Behaviorally Challenging Kid (Long)

[awkwardpenguin]

I don't post here much anymore, but I am at my wits end with my behaviorally challenging almost 6 year old daughter and I am hoping someone has some advice or at least wants to commiserate.

DD was a tough baby (cried a lot, always wanted to be held, didn't sleep well) and by toddlerhood we could see that her behavior was more challenging than other kids her age.  The biggest problem is (and has been) she absolutely pushes every limit that has ever been given to her and can't take "No" for an answer.  She's also fairly physically aggressive.  So she'll ask to go outside and I'll say no and she'll try and negotiate me taking her outside.  If I say no firmly, she'll either growl at me and hit me, or just leave the house anyway.  We have high up locks on the doors for this reason, but it's just one example.  Another example is if for some reason she doesn't want to get dressed, I might say "Do you want to wear shirt A or shirt B?" and she'll answer "nothing" and walk away.  She throws things at me pretty regularly, sometimes out of anger, sometimes it seems just to mess with me or get a rise out of me.  She frequently pushes/hits/kicks her brother over things that are small, and we have to supervise them closely for his safety and emotional well being.

When she was 4.5 DW and I did a parent behavior management training class, which was basically positive discipline on steroids, and is an evidence based intervention for children with behavior difficulties.  They taught us to "catch her being good", take the "no" out, state our request in a positive way rather than a negative way, ignore annoying but non-dangerous non-destructive behavior, and provide physical matter of fact follow through to complete requests that she is ignoring or resisting.  We also do "a break in her room" (what most people would call time out) for aggressive behavior or when she seems really riled up.  It has worked for us somewhat - we were able to troubleshoot some of her most problematic behaviors, it made my and DW's relationship with her stronger, and it decreased our parental stress because we had a way to respond to her challenging behaviors.  However, it hasn't actually stopped the basic defiance toward us and aggression toward us and her brother, and I feel like the trainers from our class would just say we need to be more consistent and apply the principles more.  Which is hard for a variety of reasons, not the least of which is that I am home with her all day (I SAH right now) and the need to be "on" all the time to manage her behavior is very taxing for me.

When the pandemic started she was in Pre-K4 and they had Zoom Pre-K twice a week for a half hour.  She hated it and would scream into the microphone and slam the computer shut.  When Kindergarten started all remote, we felt like there was zero chance of her being successful in three hours a day of Zoom class, so we opted to homeschool.  Every day getting her to do school has been a struggle - she doesn't want to listen to me when I say it's time to do school and she doesn't want me to be the one who picks the activities.  I've navigated this by letting her choose a lot of what we do (within our overall curriculum) and using a lot of positive reinforcement when she DOES do what is asked of her, but it is a daily struggle (thankfully only for two more weeks).  She's doing fine academically, is probably ahead grade level in some areas and at grade level in others.

She also goes to a behavior class two days a week and is very successful there, but while some skills have generalized (she can tell us what she is feeling more readily), the limit pushing and subsequent aggression is still very much with us at home.  The behavior class is run by the same place that did our parenting class, and it is extremely structured and the staff are highly trained at behavior intervention.  It doesn't seem possible for us to replicate that environment at home for a bunch of reasons (energy, no peer models, more demands at home than at behavior class).

I feel really worn out and like we can't enjoy things together.  Her behavior is such that I usually don't take both kids out together because if she becomes very resistant or aggressive, I have to put all attention on her and can't attend to her little brother.  Like if we go to the park and she refuses to leave, I have no real way to address that safely and effectively.  I also feel like I can't relax at home except when she's in front of a screen or DW is available for kid duty, because I need to supervise the kids closely and monitor/redirect/manage her behavior.

Things we have done:
-read half the parenting books out there (How to Talk So Little Kids Will Listen, 1-2-3 Magic (not for us), Positive Discipline (the original, the first three years, and preschool), Raising your Spirited Child, The Explosive Child)
-the parent behavior management class
-seen a developmental pediatrician and ruled out ADHD, we have another follow up scheduled so maybe something will come out of that
-seen a social worker who basically said we were doing everything right and KOKO

Things we are considering but haven't decided on yet:
-Kadzin Parent Management Training (this is another evidence based treatment, but I am resistant to the "token economy" at home even though it seems to help in her behavior class, and it's most likely out of pocket rather than covered by insurance)
-Collaborative and Proactive Solutions with a therapist (this is another treatment, and a total 180 from behavioral approaches like we've been doing.  DW is more resistant to changing paths since we've already invested so much in behavioral methods.)

