Monday, December 26, 2011

11 year old with anger overload

Hello Dr. Gottlieb,
When I came across your article on anger overload I finally felt like I had found an accurate description of what my 11 year old daughter and we have been going through (for 1-2 years).  She doesn't have the risk-taking behavior you mention but otherwise many of the characteristics are the same.  What drew me to your work was the distinction you made between anger overload and other clinical issues (defiant, ad/hd, autistic, etc) which do not seem to apply.   I am wondering about the relevance of your new book for our situation.
We have been unsuccessful in treating her/our issues, and in fact there is a pattern of escalation that is worrisome.   She had a period of depression (seemingly related to school) for several months last year that accompanied the anger overload but in large part that has subsided--leaving us with "just" the anger overload. We have seen counselors and read books on defiant children.  But after many, many months, we have achieved no real progress in this area. 
Our daughter is otherwise well behaved, does very well in school, has many friends, and plays sports well.  Her issues are generally confined to our home (although the disturbing behaviors do from time-to-time creep outside the home).  My wife tends to placate my daughter's behavior in order to avoid conflict, I tend to be the disciplinarian (especially when she is physical), and our other daughter gets stuck somewhere in the middle.
There have been many factors that could have influenced our daughter's behavior.  While our "middle class" home situation is generally calm and stable (no abuse, no alcohol or drugs, no divorce, not overly strict or loose), our daughter has certainly faced changes in her life over the last couple of years.  Her sister (age 15) was diagnosed with type one diabetes in 2009, there was a period where I was unemployed, her teachers have changed, there is a growing distance between her and her teenage sister, some friends have moved away etc.  She does not articulate any explanation of her emotions, and while not terribly apologetic about anger episodes, does share that she feels out of control at those times.
My response:
  In my new book I have a chapter which discusses strong willed children and anger overload.  Not sure how strong willed your daughter is, but if this also applies to her behavior, then this part of my book may be helpful to you.  Also, I will keep writing on this blog about how to work with children and teens with anger overload, as this is the topic about which I get the most questions.  In 2012,  I may publish a step by step guide for parents.

A few comments before I make a suggestion about working with anger overload.  If her episodes of anger overload occur more frequently when there is a downturn in mood, it would be wise to check with a professional to rule out a co-existing mood disorder.  Also, you mention some previous causes (changes in her life), but suggest the anger problem continues even though there do not seem to be any particular causes right now.  You might want to chart the next three episodes (I discuss this in an early chapter of my book as well), and then look for any patterns.  Does it happen when the attention is on someone else in the family, or when she is feeling lonely?  You mention her sister's diabetes and her friends moving away, so I wonder if any of these issues might still affect her.  Or you may find there is another issue which precipitates your daughter's outbursts.  If you see a particular type of trigger, then you can try to address that.

Whether or not there is an obvious pattern, you would want to enlist your daughter's help in understanding this problem.  As I suggested in my last post, there are ways to bring your daughter's attention to the problem without being critical of her.  When she is calm, you could point out any possible trigger you see, and ask her to consider if this seems correct.  If she disagrees, ask her if she has any ideas. Also, help her see when she is "heating" up next time by labeling the level of her anger (as I discuss in last week's post).   You are trying to get her to continue to think about the problem.  Bring this up as an issue you can work on together in the next few months.

For pre-teens and teens, it can be helpful to head off outbursts by discussing potential pitfalls and alternative solutions.  You can do this if you see some patterns.  You can talk about an issue from both your point of view and hers.  State what your concern is (for example if there is tension about homework or curfew, state why you have a certain rule) and then ask her what her point of view is.  You are trying to head off major conflict (assuming this is a cause of overload--let me know if there is some other cause and I'll try to advise you), and help your daughter begin to think about how there are different points of view.  Then you pose the question: how can we work this out?  You try to engage her in a discussion (when she is calm) about an issue and see if you all can come up with an alternative (compromise, if the issue is negotiable) that meets everyone's concerns.  You are helping her then not only identify an issue but practice working it out ahead of time. 

When overload occurs, it is best to avoid these kinds of discussions and encourage "chill" time.  Some kids chill with music, some by physical sensations (squeezing or holding something), some by music or drawing.  It may take some time for your daughter to discover a way that works for her, and you do not want to suggest too much, because it is best if she comes up with something herself.  After she calms down, ask her how she did it and reinforce her approach if it was effective and if it did not involve harming herself or anyone else.

