Our 5 year old has been involuntarily “unenrolled” from 2 preschools due to biting within the last year. Now he’s with a nanny and her 4 year old. He’s still biting or attempting biting at least once a week - she’s willing to work with us on it, but it feels tenuous. (I mean who wants to get bit or their kid to get bit every week?!)
It feels like we have tried everything over the last year or so and can’t get it down below once a week. We’ve tried: Bracelets and necklaces to chew on, chewy foods, “heavy work”, OT, methylphenidate (improved focus but made it harder to transition between tasks), all kind of books on not biting and impulse control, reviewing a social stories about biting alternatives every morning before school, a physiologist to help my husband and me to understand ADHD and develop strategies to improve cooperation at home (eg chart of what’s coming, visual timers, warnings, etc).
For about 6 months we’ve have an IEP through the city that provides him with a special education teacher who works with him on techniques to deal with frustration and impulse control for 90 minutes a week.
The developmental pediatrician who diagnosed him suggested trying Adderall - but we can’t see how that would help the biting any more than the methylphenidate did. Another pediatrician in the practice suggested guanfacine, which seems like a better option than another stimulant. We feel a little burned and lost by the last medication trial, which we thought was helping (based on the vague feedback from the school) but realized after he left and was with the nanny that it might be making things worse.
We’re really worried him starting kindergarten in the fall and in general about him being able to have stability and learn to be around people because of the biting.
He’s a very friendly, extroverted kid. He’s trying to make friends where ever he goes. It’s been so sad for him to have to suddenly leave these two schools just as he’s started to make friends.
He knows it’s wrong to bite and can tell you all the things he should do instead. But he really struggles to do anything else in the moment. Sometimes it in response to something another kid did (hit, push, etc), sometimes it’s because something surprised or angered him when he was on edge (someone got in front of him or tried to help him) and sometimes he’ll lash out at whoever is nearby when he’s mad even if they did nothing at all to him. Often when it happens, it’s like a switch is flipped and he’s a different kid all of a sudden totally out of control. It’s seems like biting is his immediate first response to stressful situations and it’s been that way since he was little.
Anyone else had this situation before? Are there things that helped you? Are there other supports we should try?
I’m looking at PCIT, ABA, and/or a child physiatrist - not sure that any will/can really address the biting. The IEP seems like it was a lot of work for not much useful help. What they doing isn’t bad, but I’m not sure it’s really helping very much.
We’ve been in a state of constant stress about him getting sent home and/or hurting someone for so long. I feel like we’ve done everything but somehow also not enough.
So I guess I’m also just looking for how you guys worked through it when it seems like no one can really help with the biggest problem you’re having with your kid.
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thanks for the reply. One of the first things we did was to take him to an occupational therapist and ask them for help with how he handled frustration. They tried to help but he never got all the frustrated while he was at OT. The novelty of the special place and the toys and especially the focused attention from the therapist made it such that he did well in that environment. So he “graduated” on dealing with frustration pretty quickly but we didn’t see much improvement outside of the therapy center in his behavior. They also suggested incorporating heavy work - we tried to incorporate some activities but we (and the school) didn’t see much improvement and once the novelty of the activity wore off he really resisted doing them.
The OT also worked on some delayed fine motor skills which he graduated (after a longer period). I think he’s now on track with peers on fine motor skills and doesn’t resist table work as much so I think it was worth the time.
All in all it didn’t seem like the OT really gave him skills to handle frustration more productively outside of the therapy office.
I am so sorry you are going through this. It is a tough one. He gets to a point of frustration or excitement and can't contain himself. He can't think in those moments, like you said it is like a switch is flipped - it literally is. He is being flooded with emotions and neurotransmitters and there is a type of short circuit.
Not sure how realistic it is to have a parent stay home with him and wait a year on kindergarten, but that could go a long way. If there have been any major changes, like changing schools, new job for a parent, moving, etc, that he doesn't fully understand that may be the root of the problem but he can't explain it and may not even know.
I wouldn't give up on medications, they are tried and true and some have been around for 100+ years. they are hugely safe and amazingly stimulants can calm the ADHD mind enough to get control in times of stress.
Having said that, he is only 5 and his frontal cortex is closer to 2 or 3 years old. If you can parent him like you would a 2 or 3 year old and have those expectations as far as emotional maturity that can help relieve some of your stress.
