Tuesday, March 10, 2015

12 yr old explodes at home and school

My son is 12 in 5 weeks time and suffers from what I believe to be Anger Overload.

I believe what I call not normal behavior begin as a toddler.  Almost OCD like, he would flip out if for exampleIf he said he was going to turn the light off and I did it instead.  He would have to turn it back on and then off again.  All the while screaming and crying about it.  While the OCD type behaviour died a natural death his anger/rage bursts have escalated.

He is of above average intelligence, and does not struggle academically in school. Although he does suffer some anxiety, and requires details/explanations of the task at hand to be repeated to him at times.  He will say it's too hard or I don’t know what to do, when the task at hand is quite within him.  The same happens with homework.  He is very good at sports and participates In many activities.

His outbursts are over the slightest thing, or if he feels he has been wronged.  His rage is intense both verbally and physically. He yells, screams, crys, punches, hits, pushes etc.  There is no calming him once he gets to that danger zone.  Trying to restrain or talk to him in this moment is fruitless.  He will sometimes say he wants to kill someone (mum,.dad,younger sister) or kill himself while raging. As he has gotten older this school outbursts have lessened but near the end of each year (like now) problems arise at school again.  We have had 3 occurrences in as many weeks.  He goes to a small school of only 230 kids and so only a small group of his age to play with.  There are 2 kids especially who push his buttons.

The other worrying sign is that he appears to have what I can only describe as rage blackout.  He will recollect a school incident at home; it is rarely his fault, but when I speak to teacher more information comes out.  Then when you ask him about this he says it never happened that way, I honestly believe him too.  He has no recollection of this extra information, usually the most damning. He is always remorseful and upset after such episodes but tells us he just can't stop.

His sister is nearly 6 years younger than him, and most of his rage at home is about her.  He has next to no tolerance of her.  Don’t get me wrong,  they can play nicely together, but when it goes wrong it really goes wrong.  His outbursts at home would be 4-5 per week. We have seen psychologists since he was about 8, at first he was very uncooperative with this, but over time this situation has improved.  I just don’t know if I am wasting my time and money on something that is not helping.

He saw a pediatrician at age 8-9 who did nothing more than a GP and deduced it was a behavioral and he needs to learn to control himself. He has also had saliva hormone tests done in the past and was found to have no melatonin in his body and cortisol levels also out of whack. I am also concerned with his growth and development.  While he is of average height / weight (50 percentile). In saying this though he is the shortest in his class.

His motor skills ?? are not progressing.  He has done athletics since he was 8-9 years old and still sprinting, jumping same times and distances as he is now nearly a 12 year old.
I don’t know much about this but I would assume that between ages 4-14 we all get faster, jump higher/longer etc even if we have no sporting ability.

The entire situation is tearing our family apart., and I just don’t know what to do anymore.  I  read the above and it doesn’t sound that bad, but believe me I don’t know how much more we can take.  I am falling apart, my husband is at his wits end, and I fear for our daughter, how this is affecting her seeing this behaviour constantly.  I fear for him as he gets older and what will become of him if he continues down this path.

Hi, It sounds like you have been through a lot and have not seen much improvement.  There are a number of strategies I recommend in my Parent's Manual for Anger Overload in Children, and in the recently published Anger Overload in Children, volume two.  In volume two, I make some additional suggestions for helping sensitive children deal with anger, and I also explain how to apply the strategies in school.  One important idea is trying to catch a child's frustration early, before it escalates into a tantrum. Admittedly this is not always possible because children can escalate so quickly.  

What you want to do first is chart each time your son loses it over the next few weeks, and then look for patterns or themes.  Then you would develop a strategy to deal with each theme.  For example, if he is frustrated when he feels the homework is too hard (though he can do it, you explained) you could prompt him before starting the homework in one of these ways to encourage him to hang in there:  "Homework can be hard, and it's okay to make mistakes."  Or "everyone makes mistakes."  Or "just do what you can, no one is perfect."  The idea is to normalize mistakes and thereby lessen his feelings of frustration.  Other possible strategies, such as emotional distraction, relaxation, and changing the sequence are explained in other blog posts and in my two books on anger overload.

If he has trouble with certain kids in school, try to find out what happens before he gets angry, and see if you or the teacher can use a mantra (or short saying) each day to remind him how to handle it.  The more you can anticipate and help him "normalize" certain frustrations, or help him learn how to deal with frustrations, you might be able to prevent some upsets.  You are right that it is hard to intervene once a child is in the overload phase.

Your son sounds a little rigid: you mention the earlier OCD.  Make sure the psychologist you see has ruled out Asperger's, which is a high functioning level of autism.  This is not likely, but you want to rule it out.  The fact that he does not remember all the details of the problems in school is not that unusual.  I find many children either minimize or forget what they did in school that contributed to the problems.  What might help is for the school counselor to meet with your son regularly to go over some of the incidents while they are still fresh in his mind, and gently help him see the connection between what he said or did, and what the other student said or did.  Then the counselor might be able to suggest a strategy for your son to deal with the  other student, or suggest a strategy the teacher could use to intervene before an outburst might occur again.  

If you feel your son is not developing motor skills or coordination, you could get a consult from a developmental pediatrician or a pediatric occupational therapist (OT).  OT's look at sensory integration and motor skills.  

Hope you see gradual improvement in the coming months, Dr. Dave Gottlieb

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