Tuesday, December 18, 2012

6 year old lashes out at school

I am on my last leg with my 6 yr old son. His behavior at school has gotten so out of control that he is on the verge of being kicked out.....permanently. The school has a system where your name either gets written on the white board or a check mark is given by your name. My son lashes out verbally and physically when this occurs. He fully understands why this happens, but still has this behavior. He has changed teachers due partly to his behavior and the teacher's personal issues.
I have tried to sit with him and discuss why he acts this way in school, he always seems to blame other kids as his reason for acting out in school.
Do you feel counseling is an option at his age?

Hi, Yes I think counseling would be appropriate.  You would want a therapist who is also going to communicate with the school staff and with you.  It would be important for everyone working with your son to think about why he is getting so upset when he gets a check mark, and what alternatives there might be.  Sometimes, cuing him when his behavior is starting to be a problem, rather than using a check mark, may work better for your son.  Try also to "normalize" check marks.  Though not ideal, they are not the end of the world.  In the morning before school, predict that he might get one, and tell him you won't be angry.  I would even consider a small reward the next couple of times he gets a check mark and does not blow up about it.  (It could be a pat on the back by the teacher, or a high five when he gets home, or a treat that he does not usually get for dessert.)

Also, ask the teacher to keep track of what your son is doing before he gets these check marks.  Is he interacting with peers, is he angry about something,  is he easily distracted, or is some subject matter in class frustrating for him?  A psychologist could help you figure out if there is anything else going on with your son that is contributing to his reaction to the check marks.

Sometimes, when I meet with a child and the parent, we go through what happened leading up to the blow-up.  I ask what was happening before the child gets angry, what he said or did, and what others said or did.  I say that I am just trying to understand what happened.  (I do not judge or assign blame.)  Once a child is comfortable with this process, I might add:  "what can you do so you won't get in trouble next time?  I see why you are angry, and I want to help figure out a way you can deal with it so you do not get punished."  I try to get the child to see me as an ally, and we work on the issue together.  If the child does not have suggestions, I offer some alternatives and then ask which he would prefer, if any.  The next time the child comes in, we talk about situations that happened that week, what he said, and what other options he would have.  I do not criticize, nor do I expect him to be able to use my suggestions right away.  Also, this process cannot be done in the heat of the moment (while he is still angry) and cannot be done until your son has an alliance with the therapist.  See if there is a therapist in your area who works with children on anger issues.  In my parent's manual, I outline other approaches you can use to help your child deal better with angry feelings.

All the best, Dr. Gottlieb  

Sunday, December 16, 2012

What to do when 2 year old hits and yells

Hi, I came across your email address when researching "anger overload" and was wondering if you can help me. I have a 2 year old girl whom I believe has "anger overload". She'll be perfectly fine until I say she can't have something or something doesn't go the way she wants it (toys won't stand up, blocks fall etc.) that's when she becomes so angry she throws things, yells, hits etc. Is there anything I can do to help stop this from happening? Any advice you can offer me will be greatly appreciated!

Hi, First make a list of the situations when your daughter gets extremely angry.  Look for patterns, and think about how you might head off some of the tantrums before the situations get to that point.  For example, you mention she gets angry when the blocks fall.  You could try telling your daughter when she starts playing with the blocks that they will fall soon, because that is what blocks will do.  Tell her "when that happens we will put them back together."  Then when you see the blocks getting closer to the breaking point, remind her they are going to fall soon.  The strategy is to change your child's expectations before she reaches the breaking point.

Often you will not be able to predict an outburst.  If she is getting frustrated but has not exploded yet, you can use "emotional distraction" to try to head off a tantrum.  By "emotional distraction," I mean that you try to do something that will change her emotional state from one of frustration to laughter or curiosity.  For example, you could mention a favorite activity, song, or funny story to try to distract her.  If she likes trains, make the sound of a train and start waving your arms and make funny noises.  Your behavior does not have to make sense to another adult (who might think you are acting silly), it just has to grab your child's attention.  Another option is to start an activity that your child likes in order to distract her.  For example, if she likes blocks, you could say "look at me building these blocks.  I could sure use your help."

Once your daughter reaches the point of anger overload, it is usually best to say and do nothing, unless she is hurting someone or breaking something of value.  If you have to restrain her, you should do so, but if you can wait her out, do that.  Young children will usually tantrum longer if you try reasoning with them while they are in the middle of a tantrum.  Furthermore, you do not want to give them attention for negative behavior.  While it might be hard to listen to her scream, she is more likely to settle down in the future if she has not received any attention from you during previous tantrums.  You will not see change immediately, but over the coming weeks, tantrums will usually get shorter or less intense if she gets no reaction from you during the tantrum.  Once she settles down, then talk with her (about other things) or play with her.

Two year olds do not have the verbal or thinking skills yet to deal well with frustration, so tantrums are more likely at this age, and should wane as she gets older.  In the meantime, try some of these strategies and see if they help.  You can read more about these ideas in my parent's manual about anger overload in children.  All the best, Dr. Dave Gottlieb

Wednesday, December 5, 2012

9 year old won't go to his room to chill

Dr. Gottlieb, We have a 9 year old boy who gets really angry sometimes when his leggos break, sometimes when we send him to his room for fighting with his younger brother, and sometimes when we tell him do do something.  We try to catch his anger at an early stage and ask that he go to his room for a few minutes to calm himself, but he usually refuses.  So we started leaving the room and ignoring him.  He seems to calm down faster then, but we worry that he is getting the message that it is okay to argue with us or fight with his brother.  Any other suggestions?

Hi, When you establish a "go to" place for anger overload, discuss it with your child ahead of time, and do not pick the same place that you use for a time out or a punishment.  Even though you are not punishing your child when you ask him to chill in his room, he may see it as a punishment, especially if his room is also used for time outs.  When your child is beginning to overheat, instead of asking him to leave the room, suggest that he take three slow deep breaths.  The deep breaths may help him to slow down.  Anything he does for a few moments may help him to gain more control of his anger.  Once he is in full overload, though, anything you say will probably lead to his responding with more anger.

Your idea to leave the room is also a good one.  Another option is to stay in the room but stop talking until your child is calmer.  If your child is not receiving any verbal feedback from you while he is getting angry, he is more likely to settle down.  I do not think your child will see your leaving the room as a "victory."   You will still expect him to do what you asked after he calms down.

Another option for the issue of his fighting with his brother would be to have them both cooperate to earn smiley faces each day if they do not fight.  They either both get the smiley face, or neither do.  They can then trade one, two, or three smiley faces for a fun activity, like a card game, with you or your spouse.  (The number of smiley faces needed to earn the game time depends on how immediate you think the reward needs to be for them to be motivated.)   

Finally, do not forget to review with your child the sequence of events after each blow up is over.  Once your child is calm, you want to briefly talk with him about what was the trigger and what else he could do if it happens again.  You do this regularly later in the day when there has been an upset, so that your child begins to recognize what causes his outbursts and so that eventually he may catch the sequence before he explodes.  During anger overload, it is hard for most children (and adults for that matter) to think about alternative behaviors, but the more you go over examples with your child, the sooner he may remember at the crucial moments when he gets angry. 

If the leggos breaking continues to trigger his anger, you might also create a list of sayings that your child could think of when he starts to get mad.  For example, one could be "leggos break eventually" or "we can always fix it."  You write them on a sheet of paper that you can look at with your child after future blow ups.  The purpose is to get your child to expect difficulties, in other words, to help your child develop more realistic expectations.  I explain more about his in my parent's manual.  All the best, Dr. Gottlieb