One possible biological change that my help in the coming years is the continued growth of her frontal cortex, the part of the brain that controls emotions.  This growth will continue even into her twenties, but the strategies I have outlined can help this process along.  I will continue to post more strategies in the coming weeks.

In your addendum (which I just read but did not print above), you mention she gets headaches and feels tired sometimes before or after anger overload.  I have noticed that anger overload sometimes occurs when kids are tired, but have not noted any correlations with headaches at this time.  Certainly when kids are tired or not feeling well, they have fewer "resources" to deal with stress.  Furthermore, anger overload can be draining (like running an emotional marathon), especially if it goes on for more than a few minutes.  If you continue to note a correlation with headaches, I would mention it again to your doctor, and follow his lead, as he knows your daughter's situation better than I.  Hope this is helpful.  Take care, Dr. Gottlieb

Wednesday, December 21, 2011

Helping your child develop self-control

So far in the blog I have been mostly advising you what to do once your child is already in "tantrum" mode.   Another set of strategies is to to help your child develop self-observation skills.  Once your child recognizes he is "over-heating," then you can teach him strategies to deal with frustrations in a more mature way.   Your child has to recognize first there is a problem (his anger is sometimes "over the top") before he will be willing or able to work on the problem.  In this post, I will write about how to help your child learn to observe his emotional state.  In the next post, I will begin to outline strategies which your child can use to alter his emotional state.

The first step is to label his emotional level with colors or numbers.  You can use blue for "low" level of anger, yellow or orange for "getting hotter," and red for "scorching hot."  When your child is getting angry, try to use these labels in a non-critical way to help him see the differences in his emotional state.  You can also use the labels to point out your own level of anger at times, so that your child does not feel singled out.  Also, by pointing out your emotional state, you are modeling what you hope your child will be able to do for himself someday. 

You would explain the color system to your child when he is calm.  Then when he is angry you gently point out in just a few words the color of anger he is expressing:  "you are blue hot," "you are getting hotter, kind of orange now," or "you are red hot now."   An alternative is to use numbers (1-5) or the speed of cars, if you think these labels would appeal more to your child.  For example, you could say you going 10 miles per hour (for low levels of anger), or you are at 40 miles per hour (for mid range), or now you are going over 80 miles an hour!

This will not in itself lead to dramatic changes in your child's behavior.  But you are setting the stage for change by  helping him see the differences in how he expresses his angry feelings.  You will need to do this over a period of months for your child to recognize accurately how he is responding in different situations. 

Another self-observation skill to work on with your child is identifying triggers.  When your child is calm (after an outburst has subsided) point out what you think the trigger was.  For example, you could say "you got mad when you had to stop playing your game," or "you got mad when it was bedtime."  You are labeling the trigger in concrete words for your child.  You want him to begin to see the pattern.  Then in the future he can learn alternative ways to deal with his frustrations.  More about that in future posts.

Sunday, December 4, 2011

Anger Overload in Children: Diagnostic and Treatment Issues

Anger Overload in Children: Diagnostic and Treatment Issues

This is an article I wrote in 2002 on anger overload which was originally published in "Attention!" magazine.  You can read it by clicking on the link above. The article is available at the website for

Tuesday, November 29, 2011

Emotional Distractions

In the last post, I talked about using distraction if you catch "anger overload" before your child explodes.  Granted many children "overheat" so quickly that distraction will not work, and you are better off then not saying anything and waiting until he calms down (if you child is not harming himself or others).  If you can intervene while your child is revving up, the idea is to use a comment that changes your child's emotional set.  You are trying to communicate to your child's emotional brain, so that what you say might provoke a different emotion in your child, other than anger.  It does not matter if your comment does not make a lot of sense because you are not trying to reach your child's rational brain.  Examples of "emotional distractions" are singing a lyric or telling a wisecrack about yourself (or someone other than your child), which might make your child smile or laugh.  While you sing, or talk about some unusual event (real or fantasy) use facial expressions that are weird or unusual for you.   Maybe you could tell a story (real or imaginary) that grabs your child's attention.  For example, you could say that you think there might have been an elephant pooping on your front yard yesterday and you are not picking up the poop (Poop jokes work with younger children), or you might say that you wonder if someday there will be a computer that would fit inside your skin so that you could play video games in school without the teacher knowing it.  Use your imagination to come up with something that will grab your child's attention.  The idea is to get your child wondering about something or laughing.    If you can get your child to laugh, his anger will diminish greatly.  It is hard to be angry and laugh at the same time! 

