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How to handle a violent 4 year old? Her outbursts come on suddenly, often without warning or any opportunity to de-escalate. They may be triggered by a request to brush her hair in the morning, or by the fact that she learned there will be salad at dinner, the car is too hot, or some other seemingly mundane detail. When she gets out-of-control upset, there is some combination of screaming, hitting, kicking, scratching, throwing things at her parents, etc.
I feel like there is a disconnect somewhere. When she’s calm, and when asked, she will recite any number of healthy ways to express her anger and frustration. Options include hitting her pillow, stomping, “being a turtle” (calming technique a therapist taught her), drawing her feelings, asking for her “calm jar” (a bottle with glitter that can be shaken), etc. But she goes SOO quickly from calm, to out-of-control angry and irrational. When she’s calm, sure, she’s an expert on healthy coping techniques. But when she gets out of control angry, she can’t control herself, much less think rationally about a healthier way to cope with her emotions.
Therapist recommended putting her in time out for 4 minutes (1 minute per year of age). Once the 4 minutes are up, if she is calm and ready to apologize, she may come out, apologize, and is given a small task she can do to make it all better. If she’s not calmed down after 4 minutes, she gets another 4 minutes of time out, until she is calm. We’ve taken anything out of her room that can be used as a weapon or used for destruction. When she is in her room, she’ll kick the door over and over, and/or open the door and slam it against the wall hard enough to break a hole in the wall. This happened twice in the past couple months. What to do?
She struggles much more with transitions than the average kid.
We’ve just started therapy a couple weeks ago, but I welcome any advice or ideas anyone here has.
Consider a complete physical, top to bottom. Family history, what she ordinarily eats, her schedule. Consider screening her for Special Education - there is usually a pre-Kinder or Kinder component, depending on where you live - suburban is most likely. You can hope it's something fairly straightforward - an imbalance in her body chemistry that's relatively treatable.
What does the therapist say? He or she is the likeliest entry point into further investigation. Best of luck with it.
What prompted you to start her in therapy? Has the pediatrician suggested having a full evaluation? Does the behavior happen at school or just at home?
First things first; what is she in therapy for? Behavior like what you describe almost never occurs in a vacuum; even in four year olds. I agree with the other posters who suggest a full evaluation.( I would say physical, and mental)
We just saw the pediatrician for a well visit; other than minor colds, she has always been healthy. The pediatrician referred us to this therapist, and we just started therapy two weeks ago. The therapy is to help us parents find better strategies to minimize her "oppositional" behavior, and also for her to learn better techniques for coping with her volatile emotions. She hasn't been diagnosed with anything yet.
She is ahead academically, and has advanced verbal skills. She loves preschool and her teacher. She is average or maybe a bit behind with social skills with other peers. Her preschool teacher hasn't noticed any abnormal behavior, other than mentioning her struggling with transitions. For example, while the teacher is reading a story, everyone else is sitting on the rug listening, while my daughter might be wandering the perimeter of the room or playing with a random toy. She is more likely to explode around people she is most comfortable with (and obviously if she is more tired or hungry). Thankfully, so far, the only people she has directed violence at has been her parents. She behaves worlds better outside the home, for the most part, and so I try to keep us out and about as much as possible.
When she gets violent, it's really violent. If it's this bad at four, I'm terrified of fourteen.
Is this sudden new behavior? What we're things like one year ago? Has she always been in your care? My son has Asperger's/autism spectrum disorder. When he was under five he had a lot of issues with transition. Would have total melt downs. He was better able to cope as he got older. But his world was very black or white, would have trouble with shades of grey or ambiguity.
Getting a full neuro/physical work up at a multi-disipline clinic may be best if traditional counseling doesn't work.
I would maybe ask for a referral to a developmental pediatrician. Is her therapist a psychologist? She sounds a bit outside the norm but a lot of it is typical just more intense or frequent than most of us would have experience with. She's struggling with something and you are on the right track sticking with it and trying to figure it out. I don't have any specific advice...I have one who would melt down more frequently than my others (not violently though) and he just needs time and space to deal with his big emotions and he knows that I don't get to be yelled at or talked back to, so he can take it to his own space. He's like your daughter, exceptionally bright, he was better behaved at school than at home (although not perfect for sure). Most kids are. But when he did have trouble at school, he was also given his own space to work it out (he was in montessori, so they had plenty of space).
Your daughter sounds like she could have Disruptive Mood Dysregulation Disorder (DMDD).
Quote:
Disruptive mood dysregulation disorder (DMDD) is a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts. DMDD symptoms go beyond a being a “moody” child—children with DMDD experience severe impairment that requires clinical attention. DMDD is a fairly new diagnosis, appearing for the first time in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013.
There is a good support group on Facebook. People who post sound just like what you are going through. My son was diagnosed with it this year. Thankfully, his case is mild compared to some I have read about.
Have you taken her to see a neurologist? There seems to be something out-of-control about the extreme nature of her outbursts. But it's interesting, that she doesn't have the outbursts at school. How old was she, when you first noticed the behavior?
I agree with the suggestion to check for food allergies, as well. Has there been any trauma in her short life?
The mood dysregulation suggestion sounds like it might be the ticket.
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