Anonymous
Post 09/03/2017 20:11     Subject: Re:Meds for Explosive Child
Anonymous wrote:OP here -- ped appointment on Friday went well. He says that we should acknowledge that this behavior is beyond the originally-thought PTSD and this might just be who she is. So what to do? He recommended that we see a psychiatrist along with the psychologist. No diagnosis at this point, and the psychologist hasn't offered one either. Ped did say we'd probably need a diagnosis for an IEP (any experience there, anyone?). Ped did say he leans against meds for 5 year olds, but would discuss with psychologist. He also said he didn't think a developmental pediatrician was needed-- no cognitive or sensory issues--just impulsive tendencies. Not EDD, but too early to know ADD or ODD.

Does this sound on target? Next step is the psychiatrist, I guess. I don't feel like we are any closer to anything. I'm dreading school next week.


The IEP would be based on emotional disability that causes severe behavioral problems that interfere with her ability to be in the classroom and learn.

You need to seek out a therapist that has specific experience dealing with kids with PTSD and helping parents/teachers with their parenting skills. It sounds like your psychologist isnt it. The school could also have some good behavioral ideas (not necessarily, but they might).
Anonymous
Post 09/03/2017 20:08     Subject: Meds for Explosive Child
^^^ Oh, and don't worry too much, just take each day as it comes. The start of school can be bumpy, many of us have been there. But with the right supports, most children do well.
Anonymous
Post 09/03/2017 20:06     Subject: Re:Meds for Explosive Child
Anonymous wrote:OP here -- ped appointment on Friday went well. He says that we should acknowledge that this behavior is beyond the originally-thought PTSD and this might just be who she is. So what to do? He recommended that we see a psychiatrist along with the psychologist. No diagnosis at this point, and the psychologist hasn't offered one either. Ped did say we'd probably need a diagnosis for an IEP (any experience there, anyone?). Ped did say he leans against meds for 5 year olds, but would discuss with psychologist. He also said he didn't think a developmental pediatrician was needed-- no cognitive or sensory issues--just impulsive tendencies. Not EDD, but too early to know ADD or ODD.

Does this sound on target? Next step is the psychiatrist, I guess. I don't feel like we are any closer to anything. I'm dreading school next week.

See either a child psychiatrist or developmental pediatrician, whichever is either. Many 5-year olds are medicated, but you definitely want a doctor who is experienced with doing it, not a regular pediatrician or psychologist.

For school, the main issue is educational impact. Discuss your concerns with the teacher and ask her to alert you to any behavioral issues or failure to do school work. Unless he really acts up from the beginning (mine did) it may take a few weeks until the teacher gets to know your kid. If there are issues at school, you'll want to a request an IEP. You don't need a diagnosis to start, the school has to evaluate. Meanwhile you can submit any reports from your own doctors for the school to include in their evaluation.
Anonymous
Post 09/03/2017 19:48     Subject: Re:Meds for Explosive Child
OP here -- ped appointment on Friday went well. He says that we should acknowledge that this behavior is beyond the originally-thought PTSD and this might just be who she is. So what to do? He recommended that we see a psychiatrist along with the psychologist. No diagnosis at this point, and the psychologist hasn't offered one either. Ped did say we'd probably need a diagnosis for an IEP (any experience there, anyone?). Ped did say he leans against meds for 5 year olds, but would discuss with psychologist. He also said he didn't think a developmental pediatrician was needed-- no cognitive or sensory issues--just impulsive tendencies. Not EDD, but too early to know ADD or ODD.

Does this sound on target? Next step is the psychiatrist, I guess. I don't feel like we are any closer to anything. I'm dreading school next week.
Anonymous
Post 09/03/2017 14:42     Subject: Meds for Explosive Child
Anonymous wrote:If the wait for a neuropsych or devped is forever, you could try a child psychiatrist. There may be medications that could be tried.


Posted too soon...not a doctor so not sure how the PTSD would factor into meds, but there's stimulants, anti-anxiety, and also risperdal, which has helped DS quite a bit in terms of lessening the intensity of his outbursts (but he has ADHD/HFA)...now he's more grumpy than explosive when something abruptly gets to him.
Anonymous
Post 09/03/2017 14:30     Subject: Meds for Explosive Child
If the wait for a neuropsych or devped is forever, you could try a child psychiatrist. There may be medications that could be tried.
Anonymous
Post 09/01/2017 13:59     Subject: Re:Meds for Explosive Child
Anonymous wrote:OP here -- yes, Child's pediatrician has called it PTSD following the traumatic event, hence the play therapy to work through that. While the outbursts are perhaps less frequent, they are very explosive and totally random.

