Hi! I have an almost 5 year old boy diagnosed ADHD who struggles with aggression and impulse control. He's medicated with with Guanfacine. I find that it's not that effective for him. Mostly just makes him tired and less hyperactive. But at this age what I'm really concerned with is not hurting others. I'm trying to see if we can try other meds (but psychiatrist wants us to keep a lot of behavior first, sigh).
So we have a pretty aggressive kid on our hands. For the most part he's happy and quite bright. But throughout the day he is prone to aggressive out bursts. These typically happen during transitions and when he needs to do something he doesn't want to or disagrees with a peer. I am able to avoid some triggers but I cannot completely stop all demands (and I don't think that's helpful for him).
If you have or had little ones with this profile what did you do during aggression episodes? I've tried time outs at home and leaving whatever public place we are at if an incident happens (like the park). But I find this just escalates him much more. And after trying this for 6 months + I'm seeing no improvement. Are there other strategies? Am I just dammed to a kid who can't handle his big feelings?
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Ember_Rose
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Hi! There are a lot of helpful books and videos on YouTube, and counseling and medications help a lot too. Just letting you know you are not alone. My son is now 8, and we struggle with very similar emotions. We're still working on the medications, but it is a very challenging process. Lots of trials and error, a lot of accommodating, and trying to be scheduled and consistent. School has a big impact too, his IEP and the staff are very helpful.
But the anger and outbursts are really hard. They don't seem to be going away anytime soon either. Hang in there and know you're not alone.
Positive reinforcement strategies can be helpful (teach the expected behavior). If this is due to ADHD, can also discuss use of a stimulant medication with the psychiatrist so the behaivoral impulsivity is reduced.
My son was very much like this three years ago. He takes guanfacine ER and atomoxetine which have helped, as did PCIT (parent training) and some use of reward systems (punishments usually don’t work and send him into a negative spiral).
We also deliberately plan activities that we think will work for him (e.g., rock climbing gives him a chance to exert himself in a way he enjoys).
Medication helped him most of all but maturity/getting older also helped a lot. He’s still challenging but much easier at 8 than he was at 5, and each year has gotten a little easier. It does (often) get better.
Guanfacein was initially a med that lowers blood pressure. It made my kid feinted. It sometimes doesnt help much with impulse control like you are noticing. Although stimulants are the first line, many doctors don’t like to give them to young kids. I would ask about non stimulants and see if you can do one of those. Stratera doesn’t lower blood pressure, and is working well for me. Based off of his demeanor though, he may do better with stimulants. Both my brother and my partner were that way until they found the right stimulant for them.
I would start by getting your doc to give your kid a gene sight test. It will tell which meds will give adverse effects. It doesn’t show which ones will work or what the side effects are, but it helps you know which to try first.
The one thing I have to always remember is that their chronological age does not reflect their emotional age. I have been told by all medical professionals that there is usually a 2 year deficit, so when expecting my 9 year old to react like other 9 year olds, I have to stop and think how would a 7 year old react? I don't do time outs, leaving venues or other punishment, because adhd is a disability and it is not the child's fault. I wait until the storm dissipates, distract or suggest a physical activity to allow them to get rid of all their feelings.
This sounds so much like our son. It is so hard. As someone else mentioned, PCIT (parent-child interaction therapy) is a wonderful tool, and your son is in the perfect age range for it.
In our experience, every medication we have tried (2 non stimulants, one stimulant, and one anxiety med) all made the physical aggression worse. We did see a lot of improvement with supplements, specifically mood probiotics and nutritional lithium. I recommend Finally Focused by Dr. James Greenblatt if you are interested in learning about addressing nutitional deficiencies that can lead to ADHD behaviors.
Finally, physical exercise. Our son needs lots and lots of exercise and outdoor time, and his aggression goes way down when he is worn out and getting plenty of exercise. Running, swimming, jujitsu, trampoline, etc. Best of luck to you, it can feel so discouraging, but you are absolutely not alone!
At school, IEP with a support on his behavior. At home, a lot of quality time, a reinforcement positive. Keep him busy. Write a journal as detective when and how occur the behavior. Find the root. Take care about yourself first!!
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Lonely little boy
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