Will 10 yr old become a "functional adult"?

My 10 year old has been having "fits" since he was a baby. He would get angry and spend 45 minutes to an hour just screaming, crying and throwing things. Kindergarten - 3rd grade was awful. I would be called into his school 2 to 3 times a week. I worked with guidance counselors, behavioral therapist, psychologist, psychiatrist, and nothing seemed to work. He was labeled as ADHD but the medications didn't help at all. I never thought he was ADHD but trying everything else I figured, why not? 

He is very bright and has been tested for gifted but misses it by a fraction. Every year his teachers say that he is the smartest kid in the class and they do not understand why he reacts to situations the way he does. If something does not go his way, something or anything can set him off. He never want to hurt anyone but will beat his head on the floor or throw a chair, or just scream and cry and hide in the bathroom. Now in 4th grade his "fits" have been better but still he gets so upset. I am worried for his future. Can he function like this as a teenager or an adult? He can be so sweet but turn so quickly. I am just worried no matter what I do he is going to end up with severe issues later, due to his anger. What steps can I take to help him become functional adult?


Hi, read through my blog posts over the last three years, and you will see your son is not alone, and you will see some ways you can work with him.  My parents' manuals are available on Amazon.  Also, in the next six weeks, I will be publishing a child and adolescent workbook on anger overload.  It follows the basic structure of the parents' manuals, and gives many concrete worksheets you can do together with your child.

Most children learn how to control their anger through practice and experience.  It doesn't happen over night, but if your child recognizes anger overload is an issue for him, then you can work him him on various strategies.  Some of the strategies that I outline in the parents' manuals you can implement without your child's direct participation.  The more advanced strategies you work on together.  

There are several overriding principles.  One is building a good working alliance with your child to help him take charge of his anger.  The second principle is to try to catch your child's frustration early (if possible).  The third principle is to develop different strategies depending on the level of your child's anger.  Some strategies require calm thinking, and that can't happen in the midst of an outburst.  

As your child feels some success, he will be encouraged to work some more on other strategies.  Having a "toolbox" of strategies is ideal, so that a child can use a different strategy depending on the situation.  

Best, Dr. Dave Gottlieb 

6 yr old tantrums only at home

Hello,  I’m so very excited to find your blog and hopefully get your book on anger overload.  My 6 year old daughter seems to fit the tee with anger overload.  At 4 years old she lost her great grandpa and the short little outbursts began.  We took her to grief counseling and she seemed to adapt well.  Her kindergarten school year she started to show a mild bout of fits that we just chalked up to be tantrums for not getting her own way.  By that summer they were more and more, however not aggressive, and we opted to take her to a psychologist where she was diagnosed with severe anxiety.  

As of two weeks ago the rages are more frequent and very aggressive.  She will begin by growling at you and then her whole demeanor changes and she goes into a rage, hitting me, my husband and especially her 4 year old sister.  She tells everyone that she hates them and has even said she wished she were dead.  This rage lasts over two hours and we finally took her to the emergency room for help.  Once we arrived at the emergency room she quickly changed and was nice and polite and the doctors couldn’t believe that this sweet little girl was doing what she was doing at home.  

She also is very good at school, sports and anything else while in public.  No one on the outside would ever think that she could act in such a manner because she is always pleasant.  She has also stated that she doesn’t want anyone to know about this (her rage).  Her rages are so frequent that my 4 year old is becoming afraid, as we have to keep my 6 year old in an enclosed area during this as she strikes out at my 4 year old.  

My husband and I are at a lost on trying to help her.  Her psychologist discharged her only after 3 months of therapy saying she was fine.  We have been on a waiting list for another therapist for going on 2 years.  I need my other daughter to feel safe in our home and I don’t want this to affect the relationship between the 4 and 6 year old in years to come.  When she is in a rage, do we just let her follow us around yelling and screaming while not saying anything to her, we just don’t know what we are supposed to do when she is in these fits, and I feel we must be doing it wrong because they seem to go longer and longer. 

Thank you.

Hi, First let me say it is a good sign that your daughter controls her temper out of the house.  That shows she is capable of self control.  Then the question is why the tantrums are increasing at home.  I wonder why the psychologist said she had severe anxiety--what was the anxiety about?  

What I would do is chart the sequence of events leading up to a tantrum for the next two weeks. What is she doing, and what are the adults doing right before an outburst?  See if you find any patterns.  If you do, then you can alter the sequence or avoid a trigger (when possible).  I explain how to do this in my parent's manual.  You want to try to intervene early, if you can, to head off an outburst.   Another strategy I outline in my manual is emotional distraction.   If you catch her frustration early, you might be able to come up with a funny comment, or you might be able to interest her in something else.

However, once she explodes, it is usually not helpful to talk with her until she calms down.  You are doing the right thing by ignoring her the best you can.  She may be escalating to see if she can get you to react to her.  