The other kind of distraction is an activity that your child likes so much that he forgets about what he was upset about.  For example, you could say you want to bake something for dessert or maybe you could say that you want to go for a bike ride now before it gets dark outside (if it is afternoon).   You could just start getting ready for the activity and your child will probably want to come, or you could ask for his help.  There is a risk of asking your child a question though if he is still mad; he might say no because of his angry state.  So you are usually better off just starting an activity rather than asking for help directly.  If your child asks to help you, just say fine or "cool", and do not bring back up what he had been angry about.  Activities are engrossing and change your child's emotional set, so that his anger will diminish or disappear.

Friday, November 18, 2011

When to ignore and when to restrain an 8 year old

The parents of an eight year old have read my book and finished steps one and two (described in my last post) for anger overload.   They have identified several triggers so far.  One is at bedtime when their child does not want to get ready for bed.  A variation of this occurs when their child gets into his bed but then shortly thereafter comes out to the parents' bedroom and says that he is not tired.   The parents tried returning him to bed, but he kept getting out.  Two other times when their child "lost it" was after school when he wanted to play outside (but it was dark already) and another time when he found out the library would not renew the video he wanted to watch again.   When their child is frustrated, and things do not go his way, he often escalates quickly and starts to scream, curse, and/or throw objects (sometimes pillows, sometimes small objects displayed in the living room), and sometimes bite a sibling.  What should the parents do when their child is already heated up and out of control?

At this point, reasoning and incentives will not work.  The child is overheated and not going to listen to reason.  If someone is about to be hurt or if something valuable is about to be broken, then physical restraint is called for.  The father of this child has held the child (like a bear hug) until he calms down, which can take five to twenty minutes.  Once calmer, the child is more cooperative and no longer threatens to hurt anyone.  At other times, the child has kicked the back of the seat in the car where the parents are sitting, or told them he hates them.  If there is no danger, it is sometimes most effective to do nothing and "play deaf."  This does not mean there are no consequences, but you wait until later in the day to discuss what happened and to announce any consequences.  If you were to discuss consequences while your child is having a tantrum, he would likely escalate further.

If the child is in the early stages of anger, and has not "lost it" yet, then it would be advisable to try distraction or compromise.  It is sometimes difficult to tell whether your child can listen to you without getting more angry, and you then might try to talk and if it is not working you would become quiet and wait for him to calm down.  You could then say you will talk with him a little later after you have thought about things (if you want to say why you are going to be silent).  You really want him to think about things, but you are more likely to provoke an escalation if you were to say that.  One of the times that this eight year old was starting to heat up, the issue was that he would not sleep in his room.  The father suggested to his son that he take a sleeping bag and sleep on the floor of his older brother's room.  This worked because the child had not totally escalated yet and because the child's issue was that he did not want to be alone.  The father came up with an idea to head off a conflict but did not allow the child to sleep in the parents' bed or to play video games, which would have potentially started a "fun" new routine for the child and would have probably been difficult to avoid the next night.  Sometimes if your child is not ready to go to sleep, a quiet activity in his bed, like reading, or drawing a picture, will help him wind down and get ready for sleep.  Sleep is one of those things that cannot be forced, but happens when a person winds down.  You cannot make a child turn off his "motor" but you can suggest conditions that will help him get sleepy. I will discuss the techniques of distraction and compromise a lot more in future posts.

Monday, November 14, 2011

First steps to help child with anger overload

Many questions I get online and in my office have to do with anger overload.  Children or teens with this problem get very angry for brief periods of time.  They say and do things which are uncharacteristically extreme:  shouting, swearing, threatening to hit someone, throwing things.  Most of the time these children are not acting like this; parents report their children usually are calm and easy to deal with.

So what is going on here?  These children have not yet developed the cortical controls to deal with the upsurge in emotions when they are disappointed or frustrated.  One way to think of this biologically is that the limbic system of these children (the emotional center of the brain) is aroused, but the frontal cortex (outer layer of the brain responsible for self-control) has not fully developed yet.  The cortex continues to develop into early adulthood. 

