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

7 yr old acts out in school

Hello. I was reading about anger overload and that is totally my 7 year old son.  Every year since kindergarten my son starts school and it's like 5 months of craziness before he gets settled in.  He acts out in class, get aggressive with other kids, and ends up miserable and with no friends and obviously upset about it. He says he's a jerk, everyone hates him, that I (his mother) think he's a jerk or an idiot.  He's always touching other kids and annoying them.  He gets angry when he feels like things aren't fair or he's not good enough.  He's really smart though. Has no problems learning. I would even say he's a little gifted.. 

I don't know what to do and it stresses me out daily. I work full time and so does his dad.  My mom watches them most days.  When he's at home or with one friend he's amazing! Totally nice, sweet, thoughtful, loves his mommy and family very much..  I'm used to when I do go to school to drop him off or pick up I get dirty looks from parents and already know the teacher is going to tell me something he did wrong that day.  I try not to yell at him at all, when he's in a rage kicking his closet and punching holes in the door I let him be until he calms down.   I take things away for short periods of time, he gets grounded for a day or two, sometimes it works and sometimes it doesn't. It's hard because he's really great at home but when he's at school it's a different story.  He does sports, swims, skateboards, and is very active.  What more can I do. I'm so tired of this and I know it hurts him that he doesn't have super close friends and relationships with peers.  I don't want him to have to feel this way anymore.
Thank you!

Hi, You point out several scenarios at school when he is likely to blow, e.g. a) he touches other kids and annoys them, or b) when he thinks things are not fair, or c) when he feels he is not good enough.  Work with the teacher to review when these types of triggers are likely to occur. That is, a) what is going on right before he touches other kids, b) what does he not think is fair, and c) what is he doing when he does not feel he is good enough.  Let's take the first scenario:  Young children often want more attention from peers and will touch them to get attention.  Does he seem to want interaction when he touches others?  If so, you could practice at home how to get someone's attention without annoying them.  Role play a situation in class.  Ask your child who he wants to interact with and then practice a way that uses words and does not intrude on another person's space.  Or if your child does not want to role play, then make up a story at bedtime that "shows" him indirectly how to get someone's attention in school.  In volume two of my parent's manual, I explain how to use imaginary stories and also explain other strategies for school.  

Self esteem issues are often another trigger.  You mention that he sometimes does not feel good enough.  There are different techniques you can use here.  In the first volume of my manual for parents, I write about lowering a child's expectations ahead of time, before anger is triggered.  The teacher may be able to intervene and use a "mantra" like "everyone makes mistakes" at the beginning of assignments that in the past have triggered your child's frustration.   .At home you can reinforce the message by telling your child that you hope he made at least one mistake today because that shows he is learning something new.  Ask him to tell you about a mistake and be proud of him for sharing this information with you.

Fairness is another trigger for many children..  Often these children have difficulty seeing other points of view.  Here I recommend helping your child to expect that things sometimes won't go his way.  Also, in the second half of my parent's manual, I explain how to teach child about other points of view.

The underlying principle of all these strategies is to try to alter a child's way of looking at things before he gets upset.  Once anger overload occurs, it is more difficult to intervene because a child is not thinking rationally then.  It is usually better to say as little as possible when a child is in overload, and work on strategies, like those mentioned above, while he is calm.  If you can catch anger early, you can also use emotional distraction:  the teacher could try saying something that can change your child's mood.  Something silly or funny often helps.  It is hard to be extremely angry while you are laughing!  There is more about emotional distraction and relaxation strategies in my original manual for parents.

Best, David Gottlieb, Ph.D.

