Tuesday, January 20, 2015

Taking explosive 7 yr old on vacation

Doctor,
My grandson has always had temper tantrums as a toddler.  This includes hitting people.  When he was 5, he punched me in the face.  Now he is in first grade and he is hitting, and kicking at recess; if he doesn't get his way he strikes.  His parents have never spanked him.  They carry him to his room until he calms down.  He is seeing a psychologist, but only 5 visits so far.  Last week he kicked a boy, today he punched another in the face.  Taking away tv and video games as punishment has not been effective.  Next week we are to travel to the Bahamas to celebrate my birthday.  All his Aunts and Uncles will be there.  My son is considering not going and keeping the 7 year old at home.  My daughter-in-law and other grandson would come.  Would this be an effective punishment?  This trip has been planned for months and having it disrupted by the 7 year old just doesn't seem fair.  What would you recommend?

Hi, I can see why you are troubled by what is happening with your grandson.  There is the short term issue of what to do about the celebration and the long term issue of how to help your grandson develop better self-control.  As for the issue about the celebration, keeping your grandson home may bot be seen as a punishment by the child, especially if he gets a  lot of one to one attention from his dad.  On the other hand, the parents may worry he will act out in front of all the relatives and that may cause significant stress for them.  I would recommend letting the parents and therapist make the final call.. You don't want to be too insistent with the parents, because then it could cause problems between you and your son.  You could express your point of view, and then go along with whatever decision they make.  Enjoy your celebration even if everyone doesn't come.  

In general, if parents spend a lot of time with a child during outbursts, the child may inadvertently get "rewarded" by their attention for his negative behavior.  It is unclear from what you write whether the parents stay with the child in his room until he calms down.  It would be important for the parents to interact as little as possible with their child while he is in the midst of a tantrum.  Only if the child is physically harming someone would they need to hold onto him (to prevent someone from being injured). 

In my parent's manual, I outline steps that parents can take to head off explosive behavior and to build a child's self control.  It takes time but is well worth the effort.  The therapist may be working toward this goal, but it can take months to see significant change sometimes.  I hope you have a good celebration and that your grandson learns how to control his anger.  Next month, I am going to publish a supplement to my parent's manual, and one section will address how schools can deal with angry outbursts.  My current manual focuses on what to do in the home. 

Take care, Dr. Dave Gottlieb