What we want to do is help children develop greater self-control, in other words, to promote cortical controls.  The first two steps for parents are 1) observe the situations where your child loses it:  what are the triggers?  Who is your child angry at and why?  Is there a pattern?  Once you have some idea of the triggers, you will begin to 2) frame the problem for your child and let him know you are going to work on this with him over the next several months.   If your child gets very angry whenever he cannot play his video games (for example), you would point this out when your child is calm, and explain that you are going to help him develop ways to better control his anger.  Give an example of an alternative to screaming or cursing:  He could say that he is angry or that he does not like your rules.  You might even tell him he could raise his voice so long as he does not curse.  What you are doing here is providing an alternative that is within the realm of possibility for your child.  (You can try for more self-control in the future if your child can master the first step of not cursing.)

Explain that this is important because it will help him deal with all kinds of things that don't go his way in the future.  People will respect him better if he figures out a way to work things out without screaming or cursing.  You are trying to frame the issue and at the same time motivate your child to work on this with you.  You are letting him know it will be a team effort; you are not expecting him to do this alone.  If your child does not say much at this point, that is okay.  If he says he doesn't care, you could reply that one of his buddies someday may hear him lose it and then not want to play with him.  Or think of another reason which might be important to your child.  Another reason might be that he will be more likely to get people to listen to what he wants if he does not scream at them.  Do not argue with your child if he says it is not important to him.  You are just trying to frame the issue for your child, and you do not need his agreement at this point. Your child may be defensive and unwilling to admit he has a problem.  However, you are beginning to chip away at his denial.  You are letting your child know that this is an issue you are going to be focusing on.  More in my next post.

Saturday, November 12, 2011

14 year old's angry outbursts

"I just read your article on anger overload on and it fits our 14 (almost 15) year old to a tee. From the time he was very little, he's had these angry outbursts that are uncontrollable and pretty severe. After he calms down, he is the sweetest kid. He is very sensitive, hates to get in trouble and is embarrassed that he can't control his behavior. He has been in several schools and we finally thought we got it right at the arts school he currently attends, but he is a few months into the year and just had another blowout today.

We have tried counseling a couple of times, but it didn't seem to help. I know he likes this school and doesn't want to have to leave it--last time we pulled him out and he did online school, he was miserable. He has no problems getting along with friends--just certain teachers (some of his teachers see him as a great, participative student!). His dad and I have been concerned for quite some time, but now that he's in high school, I'm very concerned about the impact this is going to start having on the rest of his life--he's not a little kid any more.

We have no trouble with him at home. He does experience quite a bit of anxiety and often has trouble sleeping. We are not sure what to do next--rewards and consequences have had no impact on changing his behavior in the past. We took him to a child psychologist who said just to pull him out of school, and that he did not have a specific, diagnosable disorder, but your description of anger overload sure seems to fit perfectly.

Any thoughts you have would be greatly appreciated."

Here are my thoughts:  There are two issues which you raise, which may or may not be related.  One issue feels like anger overload, as you suggested, but the second concern you raise, anxiety, is not necessarily a part of anger overload.  First, what I would recommend is observing when his anger occurs in school.  What are the teachers saying or doing when he gets angry?  Also, what does he say or do during the outbursts?  Look for a pattern.  Since you say he is sensitive, I wonder if he feels criticized or put down before he gets angry?  Is he being admonished  in some way?   What was he doing, if anything, before the teachers' remarks to him?  Some other questions to think about:  How far does your son go?   Does he swear, is he disrespectful, or does he get mad but not blow up directly at the teacher?  If you want, let me know the pattern, or think about it yourself, because this will give you more clues about what to do.

If he is feeling criticized, then you can approach it in several ways: 1) help him "re-frame" the teacher's comments.  For example, some kids react negatively to any critical remark, and it may help him to realize that the teacher talks like this to other students (if that is the case).  2) Then teach your son about "self-talk":  that is, teach him to talk in his head that "it is okay, the teacher does this with others, and it is okay to get called out once in a while."  Help your son learn how to reassure himself.  3) Can he take a break if he feels he is heating up, and ask to go to the bathroom until he feels calmer, or does he heat up too quickly? 

Since most of the questions I am getting on the blog are about anger overload, in the coming weeks, I am going to outline techniques in six areas:  1) behavior management, 2) how to model self-control techniques for your child, 3) self-observation skills, 4) changing your child's emotional set, and 5) changing the way your child looks at things, 6) helping your child learn to compromise.  A few of these areas I talk about in my book, but I will give you more specifics on the blog as I get time over the next month or so.