Behavior charts do not work well with 5 yr olds

Hello, I am in desperate need of advice. I have a 5 year old son and over the last year we have had many issues with his anger. He got kicked out of 2 day cares last year. Towards the end, we found a great daycare that would take him aside when he would get angry and take him away from the situation and take him on a walk outside. The director really took him under her wing and he started doing a lot better. But school ended and I was at home all summer with him and my other 2 year old son. We worked on a behavior chart and spent a lot of time together and he seemed to be doing well. We saw a therapist who suggested no yelling or spanking him and implementing the behavior chart w rewards. He started a new daycare this week. The first day he was okay, the second day he got upset and pushed his chair at his teacher. Then yesterday he had a very good day and he was very proud of himself. Then today he scratched another kid and hit him in the face for not playing the way he wanted to and then was hitting and kicking the director. So now he has been kicked out of the daycare. He was supposed to start Kindergarten on August 24th. I have no idea what to do. The therapist I took him to said he's too young to tell if he has ADHD and that he should do fine at school....well obviously not. And now when I call back, they tell me he was only an intern and is now gone. I need help.

Hi, With anger overload, the outbursts happen so quickly that behavior charts are not often very helpful.  For a reward to work, the child has to be thinking rationally and be ready to try to earn the reward.  But when a child is in overload, he is not thinking rationally and is not thinking about the rewards.  Sometimes charts can help if they target early signs of frustration and help a child choose a calming technique in order to avoid overload.  But this requires early recognition of anger arousing situations, and young children will need adults to help them recognize their emotional triggers.  

So first it is important to keep notes of what is going on immediately prior to an episode, and see over several weeks what triggers emerge.  Then you (or the teacher in day care) can either "change the sequence" or "lower a child's expectations" in advance in order to prevent anger overload.  Or if you can pick up signs that your child is getting frustrated, then you (or the teacher) can also use "emotional distraction" or "relaxation activities". (I explain more about the above strategies, the strategies in quotation marks, in my original manual on anger overload in children and in other posts in this blog.)   Basically, the adult is helping to catch and re-direct a child before he reaches the overload phase.  It is unrealistic to expect five year olds to monitor their own emotional states, and that is why it is important for the teachers and  parents to implement strategies.  

Last year's day care director who took your child out of the situation was on the right track. Avoidance and distraction are key strategies.  I explain how to implement all these strategies in a school setting in my second recently published volume entitled Anger Overload in Children:  Additional Strategies for Teachers and Parents.  Both the original manual and the second volume with additional strategies for teachers can be found on online book stores.

ADHD can lead to impulsive behaviors, and can contribute to episodes of overload. Psychologists who specialize in working with young children can help you diagnose whether this is a contributing factor in your child's case.

Best, David Gottlieb, Ph.D.

The overload phase and what to do about it

All the descriptions of anger overload fit our son perfectly! I understand the long term approach to identifying the triggers and working over time to develop alternative strategies.  Can you please give some suggestions about what to do when he is in a rage? Regardless of where we are he will scream incredibly loudly and be very defiant.  We are very strict at following through on consequences, and once he has come out of his rage, he will accept them and get on with it. The problem is dealing with the rage in the most appropriate way while it is happening so to shorten it and limit the extremity of it. Any advice would be greatly appreciated.

Hi, You bring up an important issue.  The strategies, especially the cognitive approaches in the second half of volume one (as well as the suggestions in part two of volume two), can take weeks or months for children to learn to use at times of anger.  On the other hand, the strategies that parents can use without a child's direct participation (part one of the first manual) can be implemented more quickly but hinge on catching the anger quickly (when possible).  That is why identifying triggers is important:  then you can anticipate difficult situations for your child and try to head off anger before it reaches the overload phase.  

The first step is prevention.  If you see some patterns, you can change your child's expectations ahead of time, or change the sequence to avoid an upset.  In volume one, I explain how to do this.  In volume two, I explain how to do this for sensitive children by using cues and mantras with your child.  

The second step is the early anger phase when you can implement relaxation and distraction strategies (see volume one).  When a child moves right to the overload phase, as your question suggests, it is usually not possible to distract a child.  Then the best approach is to say as little as possible, not even talk yet about consequences.  In other words, try your best to ignore your child, unless he is hurting himself or someone else, and then you need to physically restrain him.  A child in the overload phase is not acting rationally and will usually escalate if you try to talk him through it.  As painful as it is, try to wait it out, giving as little attention to your child as possible.  Save any talk about alternative coping techniques, or consequences, until your child has calmed down and is thinking more rationally.  

