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adoliaq June 7th, 2006 05:00 PM

severe behavior problems in 6 year old
I am dealing with a 6 year old boy who has some very serious behavior problems. He has been diagnosed with Autism and ADHD. He takes Ritalin every three hours durning the day and Valproic Acid 3 times a day. I have been babysitting him 5 days a week for 6 months.

When he first started coming to my home he would spend the majority of his day either sleeping or screaming. Although he made hourly trips to the restroom, he would wet himself frequently. Within the first couple weeks of watching him the wetting disappeared completely, and the screaming only happened a couple times a week. The parents however, are still having frequent problems at home, and at kindergarden he is out of control the majority of the time.

I am concerned with several different issues. First of all is the violent thoughts this child has on a regular basis. It is common for him to be sitting quietly and out of the blue make statments like "I am going to get a knife and stab someone in the back of the head" or "guns and knives can be used to kill people". He is not exposed to violent games or allowed to watch any type of violence on TV. These statements become worse when he is in a time out, and are usually directed at the caregiver. They vary in content from day to day, but always have a violent theme.

The second problem is outbursts that are clearly out of control. He will start screaming, as if being tortured, for no reason. He will throw himself backwards onto the floor. If you approach him he will lash out and try to hurt you. This can go on for several hours at a time. At other times he will sit and stare into space and not respond appropriatly when you speak to him. His outbursts are happening at least 3-4 times a week, and frequently more than once in the same day.

He also uses foul language frequently when he is upset. At home he tries his best to get ahold of knives. The parents both have back injuries and he definetly takes advantage of it.

He does not respond to a reward system at all. He will stay in a time out for me, although he continues to scream, curse, and hit or spit at anything he can reach. At home he will run from his parents and become destructive, and they have to physically restrain him in order to keep him in a time out. The behavior seems to end from exhaustion, but will frequently continue after he rests.

What i am looking for is resources for the parents (and myself) in dealing with his behavior. The doctors so far have made changes to his medications to try and control the behavior but offer no advice on how to deal with the outbursts. They have switched doctors twice. Their choices are financially limited, and they are running out of options.

Any suggestions would be appreciated.

ann wills June 13th, 2006 02:23 PM

Re: severe behavior problems in 6 year old
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WhHeNe June 14th, 2006 02:13 AM

Re: severe behavior problems in 6 year old
UGH...I doubt that an ad for online therapy was what was sought here. I have been thinking about the first post for a few days, and trying to think what would be most helpful. On the tantrums, I am guessing that there is some environmental trigger, perhaps that no one else can see/hear that is setting off the tantrums. It would probably be like looking for a needle in a haystack to figure out the why, but there is usually a reason.
I was also struck by him being out of control in kindergarten. Is he in a mainstreamed classroom? Does he have an aide? Sometimes the most ordinary things can be overwhelming for someone with autism, or for that matter adhd. In a typical kindergarten classroom, there is a teacher talking, other students doing things, and perhaps he just doesn't know how to pick what to focus on.
Do the parents have any other parents of kids with similar issues they can talk to? Sometimes that is very helpful, since maybe they will have some ideas to help through this rough time, or at least they won't feel so alone.
Other than just sympathizing, I suggest reading up on the disorders, and don't give up.

hrisme August 6th, 2006 01:32 AM

Re: severe behavior problems in 6 year old
As a respite provider & private tutor, I have a five-year old boy who sounds very similar. He is diagnosed with Atypical autism/PDD, ADHD, and Intermittent Explosive Disorder, among other things.

I would agree with the previous poster, the tantrums may very well have an environmental trigger. They may also been related to a physiological abnormality that has not been addressed with his current medication. Or, not unlikely, there could be a combination of these triggers & an environmental influence. He may have found tantrums to be reinforcing in the past, and as such uses them now to get what he wants. It's quite possible that both physiological and psychological factors are present--which makes it quite difficult when trying to decide what approach to use!

The only solution I have found is consistency. Regardless of what triggers the tantrum (even if there is an obvious environmental trigger) I remove him from the situation and place him in a safe place where he can calm down. This is not done as a punishment, but as a way to ensure the safety (emotional, as well as physical) of the child and the others around him. At one time we were forced to use a locked room as a safe location, as physically restraining him seemed to be both overly intrusive and risky (for him and for us). I would not typically advocate this approach--but with this child I found it vital.

We saw the same problems with this child when he was placed in a mainstream kindergarten, when he was moved to a small group kindergarten (eight children with two teachers) where the environment was less chaotic he did much better.

As far as treating the autism goes, there are dozens of approaches to treating autism that go beyond the scope of this board. I would suggest doing research on the gluten free, casien free diet, chelatin therapy, biomedical approaches, treatment of potential yeast infections, ABA therapy, neurological excersizes, sensory integration techniques, and Greenspan's Floor Time approach, to start with. Unfortunatly, many of these approaches are financially draining, and it is typically impossible to determine what will be effective without actually trying it. I would suggest the book "The Out of Sync Child" and the accompanying book "The Out of Sync Child has Fun" as resources that you, as a care provider, may find useful.

troubledwaters August 20th, 2006 02:04 AM

Re: severe behavior problems in 6 year old
He reminds me of children with Reactive Attachment Disorder. Here's a link if you'd like to read more about it:

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