OT for 3 year old meltdowns? Or what do I try next?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m missing the why here. Why does he have the tantrums?

Does he not want to do what you ask? If so are your directions clear? Are you using visual supports? Are you consistent? Just because you think he fully understands doesn’t mean he does.

Does he have sensory issues?

Ultimately your child is emotionally dysregulated and needs tools to help him calm down. You have to teach these when he’s feeling fine.

When you go to the park for example you have to show him what you need him to do. Ex. We are going to walk in the park, to stay safe first you have to walk with mom then we can have fun. When we run from mom it’s not safe and we will have to go back.

You can have a picture of him next to you to remind him. When he’s unable you have to follow through and go back.

Nothing will be a magical cure, it’ll take a lot of practice and time.

You can also ask his teacher how he walks with the class around school.

And a schedule seems like generic advice but your doctor is right. Idk if they said a visual schedule but you should have one. And a first then board to help remind your child about what’s next. (NOT to incentivize your kid to listen. No first listen then candy, that doesn’t work long term)

Op here. He has tantrums most often because he wants something he cannot have. There are other times when we don’t know or understand why he’s melting down. Just this morning he had a tantrum because he wanted to wear my flip flops and I wouldn’t let him. Then he had a tantrum because he wanted us to go for a drive, but it wasn’t possible to do that this morning.

He does sometimes engage in sensory seeking behaviors, but I’m not sure if that means he has sensory issues? He is totally fine with eating any kind of food, wearing clothes, etc. those things don’t bother him. He does seem to get overstimulated with too much noise/activity, so we avoid situations like that.

I do try to walk him through the steps for different activities but haven’t tried visuals. I’m not sure if that would help. I can give it a try.

Is he your first? I only ask because this sounds like all my kids were at age 3!

This description also sounds normal to me, but the follow up description of screaming on the way to the pool and then 45 minutes poolside and basically the entire day because a screen was turned off does not strike me as typical but clearly there are some other posters that disagree!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Jeez that is tough OP. The challenges you describe with the meltdowns seems totally at odds with the dev ped blowing you off. Some parents have a low threshold for meltdowns and bad behavior, and immediately worry their kids have "something" going on. But given the list of all the assessments you've done, I feel like any good expert is going to see there is something more going on here than just typical 3 year old behavior.

Ultimately, I'd "guess" (obv not an expert - but just from our own experience and reading this forum for 8+ years) you eventually end up with one or more diagnoses of ADHD, ASD or anxiety - but some of those may not be easily diagnosable for many years. For instance, lots of kids from this forum don't get the ASD diagnosis when evaluated at age 5, but ultimately at age 8 or 10 get a "HFA" diagnosis. We can debate whether those kids really have "ASD", but it's at least recognizing they probably have always had something going on that makes them neurodiverse.

With that whole list of assessments, obviously your parent-gut is screaming out to you that there's still something going on here that's not being addressed. I'm not a "diagnosis shopper", but I would keep going to a dev ped, psychiatrist or neuropsych until I found someone to listen to me, that these aren't just normal 3 year old tantrums, but a kid that needs support.

I disagree a little bit with this- the fact that she has had multiple evals (developmental ped, neuropsych) that all basically said her kid was normal, to me, probably means that her kid is not neurodivergent and is just a difficult 3 year old having 3 year old tantrums that are in fact within the realm of normal, even if more intense than most other 3 year olds. Not that they were both brushing her off and that she needs to keep shopping around for more specialists. Just my two cents of course.

I hear you. But she has not had a neuropsych and it sounds like the developmenal pediatrician has been the same throughout, though it does sound like at 2 a neuropsychologist said no to autism. But a day long tantrum because the tv had to be turned off at an agreed upon time (op I'm assuming you gave appropriate warnings that this was last episode etc?) is just within no realm of typical. My son's behaviors are WAY less severe and we are taken pretty seriously about concerns for adhd.

Op what do teachers say? I know you said the tantrums don't happen at school which isn't that abnormal for some kids, but if the teachers also see no autism/adhd signs that is interesting.

Agree- I hadn't seen the update. Didn't realize the post was old.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Jeez that is tough OP. The challenges you describe with the meltdowns seems totally at odds with the dev ped blowing you off. Some parents have a low threshold for meltdowns and bad behavior, and immediately worry their kids have "something" going on. But given the list of all the assessments you've done, I feel like any good expert is going to see there is something more going on here than just typical 3 year old behavior.

Ultimately, I'd "guess" (obv not an expert - but just from our own experience and reading this forum for 8+ years) you eventually end up with one or more diagnoses of ADHD, ASD or anxiety - but some of those may not be easily diagnosable for many years. For instance, lots of kids from this forum don't get the ASD diagnosis when evaluated at age 5, but ultimately at age 8 or 10 get a "HFA" diagnosis. We can debate whether those kids really have "ASD", but it's at least recognizing they probably have always had something going on that makes them neurodiverse.

With that whole list of assessments, obviously your parent-gut is screaming out to you that there's still something going on here that's not being addressed. I'm not a "diagnosis shopper", but I would keep going to a dev ped, psychiatrist or neuropsych until I found someone to listen to me, that these aren't just normal 3 year old tantrums, but a kid that needs support.

I disagree a little bit with this- the fact that she has had multiple evals (developmental ped, neuropsych) that all basically said her kid was normal, to me, probably means that her kid is not neurodivergent and is just a difficult 3 year old having 3 year old tantrums that are in fact within the realm of normal, even if more intense than most other 3 year olds. Not that they were both brushing her off and that she needs to keep shopping around for more specialists. Just my two cents of course.

I hear you. But she has not had a neuropsych and it sounds like the developmenal pediatrician has been the same throughout, though it does sound like at 2 a neuropsychologist said no to autism. But a day long tantrum because the tv had to be turned off at an agreed upon time (op I'm assuming you gave appropriate warnings that this was last episode etc?) is just within no realm of typical. My son's behaviors are WAY less severe and we are taken pretty seriously about concerns for adhd.

Op what do teachers say? I know you said the tantrums don't happen at school which isn't that abnormal for some kids, but if the teachers also see no autism/adhd signs that is interesting.

Agree- I hadn't seen the update. Didn't realize the post was old.

Got it! that makes sense. I agree first post it wasn't clear and he was still young. But at 4 and the intensity going up so much, rather than down like you said. Tantrums more than 15-20 min often, is usually not considered within typical range. Tantrums, normal, even some at 4 but they should be shortening and lowering in intensity.