Concerned about 3 year old son's behavior
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I'm really concerned about my 3-year-old son's behavior. Ever since I can remember he has been a more "hyper" and just intense child. When he was born he would constantly move his hands and sometimes legs about as he was nursing. I just seemed strange compared with other infants. He cried often and slept little. He never has slept well at night (schedule is inconsistent). Around 2 years he started to sleep through the night. Now he is having problems falling asleep and is only getting about 8 hours of sleep per night (down from 11 – 12 hours before). I tried cutting out naps, but his behavior seems to worsen with less sleep.
He is very easily frustrated. If something doesn’t go just the way he thinks it should he gets very upset. Often he will throw whatever he is playing with and I will have to instruct him to pick it up and put it down gently which is a task in itself. When he was between one and two years of age, he would get upset and often hit his head hard on whatever surface was available. That was scary, but he did outgrow that. Although now he will sometimes hit whatever is nearby with his hands.
The most terrifying experience with him is when the tantrums escalate. He can have an explosive reaction to what seems the smallest slight (i.e. a friend of his comes up and points to the sticker on my son's shirt to say "look!" and my son will yell "no!" and push him away hard enough for the boy to fall down) and his ability to handle transitions can be so difficult at times. He seems to have an immediate melt down.
When he has a normal temper tantrum because I said "no" to him, he will begin by displaying what I would consider normal tantrum behavior (i.e. falling to the ground, whining, shouting no, crying, etc.) but then he can get so riled up that he throws hard objects, hits, and just otherwise seems out of control. He can get so out of control that the only way to calm him is to hold him tight and speak very calmly and quietly that it's okay, shhh, etc. and eventually he is okay. He looks afraid when he gets to that point, as though he was out of control and really could not calm himself until I helped him.
He is behind in regards to speech and my pediatrician recommended a speech evaluation. He has had the hearing test and his hearing is fine. Over the past 3 months his speech has been progressing I feel, but I believe he may be a tad bit delayed. I have put off the speech evaluation because he seemed to progress rapidly over the past couple of months, but I am wondering if I should have it done anyway. I have a hard time believing my son will be able to follow instructions from the service provider while being tested, though. When we had his hearing tested it was a very difficult time. He would not listen well, actually refused to put on the headphones so she had to put the phones up to his ear. He just seemed irritated and bored with the whole process (which did take quite a while). I am also concerned with how my husband will feel about it because it seems to be a point of dissention for him, afraid about something being wrong with our son, etc. Our son may be somewhat advanced when it comes to ABCs, numbers. He has been able to recognize his entire alphabet since age 2 (point to a letter and he would say it).
The hardest part about all this is his behavior seems to cycle between two extremes. One extreme is the behavior I just described and it tends to last anywhere from two weeks to a month or two. Then he will start behaving in a very mild, passive manner. He still has bouts of the behavior described (quick reactions, melt downs) but they are much more infrequent and easier to work with. Then just like a switch has been flicked, he will begin to act this way consistently again.
Does anyone know what I am saying? I am unsure of what to do here. The hardest part is seeing how he relates to other children. Sometimes he is pushing them away for no reason or overreacting and other times he is talking to children too close (face to face ) and trying to hug them even when they say no. It seems that the children are confused and annoyed with his behavior. He is at home with me most of the time, or since I have a part time babysitting job, he comes with me and has interaction with 2 children there. He also goes to Sunday school.
Since he is over age 3, where do I go for help? Should I even be that concerned, or will he just outgrow this like my husband seems to believe? I am torn between feeling like a bad parent who just needs to discipline more or differently or something and this feeling deep inside that is telling me that there is something more to this!
I know this is long, so thanks so much for reading!
Bless your heart! Couple of suggestions - The book The Explosive Child is very helpful for parenting techniques for this type of child. Normal parenting, as you see, doesn't work well for these kiddos.
Second, do call the school district that you live in and ask for an evaluation. You may just get speech for now, but you might also get into special ed preschool down the road. The special ed preschool should be able to help him before he heads to kindergarten.
Another suggestion, check out the Forum on www.conductdisorders.com where they have a message board for moms of kids under 5 with these types of difficulties. Good support there. No parent bashing. (Don't we get enough of that in real life?)
Stay open mined to the possibility of medication once he hits regular school or before. The meds may be life changing for him (or not), don't know tell you try. Age 3 is a tad young for meds, but you will find kids age 4 and 5 starting medication to help with the issues. The cycling, of course, sounds a bit bi-polarish, but he's so young and things could change. He will probably always be challenging, so pace yourself.
I am a speech pathologist and I would strongly encourage you to go ahead with the speech evaluation. I promise that pediatric speech therapists are used to all sorts of behavior issues. I have been kicked, hit, bitten, spit on, slapped, etc. and even have a scar on my hand from scratches by an child with autism. The therapist will know how to deal with the behavior. Even if your child is not "cooperative", she can gain a lot of info just from seeing how and when your child has a meltdown, how he communicates it to you, how he plays,, how he interacts, and what you can tell her. Most 3 y/o's can't sit down and take a standardized test (some can, but I always have a Plan B at this age), so the assessment will be largely play-based. His behavior problems may very well stem from him not being able to express himself verbally or she may detect some things that warrant further evaluation from a neurologist or psychologist. Good luck!
Some of this sounds like my DD....the over-intensity and no idea of boundaries as far as other kids go. Meltdowns. I will try and post more later. SHe is 7 now and has calmed down tremendously but still has some issues.
My DD is on meds to sleep. Otehrwise she would be up until 12/1 in the morning.
Kids like this are HARD. I hope you have a good support system and get to take an occasional break.
Also let me point out that three is really young to diagnose. Yes it could be something like ADHD, OHD or another disorder and you will ook back and say oh I should have known. But lots of children have these moments. Not speaking at age level brings on a certain level of frustration. My dd was this way as a child (she is currently dx as ADD, very inattentive, but not at all hyper) would just lose it. I finally just had to restrain her. I would just hold her tight and hug and let her get it all out, after about 15-20 minutes she would always just end up hugging me and crying. She doesn't really display any of this now. She is a bit impulsive, but nothing compared to that. Also a lot of the things you mention (head banging) can be very normal.
My advice, go to the school, do an eval. It is free and they will tell you if he doesn't qualify. I can promise a school will not provide services unless you really need it! They don't have anything to gain by lumping kids into the program. But from that eval, they will also likely do more evals, a pshychologist for behavior, a preschool assesment. You may learn a lot, and may get more guidance on what is next. Also look into some sensory intergration information, maybe these outburst are related to that.
My son also seems to over react, especially when he is tired or hungry.
Cutting out naps won't help him sleep. Kids get hyper when they don't have enough sleep and then can't sleep well.
I suggest, in addition to having speech and OT (for Sensory Integration Disorder) evals, you set up a routine or schedule and stick to it for several weeks.
You may find routine and more sleep will help him feel comfortable. Remember, he's THREE. We have a tendancy to over diagnose in our society. He could just need a little more structure and time to mature.
Also, is he frustrated by his inability to communicate? If he can't find the words to express his emnotions, they're going to come out some other way. Help him by naming the emotions as he experiences them. Get books on emotions and read them. Role play emotions and social situations.
Pre-School evals are done within 30 days of the referral in NY, but getting the services afterward takes a lot of time. I'm still waiting for speech and OT for my son.
Good luck.
Ame
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