I wonder if she is jealous of the four year old, as you mention she sometimes strikes out at her.  If you think this is happening, try to find ways you can admire your 6 year old for helping you or for helping her sister. Express how proud you are of her at these times.  Maybe she can help in the kitchen or help you carry something.  Praise her helpful or cooperative behaviors.   

Best, David Gottlieb, Ph.D.  

Will children improve over time?

My son, who is now 12, appears to suffer with anger overload.  I am wondering what the general prognosis is for children who have this issue.  I can see that over time his ability to self-regulate and his rationality and self-knowledge about his anger issue increases.  So I see hope for the future.  But how do kids with anger overload – but no other mental health problem – fare over time?  Do most of them stop being so angry as their brain fully develops. or at least are they able to live normal lives after they have the maturity to handle their anger?  Thanks much. 


Hi, Over the last few years several parents have asked this question and it is a good one. Here is what I have found:   Research studies, looking at groups of children, show that there are significant changes when children learn cognitive behavioral strategies, like those I present in my anger overload manuals.  The studies compared using these strategies with groups that did not receive therapeutic intervention, and the studies found that the group of children taught to use the strategies handled their anger better.  

What hasn't been studied yet is seeing what happens to these children over many years, in other words, a longitudinal study.  Do the children maintain their gains over a long time period, and what percentage are still having anger overload many years later?  We do know that the brain keeps maturing throughout childhood and early adulthood, and we do know that practice using these strategies is beneficial over the short term for most children, so we believe that most children will continue to improve as they get older. 

Keep in mind that these studies have been for children as a group.  We can't make predictions for any individual child. 

A question we can't answer yet is why do some adults have anger management issues.  Did they have anger overload as children?   Did these adults receive help as children?  Is there something about their biological or emotional development that interfered with their learning better self control?  We know that adults with anger problems do have subtle differences in parts of their brain.  But we don't know how this happened. Were there other life events that impacted them in a negative way?  For example, we know that if there are serious mood problems or drinking problems, there often are anger problems as well.  But we don't know if the drinking or emotional problems caused the problem with anger, of if there is some other underlying cause.

I hope this is helpful, David Gottlieb, Ph.D.

8 yr old accused of assault in school

Hi: I have a 8 year old great nephew in whom I have been awarded the custody of in a bitter custody battle a year ago.  He has lived with me since 7 weeks of age and has been diagnosed with ADHD.  His father suffered from this as well and his biological mother  too.  He is over weight and is taking medication for ADHD.  We had an incident at school with another child trying to take his book from him.  He and the other child began pushing each other, and my son tried to hit the other child with the book.  The teacher stepped in and demanded my son to give her the book.  He refused, and she went to take the book from him, and he reacted by trying to obtain the book.  The school says he pushed on her arm twice, and they are charging him with assault on school personnel.  I have never been involved in anything like this before and don't know my options or how to even begin to protect my son.  We were supposed to meet to put his IEP in place for other health impairment. Can you help me or give me direction where to look for advice?

I have been reading your blog and it is so helpful to see that other parents are going through some of what I am going through.


Hi, I would check with your child's doctor, or your state's psychological association, or a local chapter of CHADD (support group for ADHD) to see who they recommend to help counsel you and your nephew, and at the same time make recommendations for the school.  When a child has an IEP, there ought to be spelled out ways of handling problem areas.  I have not heard of an 8 year old being charged with assault for the type of incident you describe.  Yes, there ought to be limits for being physical with a teacher, but a detention, and in school suspension, or an out of school suspension might be needed.  If it's his first time getting physical the punishment ought to be on the lighter side. 

Furthermore, I would recommend you and the staff discuss ways of handling your nephew when he gets frustrated in the future.  In my anger overload manual volume 2, I explain ways of handling anger in the schools.  There are strategies teachers can use to work around problem areas (by changing the sequence to avoid frustration, or by using mantras to remind the child how to deal with frustration).  Other approaches I explain are how to use emotional distraction when a child is just starting to get angry (including giving the child something to do, like taking something to the office to help you, since that removes the child from the difficult situation), and how to use behavior modification in schools (rewards and consequences) to increase the frequency of self-control behaviors.

Hopefully cooler heads will prevail at your upcoming IEP meeting.  Try to see a local mental health professional before your meeting, if possible.  The mental health professional can help identify possible underlying issues (maybe the bitter custody fight, or his feelings about his weight, or his ADHD), and the professional can help you devise strategies to help at home and school.  See if the person can come to the IEP meeting as well.

Best, Dr. Dave Gottlieb 

Avoiding 5 yr old tantrums

Good morning, 

I have a 5 year old son who is loving, generous, sensitive, loves to laugh and out of my 5 children is my biggest cuddle bug.  He loves to help with things, especially helping his dad build things, changing batteries in toys or cooking. He thinks himself much more capable than he actually is. Yet he hates to be alone or even be in another room by himself.  He has always been a physical child, tends to play a little rough and has a hard time calming down and understanding when it's time to stop. When he was younger he would have what we thought were night terrors and he has always had the ability to throw outstanding tantrums!  With all of our children we prefer to avoid spanking.  

