What to do about 6.5-year-old grandson out of control?

Question

About 1 1/2 years ago my grandson started acting out. It has now become so bad and we need to get him under control.

First off I will say that my grandson lives with his mother as his mother and father are no longer together. They split up long before he started acting out.

We are a loud family. We all shout and talk so loudly at times. My daughter raises her voice most all the time when she is trying to get a point across to anyone including my grandson. My daughter historically has not spent quality time with him. She has not and does not do anything more than necessary in things that I feel are very important. I believe she should have been doing more with him in the last couple of years than she has. Like working with him to get him ready for kindergarten. He is now on his second year of kindergarten.

Anyway, we are at the point where he constantly yells, cries and screams at the top of his lungs. He kicks, hits, scratches, bites, etc. He is a very angry little boy. He screams "I hate you", "you're an idiot", "get out of my house", "get away from me", etc. Then two minutes later he will tell you that he loves you.

He does have some medical issues....like reflux, asthma, allergies, etc. He has ADHD and also ODD. I fear that all the medications that he is taking could be having an effect on him. He started on behavior medication over a year ago. They have since switched him to Abilify a few months ago since he was trying to harm others (hitting, biting, kicking). When he gets sick and he has to take steroids, it is even worse. Also, it seems that when he has to take an antibiotic that his bad behavior escalates ever more.

We use time out, which he typically won't stay seated. He constantly yells NO when given instructions to do something. We have tried taking toys, etc. away from him and he does not care.

I love my grandson so much and I am so worried that if he is not gotten under control soon, that this is going to lead to a lifetime of problems.

There is so much more to this but I know there is not enough room to keep going on. Any advice or words of wisdom would be greatly appreciated.

Also, I feel that my daughter's lack of parental skills and her emotional outbursts have contributed to this so much, but I can not get her to agree to help for herself.

Lastly, my grandson is 100% opposite while at school. He is the most polite, laid back, easy going child you could ask for :)

Answer 1

+1 to the answer that recommends having a single doctor verifying meds. I have one doctor that really knows a lot about drugs and interactions, and I run all my medication past him to make sure he considers interactions, etc. You can also check with your pharmacist who has training in that area as well.

You say he has ADD and ODD. Who diagnosed those disorders? If it wasn't a pediatric psychiatrist, I recommend you go see one. There is so much nuance in those areas of medicine, and you want to make sure you have both (1) a correct diagnosis and (2) the correct medicine for the diagnosis. My primary care doctor miss-diagnosed me with a mental disorder and set me up with a prescription that exacerbated my condition dramatically. I went to see a psychiatrist who made a different (and correct) diagnosis, and had me switch the medicine completely. So seeing the right kind of doctor for your grandson is really important, if you can.

Finally, most people I have talked to about this agree that there is a two-pronged approach: the first is getting the right medicine from a doctor, and the second is making sure you have the right therapist. In most cases, these won't be the same person. I've had the same psyc doc for about 9 years and I've had five different therapists. Keep trying on the therapist front until you find the right fit. If it doesn't feel right, try somebody else.

Especially in the case of a child, YOU are his advocate, and you can fight the system to make sure his needs get properly considered, and his voice is heard. You can do it!

Answer 2

Someone who exhibits polar opposite behavior in different situations is doing so, generally speaking, from one of 2 causes:

1. Behavior reinforcement in each situation varies, so the behavior reflects what is perceived as gaining what is good/desired by the person.
2. Proper medications are administered at a time when the constructive behavior is demonstrated.

Now, if timing can be analyzed and #2 is determined to be the case, speaking with the doctor managing his care is in the best interest of the child. Probably, though, in your case, it should be his mother.

If, on the other hand, it is #1, then the key is to identify what about the other situation is causing him to perceive that his behavior is giving him what he wants. You'll need to determine what he wants: acceptance, attention, avoidance of punishment, etc. Once you know what he wants and how he accepts it, then you can interact with him in a way which reinforces proper behavior.

Dale Carnegie, author of "How to win friends and influence people", says you can make someone want to do what you want them to by seeing the situation from the other person's point of view and "arousing in the other person an eager want." (His book also establishes that one's actions must be sincere, not contrived, to be effective.)

All too often those of us who live with mental disorders suffer from conscription of all that ails our behavior to those identified mental disorders, when the truth is that we are still human and want what everyone wants: enjoyment/happiness.

Working with his mother, doctor, and him, though, will allow everyone to best determine the most effective course of action to establish a well-rounded future-adult.

One final tip: Ask him what he wants. You'd be surprised how people will open up when someone who cares asks the most simple of questions with an open ear.