I feel like there is so little help for our situation - we've already done the treatment that several providers have recommended (parent training) and she has no obvious diagnosis that points to a particular solution.  Therapy with her as the patient isn't recommended until she is older, plus she's already doing the behavior class.  She may have some sensory stuff going on but that alone doesn't seem to account for her level of non-compliance and aggression.  I'm really at a loss for what to do.

Has anyone dealt with this?  What has helped?  We really are in a better place than we were at 4, but certain things (hitting, throwing, school refusal) seem to be escalating and becoming the new "most difficult behaviors".

[zarapipe]

Have you had her evaluated for anxiety? Dd was still throwing massive tantrums at 7 when we finally reached out for help after catering to her and walking on eggshells for her for years.. I thought it was defiance and maybe a little ocd bc when things didn’t go as planned is when she went off the rails. She also had sensory issues but the physical defiance was what was the worst. Turns out she had major anxiety and it for her it showed up as defiance bc she was trying to control her surroundings. Therapy helped a little so she count find some techniques to help calm herself down but anxiety meds turned her into a completely different person. I’m sorry you are struggling. I’ve been down this road and it is incredibly hard. 4 years from starting the journey asking for help and I can say it is so different. She is a completely lighter person and still has challenges but her anxiety doesn’t control her anymore. She used to take all my energy and now my dd2 who is 6 takes all of my energy and is the challenging one these days. A good podcast I like it AT parenting survival podcast. She is a child psychologist and also had kids with ocd, anxiety, etc.

[luv2rn4fun]

I don’t have much advice but I would get her evaluated. I can commiserate SO much- like DS1 is exactly what you describe. I had him evaluated 2.5 years ago, when he just turned 4. Turns out he has ASD but also likely has anxiety and a lot of sensory issues. He’s so aggressive, sensory seeking, and defiant. It’s purely exhausting. We have been doing ABA for almost 2 years, he does speech and social skills through school, and OT privately. He’s made progress but not much in the past year. All the advice from ABA is exactly what your parenting class told you. We even don’t have to do a reward system for school as long as it’s with me...others he needs the constant reinforcement. He’s a perfect angel at school though- holds it all together and then explodes majorly at home. He does struggle socially- it’s one of his biggest challenges.

[outnumbered]

I think you should request an evaluation through your school system. This is a general guide on how to proceed (this is out of MA, but applies in most states) www.mghclaycenter.org/parenting-concerns/grade-school/how-to-get-a-core-evaluation-completed-through-your-school-district-2/

I would write the letter of request as soon as possible to get things started.

It is also can be good to proceed with private testing. Some doctors recommend a pedi neuropsychologist. Here is some info from the Clay Center. www.mghclaycenter.org/parenting-concerns/families/qualified-conduct-childs-evaluation/

[vmars]

Why did they rule out ADHD, if you don’t mind me asking. DS went thought this, he had zero impulse control and could become violent at home. Hours long tantrums from being told no. He was diagnosed ADHD combined type and autism. The only thing that has made the biggest difference is a low dose stimulant. He started taking Focalin XR and his tantrums have stopped. He still gets upset by being told no but he gets over it quickly and has been able to find ways to self soothe.

[plutosmoon]

My daughter was a lot like this, I could have written a lot of similar stuff when she was a baby and toddler. I read all those books. She received her ASD diagnosis at 3, they also diagnosed sensory processing delays, functional language delay and anxiety. I suspect ADHD as well. The constant need to be held, the poor sleep. She used to throw chairs and tables in pre-k 3. I had to hold her in time out. She punched another kid on the bus. I would take her places and the tantrums when it was time to leave would be epic, it was so hard. I would have to physically carry her out, which was hard because she was tall for her age and I'm short. We got kicked out of swim lessons. She never sat still. She refused to do things independently. I wrongly assumed some of it was just normal toddler behavior.