We have, what we call the Stick. They can earn sticks for good behavior and lose sticks for bad behavior. At the end of the day they use their sticks like money to buy stickers and collect 20 stickers for a reward of their choosing, baking a treat, money for piggy, etc.  If they lose all of their sticks for bad behavior and they have no sticks we move to time-outs.  If they refuse this they have to take a break in their room and then come out when they are calm and take their time-out.  

This seemed to be working very well and it does for the other children. However my son, recently, has become straight up defiant at times.  Will tell us no to anything he does not wish to do, from picking up his toys to getting ready to leave. Refuses to sit in time-out or stay in his room. 4 times it has escalated to him hitting, biting, scratching and saying the most horrible things. As a last resort he received a spanking, this did nothing!!! Not knowing what to do, myself or his father restrain him on our lap and hold him in such a way that he cannot hurt himself or us. He continues to fight, spit, blow snot out his nose, say horrible things, he even peed his pants once. I continue to stay calm and tell him as soon as he calms down we can let go and that we love him. Then it stops as quickly as it starts.  His whole body relaxes and he cries and says how sorry he is and that he loves us and didn't mean anything he said. It is heart-wrenching. 

Other days, like yesterday he is an absolute angel. I taught preschool for 10 years, I have 5 children of my own and we are youth ministers.  We have dealt with ADD, ADHD, Hyperactivity and Sensory disorders.  I have never dealt with something like this before and I am at a loss. My husband and I both agree that this more closely resembles Anger Overload than anything else we have read about.  The way I understand it, it is important to find out if there is more to it, which could be medical, chemical or behavioral.  Is this correct?  What can I do, what is our next step?  I have ordered your book, but it will not be here for a week or two. Please, any advice would help.

Hi, My first thought is to ignore him right away when he refuses to do what you ask.  I realize this can be a problem if you need to go somewhere, but otherwise you might be able to "become deaf" until he is sorry or until he cooperates.  With anger overload, incentives often  do not work because the child gets so emotional so quickly that he is not thinking rationally about rewards or consequences.   The more you talk, the more your child is likely to escalate.  Initially, when you try to ignore him, your son may get angry that you are saying nothing, but over the next few weeks he will likely realize that you are not going to talk with him until he calms down and cooperates.  

Another strategy I write about in my parent's manual is to re-arrange the sequence.   What I mean by this is to ask him to do what you want before he gets to do what he wants.  In other words, if something he is looking forward to comes after he does what you ask, then he is more likely to cooperate.  You just don't start the activity he likes until he cooperates.

In volume two of my manual, I write about using mantras (short amusing sayings) in order to focus a child on dealing with something that has been challenging for him in the past.  For example, if he is slow to get ready to leave, you could say something like "chug along choo choo.  It's the train.  We have to get on it."  He will hopefully smile and stop what he was doing.  Or another way to change a child's mood is to say "Big hug time. (hug him) I really need your help now"  Then ask him to help you get ready.  Another option is to have something fun to do in the car.  Make sure he only gets to play with it in the car.  

Each child reacts a little differently, so you would try a strategy and see if it helps.  The main idea is to avoid a power struggle when possible and use a strategy that helps before an outburst occurs.  Once a child is in anger overload, you wait it out or bear hug him if he is hurting someone (like what you already do).

Best, Dr. Dave Gottlieb 

                                                                                                          

8 yr old loses temper in school

Hi there
I have recently read your article on the above subject. I have an 8yr old boy who losses his temper and gets frustrated only at school. He was born by emergency c-section and his dominent hand is his left. Do you have any suggestions as to why this could be only happening at school. Is there any articles or books which would be useful for me to read?

Many thanks.

Hi, In volume two of my parent's manual, I have a whole section on how to apply interventions in the school setting.  I go over the strategies for each level of anger: a) prevention strategies (like changing the sequence and lowering a child's expectations), b) strategies for low levels of anger (like emotional distraction and relaxation), and c) strategies for high levels of anger,  Also I explain how schools have an advantage over home life in using rewards and consequences.  I explain how to tailor rewards and consequences for anger issues.

I would also suggest you rule out other sources of frustration in school, such as learning issues and attention deficit disorder.  If his academic work is good across the board, then learning disabilities are unlikely. If he pays good attention, then attention disorders are unlikely.  So then what I would suggest is that the teachers keep track of your child's triggers (what situations more often lead to outbursts) and use some of the above strategies for each trigger.  Sometimes it helps for parents to meet periodically with the teachers to plan strategies together.  That way you can discuss progress with your child at home after school, and then remind him in the mornings before school (using mantras) how he can deal with frustrating events in school. 

I know of no evidence that left handedness or birth by C-section relate to angry outbursts. Was the pediatrician concerned about brain abnormalities from the birth?  Has your child's development been otherwise normal?

Best, Dr. Dave Gottlieb 

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