Help please for aggressive behavior - CHADD's ADHD Pare...

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Help please for aggressive behavior


My son is 7 and has had his diagnosis of ADHD for a year. According to his psychiatrist it is severe and we agree. When not medicated he could stay in his seat in school but could not follow instructions or complete an assignment independently. That has improved significantly with hard work and meds. He is on Dyanavel XR during the school year and off now over the summer as he hardly eats when taking it. We landed on that med after trying 2 others and it helps him a great deal with focus and other symptoms. He won’t sleep without nighttime meds and had an allergic reaction to melatonin so is on a low dose blood pressure med to help him sleep at night. Without it he would stay up (with us, not in his bed!) until 1 am, until he passes out literally.

Our problems right now are primarily that he will not do anything we ask or require of him and this includes going to bed at night. He can be so loving and in the next breath he will tell us he hates his life and hates us. He hits and throws things when out of control. He is very self deprecating when he “makes a mistake” and loses control. His sleeping meds are hit and miss so many nights we end up in the living room at 11pm, trying to find any way to get him to go stay in his bed as he screams, cries, yells and melts down. We recognize he is unreachable when at the height of these meltdowns and try our best to address issues before or after they occur. We have tried offering rewards in the morning for compliance, we have gotten angry, we have calmly explained that it’s bedtime, we have tried everything we know. We would welcome any suggestions or advice. And yes, we have been to two behavioral therapists. Neither were very effective so we will look for another. To be clear this issue is with mom and Dad ONLY. He is absolutely fine with grandparents, at school and at Camp... oh and video games, which we recently began allowing (he used to just play his kindle fire under supervision and now he plays console games on occasion) - video games make it worse as he cannot separate from them even with advance warning that time is almost up. We are about to go from limiting game time to taking it away entirely but part of me says, he’s a kid and SHOULD be able to play some Mario here and there...

Thanks for your suggestions....

29 Replies

My son’s therapist had an idea when my son was 7-8 that you could try. He had to write down his arguments and requests. Like if he wanted to negotiate or refuse something, I handed him paper and pen and said write it down.

It helped for awhile. Like redirection, I guess you’d say. Sometimes he would refuse to write, but then I’d ignore him. Like even his screaming yelling fits, I would ignore and occasionally look over and say, write it down. We did this for a few months and it broke the cycle to some extent. He still argues and gets angry but it’s better!

Just thought of something else the therapist said. I had a lot of trouble getting my kid to wash up and stop what he was doing to eat dinner. And I said ‘I can’t ignore if he’s hungry later’.

And the therapist said to explain to him that if he chooses not to eat dinner when I ask, then he chooses not to eat.

It is not the parent denying food, it is the choice the child was making.

Also difficult to implement but I did a couple times and did not allow him to eat until breakfast. He started coming to the table when asked. Or he knew he wouldn’t eat until breakfast.

in reply to EJsMom

Thank you! I so appreciate your replies. Did your son hit? My son is so good and has the best manners but when he is having a meltdown he hits. If I ignore him he will hit. This makes it hard to ignore him as hard as we try.

I like the writing idea on multiple levels! I’ll try to implement some variation of that (he is not very mature as a writer yet).

Did you ever try any sort of token system that worked?

thanks again!! It is so hard.

in reply to Reeeba1

He also throws things and generally goes nuts if ignored.... really wish I had a way to get him to stay in his room and calm down...

in reply to Reeeba1

Yes, he hit! He would also destroy things. A few times I just held him in a bear hug for several minutes. Can’t do that now because he’s 14 and a lot larger and stronger than me.

I know there must be a way to help your son. I really believe that. It’s finding that one thing. I’ll keep thinking about it.

in reply to EJsMom

Thanks again. Yesterday was a good day. I’m incorporating a little bit of all this advice and we had no meltdowns yesterday. Small victories !

i had the same problem , put him in his room he will get out, we had to change his door knob so the lock was in the outside , we had to lock him inside his room while he would scream, trow things, break things, ripped off a mirror off the wall, never fixed the broken stuff, left the holes in the wall for him to see, we kept his room at the minimum, 1 bed, small desk , chair, books, some toys, a low draw chest, one day I forgot to close his window, he was screaming so loud the neighbors called the police and they police showed up ,

Eventually as time wen by he stooped being aggressive because he dint want to be put on his room, it took him about a year or so..... dont give up , nothing will last for ever, no even misery

The video games could be a great incentive, if you haven’t tried it yet - using something he is interested in, but not completely taking them away.