Here they do 3 year old screenings for all kids about to turn 3, they saw some flags. We enrolled her in public pre-k just before her third birthday, she did speech, OT, PT and a special pull out program for kids with autism, the first couple months were tough, but her pre-k teacher was so incredible and patient, recognized their was a problem and got her on an IEP and intervention by November. The evaluations the school did were really hard to read, they recommended the developmental pediatriician. For us, peer modeling was a huge help, as were the various therapies we received through the school district. By the end of her second year in pre-k she was like a different kid. By the end of K, she no longer required an IEP. The pandemic was incredibly hard on her without peers, couple that with her dad and I divorcing and him disappearing, I saw a huge regression the tantrums were returning when it was time to zoom, we were losing a lot of progress. Once we got back to school and peers, she rapidly improved. I also recommend getting in touch with your school district, the services we received were crucial to improvement.

[isabel]

My mind immediately goes to ODD. Have you done a full evaluation to see if she fits criteria for disorders other than ADHD?

[awkwardpenguin]

May 24, 2021 20:55:55 GMT -5 isabel said:

My mind immediately goes to ODD. Have you done a full evaluation to see if she fits criteria for disorders other than ADHD?

We did a visit with the developmental pediatrician (90 minutes), and she gave us Vanderbilts for us and her teachers.  The note says r/o ADHD and nothing about other diagnoses.  The dev pedi did mention three additional steps - referring for more evaluation with a place that does neuropsych testing (I wasn't sure what this would be evaluating for), referring to a psychologist to evaluate for anxiety, and considering ASD as it sometimes presents differently in girls.  I think she wanted to rule out ADHD first before we moved on to the other steps.

Honestly, I dropped the ball a little as I just re-read the message she sent and she said to go ahead and pursue the anxiety/psychologist evaluation and return for a follow up.  I thought we needed to have the follow up before we moved forward with the other evaluation stuff.  Our follow up is in July but we're on the cancellation list if anything comes up sooner.

Edited to add: we have not gone over the Vanderbilts with the dev pedi, she just sent a MyChart message that we could rule out ADHD and to schedule the psychologist appointment.

[awkwardpenguin]

May 24, 2021 20:41:58 GMT -5 vmars said:

Why did they rule out ADHD, if you don’t mind me asking. DS went thought this, he had zero impulse control and could become violent at home. Hours long tantrums from being told no. He was diagnosed ADHD combined type and autism. The only thing that has made the biggest difference is a low dose stimulant. He started taking Focalin XR and his tantrums have stopped. He still gets upset by being told no but he gets over it quickly and has been able to find ways to self soothe.

She doesn't fit many of the symptoms.  We did Vanderbilts, as did her behavior classroom teachers and her pre-K teacher.  She has some issues that fit, but she's missing the core symptoms of inattention and hyperactivity.

I'm really interested in how many people mention ASD/autism with similar behaviors.  DD has a first cousin with ASD and the developmental pedi mentioned it as well.  It's not something that I would have thought of myself, because her social functioning seems pretty good.  But I only know about the more "classic" presentations of ASD.  Thank you to those who have shared.

[isabel]

Tagging CurlyQ284 because she may have some thoughts on the process of testing and the behaviors you're dealing with.

[awkwardpenguin]

Reading my own posts I think I have to let the evaluation process play out. I’m just really feeling desperate for something to change.

[awkwardpenguin]

May 24, 2021 22:06:42 GMT -5 @hiphopanonymous said:

Do the consult with the neuropsychologist. I am in the process right now with one of my own kids and the doctor is the one who decided which evaluations to do. It was a three+ month wait to get in to see her, then a visit with her, then the evaluations (play based, puzzles, games, my kid had a good time), then a six week wait to get in to see her for results.

Yeah, we’re actually in the process with her little brother (for different concerns) and there is a long wait. I’ll see if I can get the ball rolling on that since we know it’ll be a long wait.

[luv2rn4fun]

May 24, 2021 21:19:29 GMT -5 awkwardpenguin said:

May 24, 2021 20:41:58 GMT -5 vmars said:

Why did they rule out ADHD, if you don’t mind me asking. DS went thought this, he had zero impulse control and could become violent at home. Hours long tantrums from being told no. He was diagnosed ADHD combined type and autism. The only thing that has made the biggest difference is a low dose stimulant. He started taking Focalin XR and his tantrums have stopped. He still gets upset by being told no but he gets over it quickly and has been able to find ways to self soothe.