Regarding the other issue you mention, your son's anxiety, what triggers it for him?  Keep a record of when he gets anxious, what is going on in the hour before he gets anxious, and what he does once he gets anxious.  Does anything help him so far to feel calmer.  There are many techniques that can be helpful for anxiety, including physical relaxation techniques, cognitive re-framing (listing your negative thoughts when you get anxious, and then listing more positive ways of looking at the situation, and practice saying these more positive explanations in your head before stressful situations), and gradual desensitization (approaching low anxiety situations before more difficult ones).  There are other approaches too, and it depends on what the triggers are.  There are many psychologists and other mental health professionals trained in cognitive behavioral approaches to anxiety, and you might want to ask in your area who is trained in these approaches for anxiety.  Good luck, and let me know if you have further questions or comments.

Friday, October 28, 2011

Excessive cursing

"My seven year old son cursed repeatedly, told us we were stupid, and said he hated us after we didn't let him play a game.  He carried on for twenty minutes.  What should we do?"

First, you want to see what the pattern is for this behavior.  Keep a record for a week along the lines of what I recommend in my book:  record what your child said, whom he said it to, and what the other person said.  See what type of situations trigger your son's outbursts.  If you see a pattern, think about how you can head off the next struggle by cuing your child ahead of time (pointing out a way he can avoid a struggle with you) and possibly offer an incentive. 

If you haven't seen a pattern in the outbursts yet, then ask yourself how long this problem has been going on and whether anything happened at home or in school around the time the problem started.  If it has been going on a long time (months or years) and does not have a clear precipitant (other than anytime he is frustrated and can't do what he wants) your child may be experiencing "anger overload".  I coined this term for children who have outbursts when frustrated, and carry on like their world has been destroyed.  In other words, the level of anger is beyond what would be expected for the thing the child is frustrated about.

In the chapter in my book on anger overload I make a number of suggestions.  Behavior management and cognitive techniques are suggested.  Basically behavioral strategies include behavior reinforcement strategies (praise and consequences), ignoring, time outs, and developing a place to "chill" in the house (a calming place).  Incentives and consequences are usually not helpful when a child is experiencing anger overload.  Your child is not thinking rationally at those times, so he will usually disregard potential rewards.  However, if you help your child see alternatives while he is calm, sometimes rewards will help motivate your child to avoid a confrontation and choose the alternative behavior.  If you have not set up an alternative in advance (or even if you have), once your child is in a "meltdown," sometimes the best thing you can do is ignore your child--as long as he is not hurting anyone or destroying anything of value. 

Cognitive strategies include helping your child develop self observation skills ("you are beginning to heat up") and helping to distract your child when he is revving up, by using humor, the computer or television, or another activity he enjoys.  If your child heats up fast and is already in "overload," then distraction techniques will usually not work.  Remember your child is not acting rationally when in the overload stage.  In that case, become temporarily "deaf" while your child is screaming, so that your child does not feed on your behavior.  Later when he is calm, you could review the situation with your child and see if he can think about compromise solutions with you.  I will give more details about these techniques in future posts.

Wednesday, October 19, 2011

Attention seeking 10 year old

I am at my wit's end with my youngest daughter who just turned 10 yrs old.  I have 3 daughters one is 21 yrs old a senior in college, a 19 yr old a freshman in college who has a rare cystic brain disease and has had to have 9 brain surgeries in 5 1/2 yrs, and my youngest 10 yrs old and in 4th grade. The 10 yr old goes to private school so she can get more attention due to the smaller class size and they have a no homework policy, as well as daycare. She has been in activities since she has been 2 1/2 yrs such as gymnastics, dance, soccer, band, eco club, girl scouts. Currently she is in dance and band.

First of all, she refuses to go to bed and many nights ends up in our bed, even though she start outs in hers.  In the morning she won't get up and drags her feet getting ready.  I make her breakfast, and lunch, pack her backpack and if she needs her band stuff I get that ready too, plus I load the car.  She is responsible to eat, brush her hair and teeth, get dressed and get in the car.  This am it took her 20 minutes to brush her hair.  She makes me late to work and is rude and yells at me:  Blaming me for everything in life.
It wouldn't be so bad, if I didn't have to be to work on time-but that isn't the case.  I asked her to pick out clothes the night before, but she always forgets.  When she eats and dresses she drops
wrappers and clothes right where she is.  I have grounded her, took her out of girl scouts and soccer, blocked her cable tv and even took away the box for a period of time, yet nothing helps. 
I have cut her some slack at times because of her sister's illness and I am sure she feels that she doesn't get enough attention, but it is just getting ridiculous and I need some help.

