Monday, January 18, 2016

10 yr old with trauma and ADHD

I have a 10 yr old daughter that I'm at my end of rope.  We never had any problems with her until 2nd grade in school where she experienced trauma from a male teacher. Her father and I reach out and got help for her and been having an in home behavior therapist coming in once a week now.  2 yrs later she has an explosive temper that she gets so mad she doesn't even realize what she says to people, and she will scream, yell, throw, swear, hit, and if you don't pay attention to her it still goes on for hours and it seems like it happens when she can't get her way or what she wants to hear and school has started to become a nightmare with her and her teacher. I don't know what to do because she is on meds for ADHD . Please can you help.

Hi, I would recommend a consult with a psychologist or psychiatrist who specializes in childhood disorders.  There are so many possible causes.  ADHD can occur with other conditions such as post traumatic stress disorder, mood disorders (like bipolar disorder), oppositional defiant disorder, or learning disorders.  You would want a full evaluation to rule  out these possibilities.  Not sure what the trauma was in 2nd grade, but post traumatic stress disorder can last for more than two years sometimes.  Did her anger issues start right after the trauma?  

My parent's manual on anger overload suggests a number of strategies that you could try after you have ruled out or treated other disorders.  You would want to observe what is happening when she doesn't like what she hears (you wrote that is when she explodes). What is she doing or wanting when she erupts?  And you say school is a nightmare--what happens there?  You would then try to target some of the times she has anger overload, by either avoiding the trigger (if possible), or re-arranging the sequence so that something she wants comes after she does what an adult asks of her.  There are also emotional distraction strategies that can help if she hasn't already hit the anger overload stage.  The activity has to be emotionally engaging for it to be effective.  

In the second volume of my parent's manual, I also explain how to use mantras (short, memorable sayings) and I make suggestions for dealing with anger in school.  Feel free also to read some of the other blog posts that explain about mantras and school problems in more detail.   

But first, you need to talk with your behavior therapist and probably get an evaluation with a psychologist or psychiatrist who could rule out other disorders.  It doesn't sound like she is making progress at this time. Is an underlying issue contributing to her exploding?    Wish I could be of more help.  Best, Dr. Dave Gottlieb  

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