If you can't wait on kindergarten then maybe something clunky like a mouth guard so it is much more difficult to take a bite. He can also fuss with it all the time, like chewing gum. You just have to establish that he has to wear it all the time except for snack and lunch. Show him how his favorite sports person wears them, you and your spouse can also wear them then it is just a thing you do.
Also explain to him that he is not bad for this behavior, explain there is a rush of mad or sad or yuck that comes over him and it is just too much for him to control, right now. He will figure it out but right now it is just a bit too much. He will understand more than you think. He can feel it coming on but he doesn't have words for it. It is like trying to control water - pour water on dad's head and have him try to catch it all. No one, not even dad or mom can control that much washing over them.
I also believe that it is never too early to explain to your kids that they think differently than most. It is a gift but it can get heavy. they may have challenges but all in all it is a great thing.
When he goes the day without biting congratulate him, job well done. You don't need a physical reward just your praise and a big hug! ADHD brains, especially the younger ones, truly only react positively to positive feed back. Repercussions literally have zero to negative impact on behavior, there are studies. Be prepared to support your son repeatedly because it is still an up hill battle. Schools want to support different thinkers but the depth of knowledge is too shallow for them to really get it.
Ask that his teachers think of him as much younger emotionally but not intellectually, it will help them reduce their own frustration. It is confusing when the really smart kid loses his little mind because someone took the color crayon they wanted, it just doesn't compute.
You have a good kid, he will grow into his emotions eventually he just isn't there yet. That is another way to describe his feelings like a coat or sweater that he just hasn't grown into. He will, he has grown into other clothes and abilities and he will grow into this.
I wish you all the best,
BLC89
Full disclosure I am an ADHD parent coach and parent of two ADHD kids (now all grown up) and would love to support you any way I can. I know it is a tough road.
thanks for your comment. He’ll already be on the older side for kindergarten and he seems ready in a lot of ways. He really wants to be around other kids and to be in school. So we’d like to find a way for him to be safe around others.
The only big changes recently are school changes that, unfortunately, result from his behavior.
I appreciate your comment about him being intellectually 5 but emotionally 2-3. That definitely rings true and somehow is so hard to remember when he’s acting up.
It’s frustrating that he really knows what he is supposed to do and not do but just can’t do it! I just have to remember that as frustrating as it is for us, it must be even more frustrating for him to be in that situation.
My son was also the class biter for many years. Fortunately when he was 4 I switched him to a good preschool that gave him the help he needed. The school called in a behavior specialist (free program from the county) who observed him in multiple settings over a few weeks. She trained the teachers on how to monitor him and look for his triggers. For example, not wanting to share on the playground was a trigger. The staff knew to stand close and help him calm down if he was getting angry before it escalated.
The director also had a special relationship with him. She would check on him daily and tell him she would email me and let me know when he had a good day. He loved that (still does with his kindergarten teacher).
I feel for you. My now sixteen year old grandson was kicked out of three different daycares.He still deals with impulse control all these years later but medication has helped. Guanfacine is an non stimulant. Medication is trial and error. A pediatric psychiatrist knows more than a pediatrician about ADHD. Might be a good thing to try.
I know exactly what you mean about a switch being flipped - especially when it was a specific sensory stimulus. My son was a biter too since he was a baby. I too tried everything but not sure if it helped or he just matured a little. I was so relieved when he moved from biting to hitting of you can believe it. At age 6 he still struggles with his anger response. I delayed his kindergarten, we did a lot of cosmic kids yoga at home which I feel is the beginning of teaching him more mindfulness. Our OT recommended Zones of Regulation program to help them identify emotions. Guanfacine didn't work for my son but I think it's worth trying...you just never know...it could work. We have been trying different meds and even among the stimulants, there are slight variations in how they affect him. He still has difficulty with impulse control but he does now have more times where he takes deep breaths and is able to make a better choice. I too have been wondering if I need to add another med to help with it. And interestingly, I actually reduced his stimulant dosage and he did better...I feel the minimum doses are sometimes too high for our little ones, especially if they are on the smaller side. Wish you luck, I know it's a hard road.
I’m so sorry that you’re having such a tough time with your son. I’m sure you just want to enjoy him and the person he is growing into instead of always worrying about the next bite or news of bad behavior. I’ve definitely been there.
Do weighted vests or does brushing help? For regulation.
I do think Guanfacine is known to help with impulse control and may be worth a try.