Anger overload has a physiological basis in most cases, and therefore it takes time for children to calm down after they reach the overload phase.  But you can lessen the frequency of these events by using the strategies that prevent overload.  Once a child is in the overload phase, your options are limited.  That is why early intervention and planning how to deal with triggers is so important.

Best, Dr. Dave Gottlieb

4 year old with anger overload and sensory sensitivity

Hello,

Thank you very much for reading my email and for any advice you have for me. I just bought your 2 books today about anger overload, but they will not be here until next week.

My son is almost 4 and a half and about 6 months ago seemed to change into a person that is very angry at times and can also be very negative too. His feelings can be very easily hurt, even if no one meant it that way. If my son felt hurt by what you said, then he will burst out crying and run to the next room. He just finished his second year of preschool and has done very well there. His issues are almost always at home with me or his dad. 

We have tried to keep track of his outbursts, and they mostly seem to happen around changing activities (especially if it is an activity that he does not want to stop, like playing baseball) or if it is an activity that he does not want to do such as a bath or go to bed. Most of the time the outburst starts with excessive crying and him running away to the next room. If I go after him and try to reason with him (which I am learning I should not be doing), that is when the violence starts with things like him trying to hit or kick me and call me names. He will also say things like "you don't want me to do anything" or "you don't love me". Then he will say outlandish things like " go ahead, put me in jail" or "just throw me out in the garbage". I have no idea why he would say something like that because I have never said anything like that to him. The outburst can last anywhere from 1 to 15 minutes. When the outburst is over he is remorseful, saying he is sorry and is asking for hugs and kisses. 

He seems to have these outbursts at least once a day up to 3 times a day. My husband and I have been trying different techniques, but if my husband does not see improvement in a few days, he wants to move on to something else. I think we need to be patient. I know this will take time to get better. We need to be consistent. 

My husband and I have differing views on how to discipline our child. He does time outs where I take things away from our son. I realize that both of us need to be on the same page so we do not send mixed signals to our son. The only thing we agree on is that we will never hit our son. 

The other thing that has happened is our son started to be an extremely picky eater at about 2 years old. He is now doing much better with his eating and is willing to try new things to eat. We call it the " no thank you bite". If he does not want to eat something, he has to at least have the no thank you bite to try it. 

He has never liked loud noises and still doesn't. He also has an extremely sensitive sense of smell. That started when he was 3. I have taken self-tests for him being highly sensitive, which it seems he is, but a lot of the books I have read do not go into the anger and/or negativity issues that our son has.

He does not seem to fit ADHD or ODD or even pediatric bipolar disorder. Do you think that this can be anger overload? And/or high sensitivity as well?

Thank you very much for your time and with helping us. This is causing a lot of problems in our family and in our marriage. 


Yes, I think it could be anger overload and sensory sensitivity.  It is not unusual for these two issues to occur together in young children.  Being sensitive to intense sounds, smells, or other extreme sensory input can be irritating for some young children and there is some overlap between the area of the brain that processes sensory input and the area of the brain that deals with emotional stimulation.  For example, the temporal lobes are involved in processing sound and smell as well as emotion.  And the frontal lobes help people organize and control their responses to all different kinds of stimuli, sensory and emotional.  For children with anger overload, there is probably either a lag in the development of part of the prefrontal cortex (that processes and controls emotions like anger) or a lag in communication between the prefrontal cortex and the amygdala (an inner brain area that sends emotional signals to the prefrontal cortex).  With time and practice, children's brains develop, and children learn to better control their anger, but it does not happen over night. 

You are right not to follow your son into the other room and try to reason with him when he has outbursts.  Give him time to settle down.  Also try to arrange troublesome situations, like bath time, so that something fun comes afterward.  For bedtime, it is tough to arrange for a subsequent fun activity but try to sit near him in bed and spend five to ten minutes with a favorite story or quiet activity before you turn the lights out.  You want your son to look forward to this bedtime activity so that he will get ready without a big fuss, and sit in bed with you.