We’ve started using a token system over the summer. It hasn’t solved all our problems, but it has helped. But my son has to purchase screentime (tv, games, tablets, etc) with tokens he’s earned. Arguing / talking back / making me repeat myself also costs tokens, though the key for us is to focus more on the earning & spending on rewards, and not just a punishment system. He can earn them with chores, reading, playing outside, doing things without being asked, etc.

Hopefully once you work out the sleeping, it will help. If my son even misses 1/2 hour of sleep, I can tell. We have to be SUPER consistent with his schedule, or we pay for it the whole next week. He goes to bed pretty early and has a very consistent bedtime routine, which we let him have some say over / choices. I got a lot out of Healthy Sleep Habits, Happy Child by Marc Weissbluth.

Wow, I am super impressed with this type of reward system. I would recommend also reward quickly dont make it a.long term reward, our kids need instant gratification in the beginning then you can you can push it out. For example: if you brush your teeth and put on your clothes ( you might need photos on your mirror depending on the age of your child) then you will earn 2 tokens. You reward for the things you are challanged with, not for things they have already mastered.

I would also say if you had a child like mine who yells a lot, you could add double token for an AM without yelling.

These are all skills you hope your child will change that will make them more independent and life easier for everyone.

Clearly after they master these easier duration you change it to make it more challanging like if you brush you teeth and get dressed 3 days in a row....

This is only until that skill is mastered then once master you find a new skill to work on. These systems work great.

Thanks for letting us know what works for you.

Thanks! The kids just found a case of casino chips in the basement, so I thought we'd put them to use. lol! They call them "Mommy Bucks". We also build in some flexibility like "Make Me an Offer" and "Mommy's Choice."

It's nice because I can access the chips immediately without having to think of a reward on the fly - thus the instant feedback, but less mental stress on me. And having all the choices keeps the reward from getting stale, versus if it was for the same reward all the time. And I never seem to have cash to pay out allowances. lol!

I kinda went over the top this summer, as we have a second level of reward system - a clip chart. If they earn 20 tokens each week, they get to go up a clip. If they reach the top by the end of July, we're taking them to a water park. Mostly I wanted this to add more incentive, and to have something that didn't include punishment, but reward only - as he responds much more to rewards. (They don't get demoted at all with this chart.)

LOVE IT, win win!! so many others can learn from you.. keep us posted.

in reply to Pennywink

Thanks for all this great advice. We will definitely be implementing a token system in tbe near future. And the sleep information is a help too. I hadn’t considered that a small lack of sleep could impact him so much. thanks!!

in reply to Reeeba1

Have you also tried analog timers, especially with the game usage? My 6 year old has ZERO concept of time - so telling him he has 5 more mins or he has an hour makes no difference, it all feels to him like he just started & I'm instantly stopping his fun and he gets upset.

We use a Time Timer, and it helps. Though they are kinda pricey - a kitchen timer could probably work as well. But he responds much better to analog than digitial, as it really helps him see the passage of time, and he can't really count backwards like a digital countdown anyway.

Keeping a daily schedule posted also helps. It's kinda a pain to do everyday, but I see him look at it & helps him know what to expect - when he can have his free time, and when I'm gonna tell him it's done.

in reply to Pennywink

GOod point about the timer. Thanks!!

You are dealing with a child who admittedly has a severe mental illness. I don't know how taking him off over the summer is going to help him. You could give him supplements like PediaSure and stuff to build up his wait if you're concerned about that.

Both of my Grandsons have problems with anger management that only medicine is able to control. My younger grandson is on the Risperdone to control his anger and that also increases his appetite.

Oldest grandson has always been a light eater and is on the thin side. But his doctor says he is on the normal weight limits for his size and not to worry about it.

