Wednesday, April 24, 2013

3 year old with ourbursts in preschool

I have a 3 yr old son who has not been officially diagnosed, but from an article of yours I read it does describe his behavior. A few weeks ago we met with my son's preschool director and teacher, and they told us he had had a few episodes of behavior that were unexpected and uncontrollable, and they did not know how to manage him. They asked us to seek outside help, so we have an appointment with a child psychologist coming up soon. In the meantime we had to pull him out of the preschool, because he was screaming and crying every morning that he did not want to go, and then I would get calls from his teacher about bad behavior. It just became too stressful.  Since then he has been home with grandparents, and he has been really well behaved for the most part. We are now debating whether we should try another preschool or keep him home with a nanny.  At home the behavior seems like can be managed, however we feel if we put him into a preschool it will help him deal with issues now rather than when he gets to kindergarden. We are trying to find a preschool with teachers that are nuturing and can work with him. What are your thoughts, should we keep him home or try a different preschool?
Hi, You ask a good question, and I'd recommend you gather some more information and consult with your child's psychologist.  In my manual on anger overload in children, I write about the importance of recording several situations when a child gets angry, and see what some of the precipitants are.  Then you can talk with the preschool staff and with the psychologist about 1) whether these are situations that can be avoided, or 2) whether behavior modification (rewards and consequences) might help, or 3) whether your son needs some more time at home with fewer emotional and social demands for another year.  Let's look at the possibility of avoiding some stressors first:  If there is a patter of outbursts around a cerain toy for example, can the situation be structured so that the toy is only taken out at certain times, or can a timer be used to indicate when it is time to take turns?  The basic idea is to prevent outbursts by altering the situation so that your son might be less likely to get upset.  I write more about this approach in the first section of my parent's manual.
The other basic approach for three year olds is to use immediate short term rewards and consequences in order to try to motivate your child to behave differently.  The behavioral goal must be explained concretely to your child ahead of time, and must be in his behavioral repertoire (i.e. it could be one or two words or a gesture that would be something a three year old is capable of; you would not expect him to use words that an eleven year old might use).  However, once your child is in anger overload, you would not talk about rewards or consequences.  In fact, if your child is extremely angry, the teacher should say as little as possible until your child calms down. 
The third alternative is to wait if you feel the social demands are too difficult at this age, or to try a different preschool that may have a structure that is easier for your child.  Some children at age three get overheated very quickly when they have to share or switch activities, for example.  I would consult with your child's psychologist to help you decide whether waiting a year for preschool would be better.  Often there is no one right answer about when to start preschool, and if you have a good nannny, it is okay to wait a little longer to expose your child to preschool and to its social expectations.  I understand your concern that he learn how to relate to other children, and in the meantime, maybe there is a parent/child activity in your neighborhood where you and your child can interact with other young children and their parents.  Some young children do better in a child/parent group for six months to a year, before introducting them to a preschool.  All the best, Dr. Dave Gottlieb

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