Friday, October 27, 2017

8 yr old's outbursts in school

Dr. Dave,

My grandson is 8, and struggling behaviorally at school. This past year he was put on ADHD medication, which does make him quieter. But his real problem is still there. He is having uncontrollable angry outbursts: throwing chairs, kicking, hitting, yelling at the adult in his way. Honestly, a description would be Dr. Jekyll and Mr. Hyde. He has the biggest heart and other than the outbursts, he is a smart, behaving 8 year old boy.   After his outbursts he is very remorseful, and beating himself up for it, accepting the punishment.  He will come to our  house and say I was bad at school I can't watch TV or play video games. Makes my heart break for him. I think the true problem is anger overload. 


First, what I would recommend is that the teachers keep a list of all the precipitants over a two week period.  What is your grandson doing right before he gets angry?  What are some of the triggers, and is there a theme to the triggers?  Themes could be:  when he feels ignored, when he feels criticized, when he can't do what he wants.   Then the teachers can try to anticipate what will cause him to get angry, and try to change your grandson's expectations in advance.  For example, if he feels criticized, the teachers could explain that every child needs help sometimes, or explain that no one gets it all right, or that it is okay to make mistakes.  They would choose ones of these phrases or another short explanation that they think would resonate with your grandson, and then begin with that phrase before they comment or correct his work in the future.  

You could also work with your grandson at home by going over the teacher's explanation with him, and maybe draw a picture together of one situation where the explanation would apply.  I call this explanation a "mantra."  The idea is to go over the mantra briefly each day before school to help your grandson deal with what he perceives as criticism.

Other strategies are described in my parents' manuals and children's workbook.  If the teachers can't head off an outburst, then they may need to restrain him if he is about to hurt someone.  While it is usually best to ignore a child in the middle of a tantrum, and praise him when he is calm or when he uses a self-control strategy, if someone is likely to be kicked or hit, then the staff would need to protect themselves and the other children as best they could.  

Children with ADHD are often impulsive.  They can react quickly without thinking in advance.  The doctor could monitor the medicine and adjust it somewhat if the outbursts do not decrease.  Sometimes that can help a child to think first, and use a strategy rather than explode.

Best, Dr.Dave Gottlieb