You also mention that he erupts sometimes when his feelings are hurt.  Keep track of those situations and look for a theme.  If for example you think he is feeling criticized sometimes, try to mention something that he handled well that day at the same time that you mention something he might not like to hear.  Keep your comments short.  If there are early signs of displeasure or disappointment, try to re-direct him or distract him before he gets too upset. 

In my manual (part 1), I explain how to use emotional distraction and relaxation strategies. The first half of this manual will be especially relevant for four year olds.  In my second book (Anger Overload Volume Two)  I explain how to help sensitive children keep perspective. This section should be helpful to you as well.  In essence you are helping to head off anger overload before it happens, and also helping your son feel better about himself so that he doesn't get as easily hurt.  

Best, Dr. Dave Gottlieb

8 yr old has outbursts when he fails at something

Thank you in advance for taking time to read this email. My 8 year old son has not been diagnosed with any emotional issues. He has always been doing well in school and has extra curricular martial arts and swim classes weekly.

Ever since his toddler stage he had night terrors, he still has the rare occasional night terrors (we still deploy a pacifier to settle him, that lasts about 15-30 minutes) At around 5 he started to sleep walk; his night terror episodes decreased. He has in the past 2 years, developed angry outburst when he fails at tasks. He does not get physical or verbal but will burst into grunts, tears and shakes. Talking to him or reasoning seems to not work, nor do distractions. We've tried to use his martial arts to let him learn control but he seems not to be getting better at it. We have used the time out to think method, it resulted in him sitting in his room crying and grunting for 20-30 mins. These outbursts will always trigger sleep walking and at times night terrors on the night following the anger. He and his younger brother both attend a school for advanced academics. He has not experienced these outbursts during school hours despite the work load.

Are there other ways we can help him to gain better anger control? He is a very smart young boy who is very socially accepted in school, but he seems not to control his anger at home.

Family back ground: we are an active duty military family and lived in many large military towns. I have two sons, both were born into military life, most of their classmates are the same. I am a stay at home mom and my husband does not spend much time away from home.

Thank you for any advice you can give me. Having to move around a lot makes getting professional advice difficult.

Hi, 

One thought I have is to help your son anticipate that he will sometimes fail at tasks, and that this is to be expected because he is learning new things.  If he doesn't sometimes fail, you would be concerned that he wasn't learning anything new.  In other words you want to normalize failing, since you said this is a situation that leads to his angry outbursts.  You would need to do this before he gets upset, not during an upset.  During an outburst he is not thinking rationally, and the more you try to talk to him, it is possible that he will continue to escalate. 

In  the second volume of my parents' manual, I write about developing a mantra that you repeat daily to your child in order to help him change whatever perception is precipitating an outburst--in this case it is failing at a task.  The mantra is a short saying with a new message for him to consider.  You could discuss with him when he is calm some alternatives and pick one together.  Examples for failing:  a) everyone fails sometimes, b) it's good to fail sometimes because it means you are learning something new, c)  I hope you will fail sometimes, or d) even (famous person like Einstein) failed a lot.  

If you discuss what led to an outburst (after he calms down), you could be understanding about his disappointment in himself, but also help him to look at things a little differently. You could even suggest that you will get him an ice cream (reward) the next time he fails (whether he gets mad or not)!  Then after a few weeks, you could say that the ice cream will be earned if he changes one thing about his upsets, and you would pick one thing he says that you would like him to eliminate or change.  You would be very specific and still allow him to get upset and earn the ice cream.  This of course assumes he like ice cream and also assumes that he does not have access to ice cream otherwise.  You could pick something different for the reward based on the interests of your son.

In the first volume of my manual, I explain other strategies:  how to teach children to recognize different levels of anger and how to look at things from different perspectives. There is also a section about developing relaxation strategies.  

