I’m not the parent of the children in my care, as they are my brothers but am the legal guardian of them.
My 7 year old brother is difficult to handle. He has violent tantrums that can last up to 2 hours. He gets mad at the smallest things (not being able to sit at a certain seat, when playing a game it’s not his turn yet and he has to wait, etc) he hits, kicks, bites, curses, yells, scratches, spits and punches me and his younger brothers. He has adhd, odd and ied. He got expelled in January from his school, and is attending a new behavior management school in September. When my parents were still caring for us, they never believed in medicine and said “it makes everything worse.” I am following in their footsteps as that’s all I’ve ever known and heard. I forgot to add in he has learning disabilities (dyslexia and dyscalculia and speach issues, he gets angered by this at school which causes some of the outbursts) Any suggestions? Any advice is welcome, Thank you.
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I may say something incredibly unwelcome, but it sounds like he could use as much esteem-building as he can get. It is an incredible hit to the system when a child sees others that are performing at school/society’s standards. He could probably use as much “building up” as he can get. I am also hoping he is getting as much school support as he can get.
It noble to go the non-medication road. I will hope that this decision continues to be a viable one for you and your family.
It is really amazing and beautiful that you are caring for your brothers. I have found, with my ADHD/anxiety kid that getting support from professionals has been key. Psychotherapy, occupational therapy - and also therapy for me and my husband 💜 We have found medical advice and medication to be extraordinarily helpful.
Medication flipped the switch when nothing else worked. My stressed out, sad, angry, out of control child is now my sweet, smart, curious, ambitious kid. All of our problems didn’t go away when we started meds but now we can engage with our problems together. The meds didn’t change her personality- they actually helped her be more like herself. Talking to some doctors or therapists about your options and whether medication is right for your family could help ease your mind. It sounds like you want to stay loyal to your parents’ which is really great. But if you are the sole caregiver, it’s okay to change it up a little. There’s no harm in talking to a doctor and asking some questions.
Also, I don’t know how old you are, but if there’s a way to get some support for yourself that would be good too (this group is a great place to start!). You sound like a really strong, caring person - but even strong people need support sometimes. I hope you stick with this forum and keep asking questions, You are doing the right thing.
There is SO much information about it but the vast majority comes from pseudo-experts and not actually from medical and pharmacological studies. Those studies show medication to be safe and the MOST effective treatment for ADHD. But I am NOT an expert so ask the psychiatrist for information on how to discern what the safest and most effective treatments are.
I am a special ed teacher of 17 years who worked in residential treatment and did child welfare. So in those realms I am an expert. (I also have ADHD and a child with ADHD.) Your brother will do better in time but it will take a LOT of consistency, routine, and support from more than just you. Please don't think you have to do it on your own.
Do your best to establish before meltdowns what happens when there's a meltdown. What are the steps. For my kids, they have a timeout in their rooms, if that escalates and a minute gets added for each outburst. If I'm losing my patience, I have to leave them in there and let the room go and the stomping and whatever is triggering me, ignore it. Nonverbal cues work better than verbal ones. So instead of saying "time out" it works better if you have a paperplate on a stick that says "stop, breathe, timeout" or something you can point to that isn't words.
Reconnecting after outbursts is good too. Remember he's 7. Hold him and tell him you love him no matter what. I have done this activity with my kids when things have gotten really chaotic called "Hand and Heart". We trace their hand and draw a heart. Inside the heart, I write things I love about my kids. "You're good with pets" "your hugs". Inside the hand, I write things they do that help me "putting dishes in the dishwasher this morning" etc. They have to do the same for me. It helps when things feel bad to get us on track so I share it in case it helps you.
I hope there's a caseworker. Ask for respite care and use the case manager to get an in-home family therapist that can help you with setting up structure and routines. This is a marathon, not a sprint, and your brothers are REALLY lucky to have you. They have their best chances at stability with you but you'll also need to ask for and take help. Good luck! It's no cake walk but obviously your family has a lot to offer each other. I see a lot of strengths in what you posted like that you play games together and are trying to instill routine with expectations of where to sit. You'll find all kinds of things that work for you.
I would agree fully with MaudQ’s response. They covered a lot of important points.
I’d add that a school IEP is absolutely needed, and if you can afford it, a full learning assessment from a psychologist so you really know what’s happening with him as a baseline. You’ll then also use that professional assessment when you request services or accommodations from a school.
I’d also add that from my similar experiences (search other posts I’ve made), the violent reactions and aggressive uncontrolled behavior is coming from extreme anxiety that’s built up over years of his frustration, fear and anger, feelings of inadequacy and embarrassment. Consider how it must be for him with his learning difficulties to be in a classroom setting. Other kids can be cruel when you’re different. It only compounds as the years go on and he falls further and further behind. Since he’s 7 I’m guessing he just finished second grade. Third grade and beyond become much more difficult for kids with holes in their learning foundation from the prior years. Expect things to get worse during the pressures of 3rd and 4th grades if nothing more dramatic is done to help him now.
