Wednesday, February 6, 2013

5 year old with anger and anxiety

Hello,  I just read an article regarding your book  Anger Overload in Children. Would definitely want to read the book. I have few question/ concerns regarding my own son who is 5 years old. He is one of the twins. He is a very emotional child ( my husband is also very emotional). He does not have many friends in school, only two of them. He is generally very good to his twin sister, but at times hits her, when she does not do as told by him. He gets upset very often, he won't listen or understand something that is not correct according to him. Does this happen with 5 yr olds?

When we go out to a  mall, my daughter and son always want to buy things, even if they have been told that we are not going to buy any toys as you have loads of them already. Any major toys will be purchased only on birthdays, though we keep buying books for them and never say no, if we come across any. Even when we go to any restaurant or any family gathering, we instruct them, especially my son, that there should be no crying, whining, screaming; whatever is troubling them should be talked out to either of the parent, and yet we have an outburst each time.

My son does not like crowds, so even any birthday parties of his friends, I always have trouble with him, he would not participate in any games, or dance, he is just sitting with me all the while.  Any attempt to make him participate would be followed by an outburst at the party, though he mentions later that he did like it at the party. He also gets up each morning crying, wanting me to be by his side when he wakes up (which becomes very difficult, as there is always a rush in the mornings).  Every attempt to make him understand fails, as he does not want to listen to what according to him is not right.

I have consulted with a Developmental Pediatrician here, and she suggested some discipline methods that, unfortunately worked for sometime and again its the same. I would highly appreciate if you can suggest what could be the reasons for such behaviour and what can be done to calm him down.
Hi, I would suggest you also consult with a child psychologist.  There could be several causes for your son's behavior, and an evaluation by a mental health professional who works with children may help you decide on the best course of action.  Here are some of my thoughts:  your son's anger may be part of an underlying anxiety disorder or social developmental disorder.  You note that he is uncomfortable in crowds, and shy at birthday parties.  He also shows some signs of separation anxiety:  he has a hard time leaving your side at the parties and also wants you by his side in the mornings when he wakes up.  What an evaluation by a mental health professional could determine is whether your son's anxiety is part of a social developmental disorder (in which case therapy would focus on social skill development) or is a sign of separation anxiety (which would call for somewhat different suggestions to deal with the anxiety).  It is hard for me to tell exactly what is going on without someone doing a more complete evaluation.  You are right to be concerned and to look into what is underlying his behavior.  Early intervention is a good idea. 
Your son's anger and frustration might be part of the social or anxiety issue, in which case it would improve as those issues are worked on, or his anger may be somewhat separate.   If it is the latter, then the strategies I recommend in my book would help.  One recommendation in my book is to re-arrange the sequence to avoid certain triggers of your son's anger.  So if going to the mall is a difficult situation for your son, I would take him less often.  With birthday parties, I would recommend you continue to take him, but I would not force him to participate.  What I recommend instead is that you sometimes get a little busy at the parties talking to the other parents.  Maybe your son will eventually model your behavior and talk to the other children.  Also, if you are busy part of the time, he may get tired of sitting there doing nothing.  However, if there is an underlying social or anxiety disorder you will have to go slow with this, and you will need to work with a psychologist on how to develop his social skills.

When he gets angry and hits his sister, I would use some behavior modification strategies, such as a short time out.  In addition, I would try to intervene early (if there is a chance to intervene when he is starting to get upset).  Sometimes children's anger escalates so fast that it is hard to catch early.  If you can catch it sometimes before there is an explosion, then use distraction, or separate the children by getting  one of them interested in a different activity.  Another strategy is to reward both of them with a small treat or a hug if they can play together without fighting for a certain period of time.  It sounds like they do cooperate much of the time, which is terrific.  All the best, Dr. David Gottlieb

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