I'm the "my kid turned out to have celiac" PP. It is not a stool collection, as a different PP commented. Rather, the first step is typically a blood panel to check for antibodies (google "celiac panel"), with an endoscopy as the next step to look at the duodenum and take samples (biopsy) to examine under a microscope for villi damage.

My kid had been seeing a psychologist for help with extreme anxiety (after another psychologist, a family counselor, and a psychiatrist, not to mention developmental pediatrician, regular pediatrician, occupational therapists, and others not coming to mind right now - it was a long journey), and the psych observed that they'd only seen a few kids before with such extreme anxiety and one (or maybe more?) of them had turned out to be celiac, so let's screen for that.

I was surprised bc at the time my kid was tall for age, carrying extra weight, etc., and we'd always thought the stomach aches and headaches were related to the anxiety. Turned out, antibodies were off the charts.

If your doc only checked the TTG-IGA (antigliadin antibodies) and did not also check regular IGA levels (IGA deficiency will affect TTG-IGA levels) or other tests (e.g., EMA, TTG-IGG), then the full panel wasn't done. It's also possible to be seronegative yet celiac (you can find some of these examples on the forums at celiac.com or the reddit.com celiac subreddit).

Finally, it's also possible to be gluten-sensitive without having celiac. There was a flawed study a year or two ago that claimed to disprove the existence of non-celiac gluten-sensitivity, but I don't think it's determinative and anecdotally, it's quite a real phenomenon.

BTW, celiac (or other issues) can drive vitamin and mineral deficiencies that affect behavior as well - vitamin D, ferritin, B12, magnesium ... (Disclaimer: IANAD, but I have done a lot of reading on this topic.)

Good luck!

OP- our son had extreme tantrums like this at five, but he also had them at four, three, two,...and was eventually diagnosed with ADHD and social pragmatic impairments.

Here's the thing- my son's friend was worse and has no issues whatsoever at age eleven.

When we took DS to a therapist, she said there is a wide range of normal for a young five, and some of it may seem very extreme.

It's why you will have people tell you "that's not normal or your son has x, y, z" because they have been fortunate enough not to experience these types of meltdowns. Others will say "my kid did that and grew out of it or was diagnosed with x, y, z."

These kinds of meltdowns alone are something to watch, but more concerning if there are social problems, defiance, delayed speech/learning, and so forth.

As for screaming, hitting, throwing things...it can be normal at this age, especially if there is a chronic lack of sleep. My son's tantrums at 4.5- 5 almost put me on anti-anxiety meds and his ADHD is of the milder variety.

You *might* observe how well your DS plays with other children- not hitting/aggression because you would know that if it was an issue- but how well does he connect with other children? We thought our DS was doing great because he didn't get int altercations with classmates and we thought he was highly verbal because he his vocabulary and verbal reasoning skills were extremely advanced.

When I observed DS's preschool class, I noted that he didn't interact much with the other kids, tended to stay only in his interest area and be a little director if someone join his game, and he wasn't using that huge vocabulary to forge friendships.

Anonymous wrote:

Anonymous wrote:I agree with PPs who recommend ruling out medical causes and getting him more sleep (by any means necessary, even if it means moving little sib in with you for a week or two) and checking into medical causes. Explosive Child is great in the meantime.

If someone had told me to look into medical causes when DD was 5 and having intense meltdowns, we could have skipped the several years of difficult behavior and eventual psychiatric issues caused by her long-undiagnosed celiac disease. Really wish I could have those years back.

IMO, screening for gluten or other food sensitivities should be part of psych assessment; it would have been nice if any of the literally a dozen various professionals we saw for assistance might then have thought to check for it and rule it out.

PSA: Undiagnosed gluten sensitivity, both celiac and non-celiac, can manifest as anxiety, depression, irritability, raging, etc., as well as the more widely known GI symptoms, and it can affect people of any age, ethnicity, and weight. (Yes, celiacs can be overweight - the malabsorption can cause some people to experience ravenous appetite and bulk up, malnourished all the while, as was the case with my kid.)

OP here - how did you eventually get diagnosed? I have been worried about this as DS is quite small and fell off the growth curve at 3. He had some bloodwork done, including Antigliadin Abs, IgA that came back negative, but I remain concerned.

You do a stool collection.

Anonymous wrote:Often this happens when a kid is working harder than normal to keep it together at school. In my kid’s case it was due to hypersensitivity to all kinds of stimuli but particularly noise and anxiety. Didn’t have issues really until kindergarten because he spent more of the day away from home than ever before. Discipline is usually not a successful intervention, but lots of connection and comfort at home. (In addition to discovering and dealing with the underlying cause.)

This was the case with our DS. As it turned out, he has ASD (not suggesting at all that OP's son has ASD, just relating our story). He was so overwhelmed at school that he'd either pick a fight with his brother, melt into tears, or melt down in a fit as soon as he got home.

