 year old does everything by himself at preschool, but he relies on me to do everything at home, eg wear sock, shoes, wipe butt etc. He says he can’t do it, but his teachers tell me that he can do it. He cleans up at preschool, but he makes a mess at one all the time.

Well, he is suspicious of adhd by children hospital because of his hyperactive behavior (well behaved at school, but more naughty at home), talking a lot ( but he can read book or do things for hours for no talking), a bit emotional ( well behaved at school & okay at home). He has no anger issue, just sometimes he cannot still sit.

[Anonymous]

Anonymous wrote:My 4 year old does everything by himself at preschool, but he relies on me to do everything at home, eg wear sock, shoes, wipe butt etc. He says he can’t do it, but his teachers tell me that he can do it. He cleans up at preschool, but he makes a mess at one all the time.

Well, he is suspicious of adhd by children hospital because of his hyperactive behavior (well behaved at school, but more naughty at home), talking a lot ( but he can read book or do things for hours for no talking), a bit emotional ( well behaved at school & okay at home). He has no anger issue, just sometimes he cannot still sit.

Yikes this sounds like my kid- did you suspect adhd or did they bring it up?