Thank you for the IEP suggestion. I think that's in our favor and have reached out to the school guidance counselor to get the ball rolling.


Good first step OP. To the extent that the behavior impacts your parenting, that's why you need to do something in addition to play therapy. You need support in learning how to adjust your parenting.
Anonymous
Post 09/01/2017 13:57     Subject: Meds for Explosive Child
Make sure that the school does in-classroom observations to help figure out what the trigger are and develops a behavioral intervention plan. Schools often would rather put a kid in a self-contained classroom than pay for a one-on-one aide, but having typically functioning peers as role models can make a big difference for some kids (for others, the small class size of a self-contained class can be really helpful).
Anonymous
Post 09/01/2017 11:28     Subject: Re:Meds for Explosive Child
OP here -- yes, Child's pediatrician has called it PTSD following the traumatic event, hence the play therapy to work through that. While the outbursts are perhaps less frequent, they are very explosive and totally random.

Thank you for the IEP suggestion. I think that's in our favor and have reached out to the school guidance counselor to get the ball rolling.
Anonymous
Post 09/01/2017 10:24     Subject: Meds for Explosive Child
Our experience in K was that the school treated DS's outbursts as entirely behavioral even though it turned out he has ADHD, ASD and significant anxiety. I'm not saying that your child has ASD, but that when we approached the school from the point of view that DS has a diagnosed condition, their management of him improved significantly.

We also did Strattera for a couple of years and noted a huge improvement in behavior. It unfortunately didn't do anything for his focus issues, though.
Anonymous
Post 09/01/2017 10:19     Subject: Meds for Explosive Child
OP, are you saying your child started having explosive tantrums after the traumatic event? Could it be ptsd?
Anonymous
Post 09/01/2017 09:55     Subject: Re:Meds for Explosive Child
Anonymous wrote:
Anonymous wrote:OP here -- that is interesting about dyes/diet. Thank you -- doesn't hurt to look into it.

Re: what we do -- at home, we ignore the behavior and don't reward tantrums/give into demands. Child usually cools quickly. Ignoring is not as easy in the classroom, when Child is flipping chairs or physically swiping at students. This is what I fear most. Can they kick you out of kindergarten?! Kidding. Kind of.

There's no rhyme or reason or pattern to outbursts (hunger, tired, etc.). It's generally when Child has an idea of how things will go, and reality doesn't match up.


yes, children can be expelled from kindergarten. you need to start the school asessment process asap both to get adequate support and protect your child from harsh discipline that will make it all worse.

btdt!



If it's anxiety driven you need more than the standard tantrum approach. He needs someone to step in before it happens and help him from that point. He cannot control it in the moment. And yes they can kick him out.

I had a child like this, I hope you find more useful help.

Mine is now 26 and still blows up easily, but not violent anymore.
Anonymous
Post 09/01/2017 09:00     Subject: Re:Meds for Explosive Child
OP here -- thanks for the thoughtful and helpful suggestions. I'm on hold with KKI now and am anticipating the ped appt today for his guidance.
Anonymous
Post 08/31/2017 22:18     Subject: Re:Meds for Explosive Child
Anonymous wrote:OP here -- that is interesting about dyes/diet. Thank you -- doesn't hurt to look into it.

Re: what we do -- at home, we ignore the behavior and don't reward tantrums/give into demands. Child usually cools quickly. Ignoring is not as easy in the classroom, when Child is flipping chairs or physically swiping at students. This is what I fear most. Can they kick you out of kindergarten?! Kidding. Kind of.

There's no rhyme or reason or pattern to outbursts (hunger, tired, etc.). It's generally when Child has an idea of how things will go, and reality doesn't match up.


yes, children can be expelled from kindergarten. you need to start the school asessment process asap both to get adequate support and protect your child from harsh discipline that will make it all worse.

btdt!

Anonymous
Post 08/31/2017 22:15     Subject: Meds for Explosive Child
You need parenting therapy/family therapy, not play therapy. This sounds psychological and behavioral, not developmental.

Have you called Children's? It can be faster to see their behavioral psych group than the dev peds.

There are also Kazdin-trained therapists who do Skype therapy. Look on Kazdin's website at Yale.

You also should start the IEP process at school asap.

Finally, many OTs can do good work on emotional regulation. An OT you trust is also just a good ally for you and it's good for your kid to have another positive adult to bond to and spend 1:1 time with.