Here are some strategies that might be of help: Teach him labels for his emotions
Teach anger management skills( take a deep breath,count to ten, say a go to phrase to have time to calm down)
Be sure your rules for behavior are clear and be consistent in enforcing them(Consequences when rules are broken)

I agree with 9:39. You need to determine if he can control this or not. It may be that he can control it at the beginning but then it spirals out of his control and has to run its course. One of my kids had similar issues with self-regulation. He's now 12 and it's gotten so much better but he still has a very low frustration tolerance and rigidity that makes playing games difficult (he's a really bad loser and will accuse others of cheating - you can imagine how well that goes over with his peers).

It helped us to identify 'triggers'. We could then be prepared when we encountered a trigger unexpectedly to contain the tantrum and also to 'practice' losing in controlled environments. We developed appropriate consequences (positive and logical/natural) for when he was able to stay 'in control' and when he was 'out of control'.

If you don't think your DS is able to control this then I would gently suggest you consider keeping him on the medication until such time as he's able to develop better self-regulation. With my DS, he was on a long-acting stimulant during the week and a short acting one during 'prime time' on weekends. He's also been on an SSRI for the anxiety. Do not underestimate the impact of anxiety on his inability to self-regulate. The 'fight or flight' response is a primordial response. Two of my kids started SSRIs in ES but their anxiety manifests in very different ways. We should have started our youngest on it much earlier than we did. I just didn't recognize his behavior was anxiety based.

Anonymous wrote:OP here and I'm still reading. These are definitely tantrums from frustration at being told no or some perceived injustice. We've seen the occasional sensory meltdown, but those never involve aggression and those are about flight from the situation.

I hate to medicate on weekends because not only is he underweight but there's also an anxiety piece and although I did not post that other thread on anxiety it describes our situation. I had even been thinking we would take much of August off to see if there was any improvement. The other reason why I have been resistant is because so much of the day is fine. If I were to draw a graph it would be mostly plateaus punctuated by three or four spikes. We have tried other meds including a mood stabilizer which was disastrous.

Are the spikes consistent? Do they have to do with hunger?

Anonymous wrote:OP here and I'm still reading. These are definitely tantrums from frustration at being told no or some perceived injustice. We've seen the occasional sensory meltdown, but those never involve aggression and those are about flight from the situation.

I hate to medicate on weekends because not only is he underweight but there's also an anxiety piece and although I did not post that other thread on anxiety it describes our situation. I had even been thinking we would take much of August off to see if there was any improvement. The other reason why I have been resistant is because so much of the day is fine. If I were to draw a graph it would be mostly plateaus punctuated by three or four spikes. We have tried other meds including a mood stabilizer which was disastrous.

For some, it hard to deal with things unmedicated when you are not used to it. Constantly being on the medication roller coaster (on/off/on/off) can cause issues.