She doesn't fit many of the symptoms.  We did Vanderbilts, as did her behavior classroom teachers and her pre-K teacher.  She has some issues that fit, but she's missing the core symptoms of inattention and hyperactivity.

I'm really interested in how many people mention ASD/autism with similar behaviors.  DD has a first cousin with ASD and the developmental pedi mentioned it as well.  It's not something that I would have thought of myself, because her social functioning seems pretty good.  But I only know about the more "classic" presentations of ASD.  Thank you to those who have shared.

When I kept pushing for answers and help with our pediatrician, my initial thought was DS1 had ADHD. Then DS1 had a classic meltdown at his 4yo appointment and I looked at his pediatrician and said “this is our life”. He referred us to a neurologist and when I asked what his reasoning was (besides the meltdown) he said to rule out ASD (we had just agreed to start the school district process to see if speech delays were causing the behaviors so we did both simultaneously). I said that I had researched and DS1 never fit either umbrella (ASD or ADHD) perfectly but had symptoms of both. He said that’s very common...and I do think he might have ADHD as well but we haven’t wanted to medicate and he does very well at school for now.

One key thing I learned in my ASD 101 class is “if you have met one person with ASD, you have met ONE person with ASD”. Everyone is so different and it truly is a spectrum. I know a handful of kids with ASD and their challenges and how they present truly are unique. None of the kids are all that much alike and yet they all have ASD. But once I truly read and learned, I had a moment where it just all finally made sense and I do believe most of our challenges are due to ASD (even though there are likely other diagnoses that are tied in as well...the good news is that most of the time the therapy is the same, regardless of diagnosis...the goal is to improve the behavior challenges).

[ladyfern]

I would also suggest an occupational therapy evaluation. For behavioral and possible sensory issues, an outpatient clinic might be more helpful than school OT

[luv2rn4fun]

May 24, 2021 22:29:54 GMT -5 ladyfern said:

I would also suggest an occupational therapy evaluation. For behavioral and possible sensory issues, an outpatient clinic might be more helpful than school OT

Totally agree with this! We finally started OT last July and it has been very helpful. Wish we would have made the time for it sooner!

[AdaraMarie]

I'm sorry you're going through this I can relate for sure. The evaluations my dd had at a young age were often borderline/under meeting diagnostic criteria but by age 8 she was diagnosed with adhd and anxiety and at age 9 with asd. At one point she also had an odd diagnosis, but her psychologist, who knew her better than the evaluator, said no, that one's wrong. At 4 she was throwing chairs at prek and 5 she punched a younger kid at drop off. Banging her head on things, rolling around on the floor in 2nd grade, throwing things, putting holes in a couple walls, destroying classrooms/having other kids have to evacuate. Often her fits were caused by anxiety, which I think could also be related to asd rigidity; things not going exactly as planned, things different than she expected, someone not following the rules, something unfair. I can totally relate to struggling to keep a younger kid safe too. I am a single mom and I had to just give us permission to be in survival mode. I could not always perfectly handle a 6 year old's melt down when I also had a 3 year old to take care of and keep safe.
Our hardest years were probably ages 6-8. Which coincidentally or not were before she started taking guanfacine and before she had outside of school ot.
She's had lots of counseling, occupational therapy, and lately medication.

I'm sorry you were in such a tough spot for school this past year. I don't know what we would have done, both zoom school and home school would have been unfeasible when my kid was younger. Do you think repeating in person K might be a good fit?

Bribes/tokens/points never worked for me at home and were not great at school. My dd was good at cost/benefit analyzing and would stop trying if she knew she wasn't going to get her reward or would get a look in her eye like, future me might regret it but current me is going to burn it down.
Best things for us, staying calm as a parent (not easy at all, but does keep from adding more negative energy for her to feed off of), trying to stay ahead of any sensory, physical, emotional needs (hangry only makes everything worse). I hesitate to think I ever really had it all figured out because yes, a lot of things are easier now, but she has also matured and changed a lot at almost 11 so maybe we just got through it

Meeting other parents with similar kids in the parent part of my kid's group therapy was pretty life changing.