Possibly in coordination with Ritalin or Adderall. Everyone is different and getting meds correct is a long term process.
Also breathing techniques can be helpful there are tons of online apps..like calm.
My son got “unenrolled” from his first preschool too for biting. He was only allowed to attend 4-5 hours a week with a SEIT who monitored his behavior when he was at that school.
We were lucky to find a wonderful small preschool with only 9 students in his class and 3 teachers which made things much easier. The preschool biting stopped but play dates were still challenging. My son’s last bite was in about 2nd grade in our home with a friend he played with all the time. It came out of nowhere and those same feelings of fear, frustration and what am I doing wrong came right back. My point in saying this is I do really get it.
That being said, maturity really does help a lot. Do what you need to keep yourself calm and continue the work with OTs and psychiatrists. You will find what works for your son because you’re doing the work. And he’ll grow and mature and you’ll be happy you were able to put in the time and effort.
My son is now 18 and headed off to college in the fall. I still worry about his time management and his ADHD but he’s come so far from those early days of biting kids just because they unexpectedly entered his bubble. It’s a marathon for sure but you’ll be amazed by your sons growth as he ages and matures. And try as much as possible to let him be himself as hard as that can be..it will help reduce his stress if he feels supported by his parents because other kids are tough and teachers can be impatient. If he knows you have his back it’ll go a long way.
Try to tell him something positive every day and enjoy all the hugs he’ll give you (if he’s a hugger). Older kids especially sensory ones tends to stop wanting hugs when they reach middle school/high school so store up as many as possible.
I feel for you. Have been down this road. We had better success with adderall XR. Our son did not have success on Ritalin, or any other stimulant / non-stimulant meds. However, there is still a problem, at least where we live, with adderall shortage. We have seen more behavioral issues due to this, having to try substitute stimulant meds, etc. It’s very frustrating. We did have Alex in OT from 5-11 years and that seemed helpful. Best of luck, it is challenging to find the right med or combination when they are all neuroatypical and unique.
I agree with the other posters that you have tried a lot of things. Kudos!
One idea that came to mind when I was reading your post is roll playing. This could work by using a stuffie at first to fill the roll of another child. Start by having him tell you what he should do in X situation. Then make the stuffie talk and do whatever the trigger is (pushing, taking a toy, etc). The stuffie should react like a kid (ouch - why'd you bite me? You're mean). Then try to break it down into stages. Like waiting 2 secs before responding = reward (something small like 2 m&ms). Don't expect him to go from 0 to 100 all at once - think micro-steps.
Also involve him in brainstorming at each stage. What kind of reward would he like best? What ideas does he have for a way to slow his reaction time or respond in a different way? What could he be thinking about that would help in x situation? Like if he never bites the stuffie in roll playing, then why? If he then imagines the other kid as a stuffie will he not bite them? You may be surprised at how creative he can be to help solve the problem.
If he doesn't want to do the roll playing, then you may need to offer a reward for working at it every day for x minutes. Or have him suggest another way to solve the problem (biting).
Once you start getting some small successes with the stuffie, then consider moving on to you being the other kid. You might have to backtrack to the stuffie several times and that's OK. 2 steps forward and 1 step back still equals forward motion. Celebrate all successes and don't sweat the backtracking (it's a normal part of the process).
If you can find a behavioral or occupational therapist they will also have additional ideas.
If it is mostly an emotional/anger response--my son is a hitter, not a bitter, but no amount of reasoning/therapy/zones of regulation training/OT/etc could get him to pause a moment when triggered. He knew it was wrong... but after the fact.
Guanfacine is what has helped him most. He's still very impulsive, but now it's very rarely emotionally driven. He has the pause he needs to turn off the fight or flight response and consider a good reaction.
Thank you to everyone who has replied so far. I’ve read and so much appreciate all of your responses, ideas and support. I will try for a longer response this weekend. Thank you for being here and taking the time to reply to me.
My now 13 year old was a biter when he was little. I didn’t enroll him into any type of preschool until age 4 as a result. He had a 1:1 aid in a very small and low stress preschool 1/2 day program. He seemed okay to start kindergarten and then a few months in -chomp-! Kicked out in the late fall and frantically looking for a small, special education school.
The right school (small, supportive, focused on social emotional etc) and time/maturity was what it took.
I’m proud to report he’s not biting anyone in his middle school. ; )
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