Wednesday, September 16, 2015

Gifted 9 yr old wants more freedom

In reading your article on the topic, I understood some of the underlying issues with children can often stem from having learning disabilities. Our 9 year old son presents as a child with anger overload, but actually is very bright, likely gifted- although I am resistant to having him tested. 

Are there examples and guidelines in your manual on how to deal with this type of child? We are challenged by his outbursts that are often triggered by our objecting to him engaging in activity that we feel is way above his age level, not allowing him the types of freedoms that are generally reserved for teens and pre-teens and his vehement protests to treatment toward him he feels is unjust (generally compared to his brother or others in his peer group). He has huge issues with our authority but thankfully it does not permeate into his school surroundings, Rather he has decided school, in general, offers him little and his teachers are, well...'dumb'. We are challenged every day. I'm hoping your book can assist us in putting a realistic approach in place that can help moderate his outbursts and help him cope until he matures to the point where his somewhat advanced mind catches up with his young body.

Hi,  First, what I would recommend is keeping track of what rules he feels are unjust.   What kind of freedoms does he want?  In other words, what are the issues he is getting angry about?

Then you would either try to anticipate these issues, and let him know ahead of time what the plan will be, or use "emotional distraction" (a technique discussed in the first half of my parents' manual and in other posts on this blog) to try to prevent outbursts.  You want to try to avoid a back and forth argument.  

In the second half of my book, I write about teaching your child new skills to cope with anger.  Here you want to teach your child self-observation skills and teach him about other points of view.  In my manual I give examples of how to do this.  One other technique to consider is to teach your child how to compromise.  Is there some part of what he is asking for that you would consider it he would lower his expectations?  This kind of discussion is best when everyone is calm, not in the midst of an argument.

You mention your son is bright, but also you bring up the topic of learning disabilities (LD). Does your son have a learning disability that is contributing to his outbursts?  If so, you would want to work with his school to address the LD issue, as this would likely help him deal with his anger better. 

Take care, David Gottlieb, Ph.D.  

Wednesday, September 9, 2015

3 yr old with high energy and melt downs

Good morning,

I am the grandmother to an adorable three year old girl. I am also a social worker looking for answers. There is a history of mental illness in my maternal family with ADHD, OCD, Bipolar Disorder, generalized anxiety, and Schizophrenia. My granddaughter is usually friendly, loving and kind. However, when she has her "melt downs," she rages and screams, uncontrollably for up to half an hour. They occur a minimum of five times a week.  She contorts her body, twists her fingers, and has extraordinary strength.  She does not injure herself or breaks things.  

Any little thing can trigger her.  For example, her sandals came off and she wanted to put them back on instead of me, or she wants her teddy bear, but she wants someone else to retrieve it although it’s right next to her.  It’s almost as if a switch goes off in her brain and she needs to go through the melt down.  Sometimes she becomes fixated on saying certain words during her melt down and keeps repeating them.   Her parents and I have tried to see if there is a pattern, like if she is sleepy, tired, hungry, had too much sugar, etc.  But there seems to be no pattern.  

We have done time out, ignored her, but nothing seems to diminish them.   We talked to the pediatrician who said these are tantrums and she will outgrow this behavior.  But….. it doesn’t seem like a regular tantrum.  Additionally, she is fearless and a risk taker in the playground and at home.  She has lots of energy and can spend hours in the park, or jumping in those party bouncing houses without taking a break.  When she is watching a video clip on my phone that she likes or listening to a song, she repeats it like 25 or more times. Any suggestions or strategies we might use?  At this young age should we see a child psychologist or psychiatrist?

Hi, Given your granddaughter's high energy level, intense tantrums, and family history, I would recommend you consult with a child psychologist or child psychiatrist.  Your pediatrician is also right that it is not uncommon for three year olds to have tantrums.  But the family history and her high energy level makes it possible the tantrums are an early sign of anger overload and may not remit in the next couple of years without working on strategies to help her self regulate.  You would want to consult with someone who sees young children and their families.  I doubt they would suggest medication at her young age but they might recommend strategies similar to what I outline in my parent's manual.  My manual is designed so that you can use it on your own or with a therapist. 

In the situations you describe, she wants things her way, and rather than engage her when she seems ready to get into a power struggle, I would recommend trying "emotional distraction" or a relaxation strategy, if possible, before she erupts.  Emotional distraction means that you come up with a song, saying, or activity that changes your child's mood from one of irritation to silliness or happiness. You can sing her favorite song, or you can change the mood by bringing up her favorite activity or doll and asking her or the doll to play together with you.  Basically you are re-directing her, but in a way that just doesn't distract her for a moment, but changes her emotional state.  

Relaxation strategies for this age child might involve her hugging a large stuffed animal or wrapping her in a blanket or having her lay down on her stomach and rubbing her back.  Sometimes a spray with a cool fragrance can help a child relax.  I realize all these suggestions take up time, and you may not be able to do them if you need to get somewhere or do something else.  

If she does tantrum, try to give her as little attention then as possible until she calms down.  Since she is not hurting herself or anyone else during the tantrums, you do not need to restrain her.  By ignoring her at this point, you will not stop the tantrum, but you send an implicit message that she will not get your attention this way.  Over time (weeks or months) the tantrums may lessen in frequency or duration.

Part of what may be feeding the tantrums is her high energy level and high activity level.  Children who react quickly and intensely to stimulation are also prone to react quickly and strongly to frustration, and hence are more likely to exhibit anger overload.  So it will take time (again months) to see improvement in many of these cases, but working on strategies, like what I outline in my manual, are important to help children develop self regulatory (calming) skills.

Best, Dr. Dave Gottlieb