I would suggest as first step to address the basics. Make sure he has a good diet and that he's eating something as soon as he gets home if not on the way home. Address the sleep issue. Establish a solid family routine and don't disrupt it even on weekends. If he's not getting the basics, his ability to cope with stress will be drastically diminished. After you've done this for a couple of weeks, if he's still not able to control is meltdowns, then seek a professional evaluation.

Anonymous wrote:I agree with PPs who recommend ruling out medical causes and getting him more sleep (by any means necessary, even if it means moving little sib in with you for a week or two) and checking into medical causes. Explosive Child is great in the meantime.

If someone had told me to look into medical causes when DD was 5 and having intense meltdowns, we could have skipped the several years of difficult behavior and eventual psychiatric issues caused by her long-undiagnosed celiac disease. Really wish I could have those years back.

IMO, screening for gluten or other food sensitivities should be part of psych assessment; it would have been nice if any of the literally a dozen various professionals we saw for assistance might then have thought to check for it and rule it out.

PSA: Undiagnosed gluten sensitivity, both celiac and non-celiac, can manifest as anxiety, depression, irritability, raging, etc., as well as the more widely known GI symptoms, and it can affect people of any age, ethnicity, and weight. (Yes, celiacs can be overweight - the malabsorption can cause some people to experience ravenous appetite and bulk up, malnourished all the while, as was the case with my kid.)

OP here - how did you eventually get diagnosed? I have been worried about this as DS is quite small and fell off the growth curve at 3. He had some bloodwork done, including Antigliadin Abs, IgA that came back negative, but I remain concerned.

Thank you all for these helpful suggestions!

Often this happens when a kid is working harder than normal to keep it together at school. In my kid’s case it was due to hypersensitivity to all kinds of stimuli but particularly noise and anxiety. Didn’t have issues really until kindergarten because he spent more of the day away from home than ever before. Discipline is usually not a successful intervention, but lots of connection and comfort at home. (In addition to discovering and dealing with the underlying cause.)

I agree with PPs who recommend ruling out medical causes and getting him more sleep (by any means necessary, even if it means moving little sib in with you for a week or two) and checking into medical causes. Explosive Child is great in the meantime.

If someone had told me to look into medical causes when DD was 5 and having intense meltdowns, we could have skipped the several years of difficult behavior and eventual psychiatric issues caused by her long-undiagnosed celiac disease. Really wish I could have those years back.

IMO, screening for gluten or other food sensitivities should be part of psych assessment; it would have been nice if any of the literally a dozen various professionals we saw for assistance might then have thought to check for it and rule it out.

PSA: Undiagnosed gluten sensitivity, both celiac and non-celiac, can manifest as anxiety, depression, irritability, raging, etc., as well as the more widely known GI symptoms, and it can affect people of any age, ethnicity, and weight. (Yes, celiacs can be overweight - the malabsorption can cause some people to experience ravenous appetite and bulk up, malnourished all the while, as was the case with my kid.)

Hitting and biting and losing control daily at 5 is not normal.

Daily tantrums are not normal at that age! Seek out a doctors advice.

I actually had a phone appointment with my pediatrician about my 5.5 year old's angry outbursts. DD is a model student but loses it at home. The ped had some good practical suggestions but basically said my expectations are too high and I need to let her be a kid, which means tantrums. DD is not that far removed from toddler hood, plus K is stressful. I need to listen and reassure, not impose consequences which just escalate things. She is a fan of the ahaparenting website and also of guided meditation ("feel your toes, they're relaxing...") at bedtime.

There have been a ton of posts lately about emotional 5 yo, because of K starting. YMMV but talk to your ped.

Are these tantrums a new thing? I’d look into a possible medical cause. The other thing I would look at is a social skills group. Something like unstuck and on target which helps teach flexibility.

Sounds a lot like mine at that age. We did go to a psychologist and were told he was within the range of normal (whatever that means) but that he had impulse control problems. Psychologist said a lot of kids even out in 1st grade, and we did see marked improvement over that year, but even now (at 8) he still struggles at times (no where near as bad as he was at 4-5 though). If you think its something more than impulse control issues, then maybe it's worth the trip for some peace of mind. We also did one of those parenting a difficult child classes which helped with some strategies for how to try to manage behavior so that tantrums decreased (moderate success on that front).

Get your kid more sleep before you see a psychologist.

DS is a couple months shy of 5. Bright, reads above grade level, friendly, extremely verbal, and has never had problems at preschool- teachers adore him. At home, however, he frequently goes to pieces - almost daily - with tantrums where he can't calm down - hitting and biting (though he'll try to restrain himself and hit/bite something that's not a person but it doesn't always work), screaming, throwing stuff. We've tried strategies like breathing, counting to ten but he will even say after the tantrum that he can't calm down.

He is a kid that also needs a lot of sleep and I know is not getting enough because of a short nap at school and sharing a room (by necessity) with a noisy little brother that wakes up early. I am reading the Explosive Child right now but curious if people have thoughts if this sounds like a child that should have an evaluation from a psychologist. Thanks!