Dear Mom, 
If your daughter is seeking your attention, try to turn it around so she gets more attention (praise, and/or earns time with you doing an activity) when she cooperates rather than negative attention when she does not do her chores in the morning or night.  Pick a few specific tasks to target at first.  Let her know if she does these with only one reminder she can earn time with you in the evening doing an activity you both agree on.  Discuss ahead of time what that activity might be, and if it is long, then have your daughter earn some time each night and complete the activity another night.  Pick something she won't be able to play with you unless she earns it.  Up until now, most of your behavior modification has focused on negative consequences.  You want a mix of positive and negative usually.  In your case, I would use mainly positive if you feel she is seeking attention, which sounds likely given your family situation.  The praise and/or activity should be daily if possible, as younger children will not stay focused as well on a long term goal.   Ignore her negative comments, such as blaming you.  The more she engages you in negative discussions, the more of your attention she is getting.  If you find the frequency of the targeted behaviors decreases in the next few weeks, eventually you can target a couple of additional behaviors in order for her to earn "game" time in the evening.  

One other suggestion if she is taking too much time brushing her hair, for example, is to have her look at a clock (in the bathroom) and have her earn time with you if she gets done in 5-10 minutes, or whatever time you think is appropriate.  This could be one of her behavioral goals to earn your time playing a game.  Also, have her do the hair last in the morning, so that if it is not done you can leave anyway and she will have to deal with the hair the way it is.  If you want other suggestions, check the chapters in my book on situational causes of defiance and on strong willed children. Good luck, Dr. Gottlieb

Friday, October 7, 2011

My child is disobedient only in school

A parent contacted me about her first grader.  She explained that her child is obedient at home but won't follow directions in school.  More specifically, her child won't sit in the circle for story time, often does not complete written work, and tells other children what to do during play time.  What I would suggest is ask the school for a case study evaluation.  The purpose would be to rule out any learning disabilities and to rule out attention deficit disorder.  Either of these problems can cause the behavior you describe.  If your child has neither of these problems, then you would want to consider whether there are any emotional issues interfering with your child's learning in school.  The psychologist or school social worker may meet with you and also observe your child in class to see if anything may be troubling your child.  Is your child angry about something?  Or does your child have problems in social settings other than the home?  You would want to rule out Asperger's syndrome--these children have trouble adapting to new situations and have difficulty in social situations, like a classroom setting.  Once you figure out what is the cause of your child's behavior, then your school's psychologist may offer some suggestions.  Also, you can read in my book about what you can do to help your child once you know the cause.  Each chapter of my book offers parents strategies based on the cause of their's child's  misbehavior.

Thursday, September 8, 2011

Phone call about 4 year old's defiance

I received a phone call about a new appointment for a four year old who was not listening to his mother.  I suggested she think about the situations when her child is defiant, and write down some examples to bring to the first session.  There is a chart on page 3 of my book which outlines the information I like parents to record.  It is important to note 1) with whom the child is defiant and 2) what the parent and the child were each doing in the hour preceding the problem.  Then think about when the defiant behavior began: 3) write down what child said or did, and what the adult said or did in response.  The interaction may go back and forth a few times, and I'd like parents to capture as much detail as possible (write down a few lines or more).  If parents record this information over several days, we can see if a theme emerges.  This information will start us on a path toward figuring out the cause of the child's problem.  Once we we figure out the cause, then we will know which strategy to use.

Tuesday, August 30, 2011

Your Child is Defiant: Why is Nothing Working?

The title of this post is also the title of my new book, which is now available at,, and   In this blog, I will show you how to apply the ideas in my book so that you can determine which strategy to use for your child's angry, disobedient behavior.  My goal here is not diagnose your child's problem online but to offer suggestions to help you unravel the cause of your child's behavior.  Once you figure out the cause, then you can choose the best strategy.  You can send me questions at, and I will post some questions with my answers here.  I will keep your name and email address confidential.