[lynn07]

I would definitely move forward with a neuropsychologist. They will do a much more thorough evaluation. For reference, when DS2 got his ADHD/anxiety diagnosis (and lost his possible ASD diagnosis), the evaluation took place over 2 separate days and totaled about 6 hrs, plus more time where we talked one on one with the dr. It would be difficult to tease out some of the quirks in only 90 mins. DS2 is not hyperactive, but is very impulsive, which shows up as anger sometimes. He was quick to tantrum/scream/hit. Especially when anxious. I’m sorry, I know this can be a lot to deal with, and can take a long time to figure out. We’re 8 years in to the first time we got any sort of diagnosis and still feel like it’s an ever changing puzzle sometimes.

[AdaraMarie]

I read your post again and thought of more stuff, maybe just commiseration.
When my dd was in 2nd and 3rd grade she would not/could not do what the other kids were doing. In the sense that for most of 3rd grade her teacher would give her a list and say, here is your work for the day, you can do it in whatever order you like.

I also understand about not being able to go places with two kids due to fits/meltdowns/etc. It gets better if/when you get to a point where the younger one can be trusted to do what you want regardless of what the older is doing. Or, if you can "wear" the younger one, but you might be past that.

I totally understand how consistency feels impossible, I said the same thing, but it really is effective when they know that no amount of arguing/throwing a fit will change the situation to what they want. Now that my dd is older I have opened the door to some negotiations because sometimes she has good points I didn't consider, but she still tries whining/yelling fairly often and I have to shut it down almost every day.

I also, still, send dd to her room for breaks. It currently works quite well. However over the years...in the best of times, she calms down in a few minutes and rejoins the family. Next best, she comes back and immediately starts fighting again and gets sent back. Terrible, I hold the door to her room closed while she screams and throws things. And in the worst of times, I debated taking her to the hospital because she was threatening to break the screen and jump out the 2nd story window. So maybe just commiseration here.

During the hardest years, my dd had a lot of sensory seeking and avoiding behavior. Not sure how yours is, but sometimes full body pressure helps her calm down and I discovered accidentally (when I was beyond my temper and wanted to literally beat her) that hitting her with a pillow also can provide sensory input that helps her regulate. Also...little trampoline, pushing our palms together, last year when we were mostly locked down she started "falling" on the floor all the time and that was how I could tell she was feeling off. Places were to loud, clothes were too itchy...those kind of things could set her off but she couldn't always articulate it.

For her anxiety, it was like on an alertness scale of 1-10, she was spending most of her life at about a 7 so any little thing could kick her up to a 10 even if other people walking around at like a 3 wouldn't be too bothered. It helped me to think of it as her having an overly sensitive fight or flight instinct (she could also be a runner). It helped me to think of it as her brain giving her signals that were wrong or too strong instead it being deliberate bad behavior. You can't reason with someone in that state and trying just prolongs the emotion in my experience. (She was also a hitter, I believedue to poor impulse control, heightened fight reflex, and lack of other social skills to get what she wanted).

Other helpful things people have expressed over the years: Kids who can do better will, they are not doing this because they enjoy it or because they are bad. You are a good parent doing everything you can.

[AdaraMarie]

Ooh yes, therapy for you is also great! I found that helpful as well.

[AdaraMarie]

Sorry, more, I can't help myself. My dd (almost 11) is still working on generalizing stuff from counseling/OT to real situations. It is not easy for some brains to do.

[CurlyQ284]

Every behavior you're describing sounds like my son, he is always testing boundaries and trying to push them. It reminds me of the velociraptors in Jurassic Park testing the electric fence. He also refuses to do schoolwork, the other day he said that when he goes to 3rd grade next year he is just going to sit in his chair and refuse to do work for the entire year. I told him if he doesnt do work for the whole year they won't know if he can move up so they will hold him back while all of his friends move up and he shrugged and said "fine, I don't care". We also don't take him anywhere, usually if we have to run errands one person stays home with DS while the other person goes because its not worth the effort. Its pretty exhausting. He was violent when he was younger, we were kicked out of a daycare because he was ripping everything off the walls and yelling profanities when he was 4. A few months later he started junior kindergarten at the elementary school and started throwing chairs. He was suspended because he threw a rock at a substitute and hit her in the head, she had to go to urgent care. Somebody called CPS on us and they came to the house, it was so humiliating and I was DEEPLY depressed during these months before I was able to get him diagnosed. He was always kinda difficult but his behaviors got scary after we moved when he was 4 years and 4 months. I started therapy and looking for help and got turned down a LOT, so he was diagnosed 3 weeks after his 5th birthday and started meds right after.