They both see a behavioral counselor and she has said that when they are out of control and they can't stop and think maybe I should control this for a reward. We are working on getting them to recognize the signals that they are starting to lose control

in reply to anirush

While I appreciate your desire to provide advice, ADHD is not a mental illness and this comment is uninformed and a little offensive. I take him off his medication over the summer because a) his psychiatrist (medical doctor) advises it, and b) there is no need to medicate when he is not in school. The medication helps him to focus. It does not prevent meltdowns. Sometimes it exacerbates them. While on meds he eats almost nothing. These are all reasons for a summer med holiday which is very common with ADHD kids.

you are correct ADHD is not a mental illness, it is a condition, a child with ADHD don't produce enough dopamine , so besides not being able to pay attention at school they get depress, angry, short temper,moody,impatience , easily bored unmotivated ,people mistakenly with a mental illness because the dopamine is produced in the brain so they assume is a mental illness,

I recommend people to watch you tube videos of Dr Russell A Barkley he explains very well this condition

Hi, I'm reading this book by Daniel Amen (healing ADD) and there is a part in the book that provides the right medications and supplement for the specific type of ADD. It might be a good reference to see if you are on the right meds and/or you want to try supplements. The sleeping part is rough on everyone and I'm sure it doesn't help with his aggression. Hang in there.

My son is 10 with very similar issues. I'm inclined to believe my son CAN control the aggression because he's able to do it outside of our home, albeit with greater difficulty when his medicine wears off. In fact, the rebound from the medicine withdrawal directly correlates to aggressive behavior. He regularly challenges our authority, but this is ODD & can be managed. We have house rules with number one rule, 'BE RESPECTFUL' and that means zero tolerance for aggression. If he starts to sass, we warn him, 'Are you being respectful?' If he escalates, he is ordered to timeout. If he gets violent, he loses his precious video games for 3 days and must show no aggression to earn back. We chart that so he's reminded daily, as this is critical for ADHD kids. For me, he usually protests in timeout, swears, marks up the wall, etc. I ignore it generally but will remind him that he'll be able to come out of timeout when he's calm. When he leaves timeout, I put him back there physically, firmly, but not with anger. I show confidence, like I can do that all day. He's punched, kicked, and spit in these situations, but I hold firm. My wife doesn't put him back because he's too strong and will get too violent. She just takes away gaming. When he goes after her, for attention, she slips away with a book and goes to her room. Eventually he calms down and asks her when she's coming out. She responds with, are you ready to speak calmly to me now? This works well, again showing him confidence that we're in control, not him

in reply to Mmagusin

I love this post. It is so relevant to us and my son. Thank you.

Thanks everyone for the great advice. One of my takeaways is that video games should be our incentive. I went out today and set up a token system. He can earn video game time in 20 minute increments by completing one of several tasks… Reading a book, walking his dog, doing other required chores, or anything else we deem worthy. Each time he gets a token we also post a penny on the board for that day. If he earned 30 pennies in a week he gets an additional bonus, going to a store and picking out a toy. Then we have the bedtime bonus! If he goes to bed 7 nights in a row without incident (go to bed, stay in bed) he gets a BIG reward like a lunch out at his favorite place, bowling, free game day or other appealing activity. He can lose the 20 min game tokens for poor behavior but he will never lose the pennies we post on the board as they represent his good behaviors and achievements.

I know we may have to adjust this system and the time frames may change (7 Days is a long time for an ADHD kid but I was hoping to keep it on a weekly cycle). But the board is posted as are the rules. I explained it to him and he is excited to be able to earn tokens for game time... so we will see. Thanks again for all the feedback. This is such a challenging topic.

in reply to Reeeba1

Sounds terrific - keep us posted’

If it turns out the 7 day’s is too long for th reward, let me know. I have a few suggestions.

It was definitely a trial & error around here to get the right balance of earning vs spending. Good luck!

Hi there, I have Inattentive ADHD. Your son kinda reminds me of myself as a child. I absolutely hated going to sleep early, still do. I am a big advocate of taking supplements along with stimulant medication in order to help the medication work to its full potential and to help eliminate side effects. Here in the U.S. it is very rare for psychiatrists to recommend supplements to take with stimulant medication unfortunately. I am in grad school to become a Psychologist MFT and hope to help change this. Stimulant medication, like what your son is taking, works with the neurotransmitters Dopamine and Norepinephrine. After the medication has worn off, these two neurotransmitters are going to be temporarily lower than usual, and this can make a person really irritable, sad or a combination of both. This is what is known as "the crash" by people who use stimulant medication. Since he is taking Dyanavel XR, which is extended release form, I'm assuming that his medication is wearing off or has worn off by the time he is told to go to bed, and the meltdowns have to do with this. After much research through the years, I've discovered that taking the supplement N-Acetyl Tyrosine 30min to an hour before the medication wears off, helps eliminate the crash. The reason why is because that supplement helps the brain restore the levels of Dopamine and Norepinephrine. I also take L-Tryptophan about 40min before going to sleep, and it greatly helps me to actually go to sleep, and immensely improves the quality of my sleep. People with ADHD, especially people with Inattentive ADHD, have what is known as slow onset sleep. Meaning that it takes us quite a long time to go to sleep once we're in bed. I remember laying in bed for 2-3hours as a kid and not being able to go to sleep, it was torture.