Remember to be patient and understanding as you "seed" a new way of looking at failure. You don't want to rush things because then your son might feel like a failure for not being able to accept failure right away!   

Best, Dr. Dave Gottlieb

4 yr old explosive only with family

In advance, thanks for any thoughts or insight you can provide.  We appreciate your time and expertise on this matter.  My wife and I have been having issues with our 3 (will turn 4 next week) year old daughter and to us, it sounds like the personification of Anger Overload. 

Our daughter is usually sweet and lovable with a really good vocabulary for most of the time.  She has a really good imagination and often plays by herself with her dolls or colors for long stretches by herself.  She also behaves herself perfectly fine at school (really no complaints and no violence or acting out) and with almost everyone else- other than us (my wife and I).  With us, her fuse is often incredibly short and can be lit by even the most minor (as perceived by us) slight or use of the word no.  She has a big brother (he’s almost 7) and he sets her off rather frequently as well.  

Once the tantrum or behavior has started, usually with hardly any advanced warning, she calls us every bad name she can find, often says we’re ‘meanies’ or she hates us or she doesn’t love us, and tries to throw anything she can find on the ground.  Sometimes she rips things in half or will just throw things across the room.  It’s like she’s possessed and focused on violence and destruction for as long as it lasts.  There are also frequent episodes of violence (hitting, kicking, scratching) against us or her brother mixed into these fits of anger.  The duration is anywhere from 1 minute to 20 minutes but they usually end as she explodes with emotion and regret- crying, hugging, telling us she loves us, and she’s sorry.  It has forced us to walk on eggshells for risk of setting her off and has certainly adversely affected life in our home- both for our daughter and for our entire family.

Do you have any thoughts on this?  We recently bought your book through Amazon and are just getting to read it.

Hi, 

First, keep track over the next few weeks of some of the "minor slights" or times you say "no" that lead to her outbursts.   Do you see any themes, or issues, that come up repeatedly?  If you can find find some patterns, it allows you to anticipate and try to head off a tantrum.  Admittedly there will be unexpected outbursts, but you want to try to anticipate some of them so you have a chance of preventing them.  Once a child is in anger overload, it is best to say or do as little as possible, but if someone is being hurt or something of value is being destroyed, you may have to restrain her.  

There are a number of strategies I discuss in my two volumes on anger overload in children that you can employ if you find patterns and can catch your daughter's frustration early, before she erupts.  For example, you can alter a routine so that what she wants to do comes after what you want her to do (if some task is contributing to some of the outbursts).  Another option is to use language that is balanced with "carrots" when you say no to her.  For example, when she cannot play a game, at the same time that you say no, mention when she will be able to play it.  Or use emotional distraction:  come up with a pithy saying or a visual distraction that will get her to laugh or be amused.   It is unlikely that she will rage if she is feeling amused.  The two emotions are contradictory.  I explain more about this strategy in volume one of my manual.

Often children are more explosive at home.  In your case, your daughter has no outbursts except with you and her brother.  The question is why?  Is she real sensitive because she counts so much on your approval?  Is she jealous of things her brother can do but she can't yet?  Is she strong willed and self-centered, as most three and four year olds are?  If you can figure out any underlying emotional sensitivity at home, you can try to help her out by using empathy, and by using mantras that speak to a different way for her to look at things.  I explain about mantras in my second volume.  Essentially it is a way of seeding a new idea, by repeating a catchy phrase daily before any emotional situation arises.  Over time, a child will internalize the phrase (if she pays attention when you say it--that's why it has to be "catchy").  This is one way to help your daughter begin to look at things from another perspective.  Looking at things from another perspective is difficult for young children, so expect that this strategy will not yield immediate results.

There are likely biological aspects to her rapid and intense emotional arousal, and the basic goal is to use cognitive and behavioral approaches that help her forestall the emotional outbursts.  It takes time, but it is well worth the effort.  Also remember that the part of her brain (prefrontal cortex) that helps her with self-control will develop further over the years, so that in this way, time is on your side!

Best, Dr. Dave Gottlieb