He was diagnosed with ADHD and ODD, but he definitely has the hyperactivity and the attention issues. When he is on the right meds for his ADHD his ODD behaviors get better.

He was tested when he was just under 5 by a specialist, it took forever to find someone who would do it because of his age but it was a 2-4 hour process depending on the child's ability to focus with lots of breaks built in. She also observed him at school as part of the report. Im looking at the eval report now and she did: Stanford Binet Intelligence Scales, Wechsler Individual Achievement Test, NEPSY, Beery-Buktenica Developmental Test of Visual-Motor Integration, Brown ADD scales (teachers and parents filled out). It looks like some of those may have been to assess for learning disabilities.

So it sounds like ODD to me but I've only read about ODD in conjunction with ADHD and how treating one helps the other, if she doesn't have ADHD I am not sure what to do. Maybe if she does have an underlying condition like anxiety it works similarly in that treating one helps the other?

[CurlyQ284]

Oh and I agree with AdaraMarie about not negotiating and having firm rules that don't budge. DSs favorite thing in the world is video games. I got lax with his screen time limits over the last week, my H was out of town and we are spring cleaning before my ILs get here in a week for my SDs graduation so I was super busy and let him play more and he is definitely worse. It sucks because I feel like I have to have those damn Jurassic Park electric fences on all the time and I just want to get along and be normal! So today I locked it back down again to his normal limits and he pushed a little but wasn't as bad.

Also he does not appreciate anything. He asked me to stay up late on Saturday and I said he could stay up an hour later and he's like "only an hour?" And fussed about it. So it really doesn't even get me anything if I let the rules slide.

[ellipses84]

I think you need to push your pediatrician to refer her for more evaluations. There’s many other things it could be aside from ADHD. This may involve her seeing a therapist as part of the evaluation but they may be more familiar with the possibilities than the behavior instructors. It sounds like you are doing everything you can think of which is great, but that may mean her behaviors don’t seem as severe, so make sure the Drs understand the history, how severe it is and what you’ve done to help her. Sometimes the difference between a diagnosis or not is frequency and intensity of the behaviors. I think occupational therapy could help her, and I don’t know how much overlap there is with the behavior classes you have her in. It sounds like she specifically needs to work on empathy and impulse control. They may be able to help identify what is triggering her reactions and how to respond better, ie. Anxiety or sensory overload. I don’t think occupational therapy would be detrimental to anything else you are doing. It would just more focus on specific issues and most kids I know really like going to OT.

[momof2]

I think you are likely to end up with some combo of ASD/ODD/anxiety/ADHD.

My advice is to follow up on all referrals for additional testing. Don’t rely solely on the school system for all this testing, although using them as one outlet for testing wouldn’t be terrible — but it will miss things given their very specific focus. It will take time and be frustrating and expensive, but likely worth it.

And honestly, wrap your brain around medication sooner rather than later depending on what the diagnoses end up being. Neither your, your partner or your child should have to live like this. It seems pretty clear you have done all the right things from a parenting perspective. It is time for some medical intervention once you have a better handle on what you are dealing with.

[minzy]

I’m offering commiseration. From your description, I thought ODD right away, too. We deal with a bit of this with my younger daughter, 7.5 y/o, though she doesn’t usually physically act out. I’d frankly describe my DD as sub clinical for a few things at this point. I review the checklists and she never quite meets all the criteria. Life is better than it was years ago when she did a little therapy for tantrums, and she’s able to function reasonably well now. But her behavior can still be frustrating and can impact the mood on the whole family. She is defiant a lot at home, always arguing her case, negotiating for more. (FWIW my husband and I met in law school, though we’re not generally super argumentative people.) Consequences don’t mean much to her, except for screen time, which she is obsessed with. She is a picky eater who loves sugar. Though they can play okay together, she is not affectionate with her older sister, which hurts her sister’s feelings. (She is affectionate with me and will snuggle with my husband.) She has some sensitivities, like she’s very afraid of losing her fourth tooth right now and she’s trying to grow her nails out. She seems to do great at school and is a good friend to peers. She’s agile and capable and artistic and decently smart. She seems to be wired differently than the rest of us, but as I remind myself, that’s not a bad thing; it’s just different.