Lots of people with ADHD get great help from their stimulant medication but sadly the side effects force a lot of people to stop, and unfortunately lots of people don't know that supplements can help fight off a lot of the common side effects from taking stimulant medication. Also after using stimulant medication continuously for a few months or so, the medication will start losing its effects. The reason for this is because of the depletion of specific neurotransmitters (Dopamine and Norepinephrine), and in consequence of boosting Dopamine frequently, Serotonin will go down as well.

I take a variety of supplements now, but here are the one's I started out with that are of essential importance in my opinion.

1. COQ10: this supplement is to keep the heart safe, and not cause a rise in your heart rate or blood pressure, which is common with stimulant medication.

2. Magnesium Chelated: This supplement is great for digestion and helps the body in digesting and absorbing the medication. Chelated form is the most bioactive form of Magnesium.

3. Flaxseed oil or an organic fish oil: I take a flaxseed oil supplement because of the benefits of EPA and DHA, which from research I have done is great for people with ADHD and goes great with stimulant medication as well, it has a calming effect.

4. A good multivitamin with Antioxidants

5. A newer one for me that I would recommend is R-Alpha Lipoic Acid (RALA). Stimulant medication produces oxidation in the body, which is not good for you, so the body needs a strong source of antioxidants. RALA is known as one of the strongest antioxidants out there and makes my medication feel smoother and fresh. It also helps the brain utilize the neurotransmitter Acetylcholine, which is one of the multiple neurotransmitters we lack. Because of this, my moods do not drift dramatically, and I feel more at ease. I also drink matcha green tea for its immense antioxidant and Serotonin (from the high theanine levels) boosting properties.

6. Melatonin: I read that your son is allergic, but I am not sure how large a dosage he was taken. Most stores only carry Melatonin in milligram (mg) quantity. I advise against that, and recommend clients I have seen to take Melatonin in microgram (mcg) quantity instead, it is quite a smaller dose. When melatonin was synthesized in the middle of the last century, it was done so with 300mcg. It is known as melatonin's optimal dosage from research I have seen. After switching from 1mg dose to 300mcg, it was a major difference. 300mcg worked a lot better and really helped with my sleep. Melatonin is also shown to help fight oxidation while sleeping, and is actually more beneficial than previously thought. I also recommend it in 6hr extended release form, so the pineal glad can secrete it through out the night and have your sleep be more continuous

7. L-Tryptophan: It is in my opinion the best supplement to take to help the brain with Serotonin due to it being the direct precursor to Serotonin, unlike 5HTP and others mentioned. I take this about 45 minutes before going to sleep, and it helps me out quite well with getting to sleep, and having lots of essential deep sleep. It is also great to take during the day, because of the help it brings in mood, enthusiasm, and sociability just to name a few. People with ADHD lack Serotonin.

theres a link on my profile page of a google doc I made of every supplement I take along with the ones I mentioned. It mentions what grocery stores and online stores (mostly Amazon) sell these supplements, and some information about each of the supplements and why they help people with ADHD, just in case you're interested.

Wow!! Thanks for all this information! I will look into the supplements for sure. Our psychiatrist isn’t against supplements and actually recommended Vayarin to accompany the stimulant med, so he is on that - hard to gauge the impact tho. I appreciate your insight into the sleeping issues. My son HATES going to bed and my husband is the same way. Pretty sure he and my son have the same diagnosis. The meds help and I am a huge advocate of using what helps. Again thx for the suggestions.

You're very welcome, I hope you guys find the help you need. Vayarin is great because it is a mixture of 2 supplements essentially, it has PS100 (which I take) which is a good neuromodulator and helps greatly with recall, this is vital since people with ADHD have difficulty with short term memory. It also has EPA, omega 3. Omega 3,6, and 9 oils are a great help for those of us with ADHD from research I've seen through the years. I take a Flaxseed oil supplement for this very reason, as well for the DHA. That's good to hear that your psychiatrist is recommending supplements, I don't hear that too often from the people I've worked with. N-Acetyl Tyrosine and L-Tryptophan should be of great help for the sleep and crash issues. Hope all goes well.

