Thursday, November 13, 2014

7 yr old sensitive and explodes in school

I have a 7 year old son who fits your description to a tee. It started out mostly at school where something triggers him and he will become enraged. It was never physical with another person, only objects. He screams for 20 minutes straight, covers his ears, is disrespectful to adults, kicks things, throws things, rips things off the wall.  The triggers are usually very minor. He will get upset if he is not called on, or if someone gets a turn and he doesn't.  He does not know how to cope. 

He is beginning to become really aware that others know he is different. When he talks and the other children look at him, he will yell "don't look at me." This is very wearing on the teachers and I feel he has now been labeled at his new school after 2 months. He hit another child, which rarely happens but said the other boy hit him first. No one saw the other boy hit my son, so my son was punished. 

He has developed really low self esteem saying you don't love me, no one believes me, and often calls himself dumb. He has even questioned what is wrong with me? He was diagnosed with ADHD, but his current doctor doesn't offer therapy and wants to keep him on the lowest dose. It is helping a lot with the frequency of outbursts, but i need to do something now. I'm having a hard time finding a good therapist for my son who won't let him run the show in sessions. Could you help us find a good therapist?

Hi, I would recommend you ask the school psychologist or social workers whom other parents have gone to in the area, and ask your child's primary care doctor as well.  Another resource is that most states have a psychological association, and that association has names of masters and doctoral level therapists who work with children.  When you get a few names, you want to find out how often they work with children and whether they have helped children who have intense angry outbursts.  You might even refer them to my blog or parent's manual to see if they have experience in some of these strategies.  Also, a therapist could help rule out other possible causes for your child's outbursts. 

It sounds like your son is very sensitive to feeling left out when he is not called on.  It might help for the teacher to cue him first thing each morning that she will give him a turn once in a while when he raises his hand, but that she needs to call on other children to give them a chance too.  He could earn points for staying calm when other children are called on.  

You would want to identify other triggers as well, and work on ways to help him think through ahead of time (on a daily basis) another way of looking at these triggers.  These cues would be brief reminders to help him keep perspective.  He could also draw pictures to illustrate the situations and together you could come up with a short phrase to say to himself when these situations occur. Then you could remind him of the saying in the morning before he goes to school, and check in with him after school if he used the saying that day.  The basic idea is to get him thinking of a new way of looking at the situations that trigger him before he explodes.  

Once he is having an outburst, it is best to say as little as possible.  If he can be moved to a quiet area until he calms down, that would be ideal.  But not every school has a space nearby for children to calm down.  Check with the social worker or psychologist in your child's school to see what space might be available for calming down; also the school social worker could work with your child's teacher on putting these strategies into practice.

All the best, Dr. Dave Gottlieb