Here’s my priority list for you:
1) Find a psychiatrist (preferred, one that prescribes and provides good therapy) or a psychologist and a prescriber (could be a psychiatric nurse). Address the anxiety first which will take 1-2 months (this will help with his daily functioning...for him and the whole family), then see what’s left to address for the ADHD. Meds and therapy go hand in hand. The first professional you find may or may not be a good personality fit with your brother. Don’t feel badly about seeking out somebody else If the two of them don’t hit it off within a few appointments. They have to have a good trusting relationship in order to make this work.
2) Contact his school to request the IEP process start. Unfortunately it’s summer and it’s still during the pandemic so I’m not quite sure how this will work. Still, do not delay. It’s a process and assessments from his previous teachers will be needed so it all takes a while.
3) If you can afford it, have a full learning assessment done by a psychologist familiar with kids with ADHD and learning difficulties. Around $3k.
4) If you can afford it, have summer tutors. Ideally one with actual dyslexia training. There’s many ways to teach reading, spelling and composition. More of the typical teaching method may not be helpful and a waste of precious time and money. Teaching a dyslexic learner is a specialty. Range $50-120/hr. If not use online free resources like Khan Acaddmy.
5) Always be on the look out for anything (positive) he shows an interest in and then encourage him to engage and follow his passion. He needs an anchor, something to help keep his self esteem up because it’s going to be a tough battle through these years when his self identity is forming.
6) Be sure to include him in the daily household chores. He may resist but be strong and confident in these small repetitive tasks as a way to help build his self help skills, his self esteem, and contribute to the greater good of the the family. Others in the family will appreciate him pulling his weight...this is needed because Years of his aggressive behavior towards them will build animosity.
I don’t mean to be dramatic but the truth is that this situation unaddressed could easily lead a desperate young person to self harm and even suicide. It’s already difficult for all kids to grow up in today’s world, then add your brother’s additional health concerns and it can be a cruel recipe. This is serious. Even some 7 yr olds have tried self harm. It’s not necessarily that they want to end their lives, self harm can be because they feel they deserve it (my heart aches to even write this truth). Anxiety left unaddressed invites its cousin depression. When depression hits they don’t care any more. There’s no interest in doing anything. Discipline doesn’t deter unwanted behavior anymore. When a person’s most basic level essence is filled with all negative experiences and self talk, it’s really hard to set restart. The good news is that you are still at the crossroads where you can make a difference in his life. Please don’t have regrets later and do this now.
And sorry to Harnessinghope, but I don’t agree at all with the comment about it being “noble“ to go the non-medication road. This approach doesn’t consider the science and knowledge that ADHD brains and dyslexic (and similar) brains simply function differently (and there’s nothing wrong with that!) and finding the right medication can improve the person’s life. If your child needed glasses to correct their vision or diabetes medicine would you also think it’s noble to not address those? Of course not. ADHD and anxiety are health problems. When they’re not addressed fully and continue on for years they compound and become much worse. Do not do this to your brother and his future! Please take this seriously and don't let any more time go by thinking it will clear itself up on its own if you just wait it out and continue on. It doesn’t.
You know what is noble? You! You’re seeking out the best information to help your brother when he so desperately needs it! That’s an awesome responsibility and chance to make a positive effect on his life. Please remember that you need a break, you need support too (this website for one). You’re not perfect, you’ll make mistakes. But you’ll get through this together!
Bless your for caring for them, and for reaching out and trying to find more answers and support for them - what a great blessing it is for them to have you!!!
I too believed in, and tried the no-medication route, for years with the siblings in my care that had similar outbursts, behaviors, and worse. I tried supplements, many many therapies, and we already eat extremely healthy since we grow our own food with a food-forest, vineyards, and orchards. So if anyone tried and tried and tried and was clearly anti-medicine... it was our family! There was a point that I had 52 appts per month for the four of them. Well... it has taken time to find the right medications, the right therapies, and we adopted all four when they were younger and they and forever ours - and now it has been 10 years!!!! Looking back with so many years of before meds and after meds under our wing now, I understand just how much they truly needed the medications to help them manage their impulses, help their nervous system calm, and help them focus and learn. So thankful that I did not maintain my original stance, as my children would not be who they are today. It does take time to find the right medicine, or maybe just the right dosage... bit I would not have the wonderful well-adjusted children I have today without the help of the medicines.
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I think is not the right school help!
11yo school refusal when with mom, aggression 
drowning
“Bad” first day of school
10-year-old with lots of impulse control issues