In addition to everyone else's good advice and experience, one thing I would do- not when its bed time, during a quiet time when he is comfortable- is ask him how he feels at bed time. Is he worried about anything? My 8 year old son, who seems kind of tough, is actually afraid of some things. He recently confided , for example, that he is afraid of "ghosts". Nothing would convince him that ghosts do not pose a threat, so we made some "ghost repellant" (water, a few drops of soap) for a spray bottle and got him a night light. We practice some relaxation breathing and I read to him. Even if it is not related to a fear, just asking your son if bed time is hard for him and what makes it hard might help him.

in reply to abryans

Good point! Most of our bonding / one on one time is when he’s in bed. It really helps. 😊

I know what are you going through I have a 9 year old son, he is always being the same way you describe your son,( he is started at 2) being defiant , not wanted to do anything we ask him, the everyday stuff, screaming , crying, we didn't know any better at first , his Dr was saying its the terrible 2's and then 3's 4's, I knew it was something more that that, because he will never be a happy kid no matter what he would never get exited to do or go anywhere,diagnosed with ADHD we tested him his dopamine levels and came at 6, extremely low, I dont have him in any medication because I am afraid of the side effects and long term effects, at first when he was little we didn't know any better and following family advise we spank him, took things away from him, time out, the " normal punishments" we all grow up with, but nothing worked actually he was get even worse, so we stooped doing those things and when he will scream an yell we will ignore him, and just put him in his room, we started to take him to the YMCA since he was 5 years old at 5pm for group play for 1 hour or 2( called catch for kids) I notice that when he gets 1 to 2 hours of exercise/ physical playing between 3 to 7pm ( the worst hours for melts downs) he would be calmer and nicer, exercise raises dopamine and stays on his brain, also he loves to play any electronic video games and he also went crazy after we tell him it was time to get off, even with reminders, even with a sand watch, a kitchen timer anything that we tried didn't work he would say that was not an hour? he would cry , yell , scream , get mad, so we decided to take all electronics for a year , I read that playing electronics the brain gets a big rush of dopamine level but in a non natural way, so its only a temporary fix, like drugs and as soon as the child gets off the electronics the child brain does a big crash, I introduced electronics recently for 60 to 90 minutes only on the weekends, and still gets me a hard time but no so bad, he is taking Vayarin is a lipid (kind of omegas) that helps to calm the child, my insurance dont cover it, its about $50 on theirwebsie VAYA website, you'll need a prescription, I seen him more calmer and nicer to be around, also I just to give him melatonin at night for years but I also read that melatonin also lowers dopamine levels so now I make him a extra strength sleepy time tea ( the one with the bear, the one that has Valerian herb roots) that works great in 20-3- minutes he is sleep.

we also tried Craniosacral therapy its done at a Physical therapy location, were the therapist kind of massages the back of the child's head to loosen up the muscles, cranial bones and spinal fluids, I saw some changes after 8 sessions, not sure if it is the Vayaring the vitmains , the physical activity or a combination of all but I am willing to try anything that may help alleviate the horrible mood swings of ADHD, if any one knows of any other therapies and or alternative medicines please let me know I am whiling to try them, thank you.

I’m sorry. I know how tough the ‘battles’ can get ... I have posted this as a come t on another feed, but I believe in it, so I will post it again...Look into Neurofeedback.

I am starting this with my son next month... painless, no side effects- physical therapy for the brain and trains the mind to build the ability to focus and concentrate. Amazing testimonials (across the board for brain development in people with Autiam, ADD, ADHD, etc). It also helps to reduce the medication dosage for people ADHD and often eliminates it altogether.

It is expensive $160-175/per session but amazing if you can help them to develop neurologically- the areas of the brain controlling their impulses, behaviors and lack of focus. My son is also aggressive and he IS his impulses. Medication is the last option for us... too many side effects and no long term damage data available, plus we will one day be entering the teenage years and I don’t want him Self medicating and experimenting with an already high tolerance to prescribed medication (worried about it all- as you can see..) Look into it.

Drake Institute


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