I keep hoping that a “reset” will reduce some of the issues, like going back to the school building after a year at home, and otherwise getting into a more consistent post-covid routine. I think time spent outdoors playing/exercising can help. (At a minimum, it gives me something of a break.) I took just her on a trip recently, and it went great. I hope some structure with more time in school and with camps this summer (and less time with me, as it is) has her grow past some of it, but I realize we may be looking at a more comprehensive eval in the future and maybe an eventual ADHD diagnosis. Sigh.

Hang in there, you are not alone.

[aspentosh]

I just want to send you all hugs. This sounds exhausting and I can only imagine how helpless you feel

[konapoppy]

No advice, I am just sorry you are going through this.

[konapoppy]

minzy, you almost exactly described one of my daughters. It doesn’t help that I have twins to compare, but one is challenging to parent in the ways you mentioned. Mine also lacks impulse control. At the park, she will just bolt. I don’t know what I will do when I can’t physically restrain her anymore from running away. Hitting is common when she can’t get her way.

Her refrain since she was 2 is basically along the lines of “I do it myself”. And screen time or sugar are the only motivators. I had to stop doing tv no matter how early she woke up because she would then wake up to watch or have a huge melt down. She has practically picked her toe nails to death. She doesn’t sleep as well. She is smart, but only does what she wants when she wants. She loves drawing and is very creative.

She likely inherited some of my high functioning anxiety. My husband also has anxiety, and my sister had ADHD, so the hereditary piece is there.

[dcrunnergirl52]

This sounds a lot like DS2, who was diagnosed by his dev pedi at about 6 years old with severe anxiety, leading to OCD and ODD. If you met DS2, you would never, ever guess that he has anxiety. He comes off as the most confident kid in the world. However, underneath it all, he's extremely anxious, and it resulted in extreme irritability, defiance, etc. However, he only displayed this behavior at home...at school he has never had a report for behavior ever...but that meant he bottled up everything and let loose on us the second he walked in the door.

Our dev pedi was easily able to diagnose based on the SCARED form (and b/c DS2 had several OCD behaviors by the time we got an eval and that's almost always anxiety based).

We tried CBT therapy alone, and that didn't help, so our dev pedi prescribed anxiety meds. We tried a few, and while they provided some relief, it wasn't until we added guanfacine to deal with the anger/irritabilty along with weekly therapy that we got real results. He still has some VERY hard moments (last night for one) but his behavior no longer ruins every family outing, meal, etc., and it's made a huge difference.

Good luck--it is so, so hard and heartbreaking to see your baby experiencing this and to be the one they go after repeatedly.

[cricketwife]

I'm really sorry you are going through this and I can tell from your post that you are a great parent.  

I haven't dealt with this personally, but a friend has had a similar experience in terms of their child's behavior and being generally unmanageable.  FINALLY, after trying seemingly everything  -- counselors, doctors, parenting classes, trying different diets, etc. etc.,  they discovered there was mold in their home and mold can be/is a neurotoxin.  I am NOT saying that your child has been exposed to mold.  I'm sharing it because they had so many similar struggles and the road felt so long.  Their son was 8 by the time the figured out the root cause of his behavior.  You are doing all the right things and I believe you will get your answer too.  

Do physical outlets help her at all?  The friend I'm speaking of basically turned their dining room into a gym with swings attached to the ceiling, climbing stuff, etc.  They also got him into ninja training stuff and it's been really helpful for them. Again, I think their root issue is highly unlikely to be the same as yours, but I'm just throwing any ideas out that may help you manage the day-to-day while you go through the process to get more answers for your daughter. 

They also had to super limit screen time because it basically caused/exacerbated all undesirable behaviors. 

Again, I'm sorry and I hope you are able to get some answers and help.