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I honestly am confused about what to do as a parent. I have a 4 year old child with severe ADHD symptoms and ODD and persistent impulse control issues. My child experiences level 10 tantrums multiple times a day over various things. Sometimes it's because we're following through on a punishment like turning off the TV or tablet when he is using foul language or being mean to his brother. Sometimes he randomly hits his brother or the dog and we remove privileges when he does. It's at the point where every attempt at anything remotely resembling discipline is met with extreme rage and violent tantrums for at least half an hour or more and this happens multiple times a day

During these episodes if we don't lock him in his room, he will continue to punch, kick, and bite at us and his brother. It doesn't end until he is a quivering exhausted mess or he ends up hurting himself in his fit of rage. There is no point at any negative or positive consequences or attempts to punish the behavior as communicating with him during this stage is impossible. I and his therapists are not sure how to calm him down. I have tried physically restraining him to keep him from constantly attacking us or his brother, but that is dangerous for both of us. I have two damaged teeth from random headbutts. The last time I have tried this he clocked me in the face and I saw red and unfortunately lost my cool and screamed at him in his face. The terror in his eyes was too much to bear, but he did stop. This cannot be the only way to snap him out of it, surely, because I cannot accept for him to not be violent that he must fear us?

My parents and in laws are disgusted with us as parents and make it known that they think we are raising a psychopath because we refuse to beat our children. They make it explicitly known that they think this is 110% our fault and that ODD and ADHD are made up diagnoses to sell therapy and drugs.

Any ideas on what we can do to bring the violence under control in our house? The doctor highly recommends we get him on ADHD medication soon but wants to wait a few more months when he is closer to 5.

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    One thing to try (apart from medical attention) is to remove all electronic entertainment devices from your family for a couple of month. Make up a story (Internet is broken or something). This might reduce a lot of your conflict points. I am not saying any of those cause adhd or odd, but I believe they increase the stress level of the child experiencing stopping this activity.
    – lalala
    Jul 5 at 9:49
  • The first time in your question when use use an acronym, it is helpful to define it. Jul 6 at 0:48
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    I wonf repost, but you may find my reply and description of support and meds and impact of adhd, useful: parenting.stackexchange.com/a/41871/28563
    – Stilez
    Aug 18 at 20:56
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Someone will probably comment that ODD and ADHD can't be diagnosed reliably in a preschooler. Not only is that unhelpful, it's also untrue. I can't speak to your child's ADHD, but it sure sounds like they have ODD. What can you do? It's hard to say, because you don't mention everything that you do try before the tantrums erupt.

You don't say what kind of therapist(s) your child has. The importance of a good, experienced child psychiatrist cannot be overstated here. If you don't have one, please start looking. If you do have one and they don't know how to help you, start looking for one who does. Positive interactions should precede tantrums (validate emotions - which does not mean agreeing with them - and try to understand why the child is upset, which requires emotional literacy on your part and theirs), and deescalation tactics are crucial, as is the ability to remain calm and to disengage. A good child psychiatrist can guide you here.

Sometimes he randomly hits his brother or the dog and we remove privileges when he does.

This strikes me (no pun intended) as strange. Removal of a privilege doesn't seem like an effective consequence for violence; removal of the child from the situation does. No being, child or dog, should be subjected to violence, and the consequence should be immediate, consistent, and significant: removal of the child to a safe place (not restraining him), done without emotion or discussion until the child is calm and shows evidence of ability to engage in meaningful discussion. ("...communicating with him during this stage is impossible." That's correct and completely normal.)

Since his behavior affects the entire family, Family Therapy should strongly be considered. Depression is common in those affected by the disruptive behavior. Family Therapy - with or (maybe better) without your ODD child can be a sanity-saver.

My parents and in laws... make it known that they think we are raising a psychopath... [and] they think this is 110% our fault and that ODD and ADHD are made up diagnoses to sell therapy and drugs.

It sounds like you can't count on your parents and in-laws for emotional support, so it might be beneficial to join a support group for people who are experiencing the same problems that you are. Your Psychiatrist or Family Therapist should be able to guide you here. Knowing that others are coping with the same problems and getting support are important. If the input from the grandparents is really bad, then learning about boundaries (and how to set them) might help a lot.

To end on a brighter note, hopefully someone has told you that a lot of preschoolers with ODD (some literature states up to 50%) outgrow it. So there is hope!

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Oppositional Defiant Disorder

Age 4 predictors of Oppositional Defiant Disorder in early grammar school

If you could get your library to borrow a copy of the Handbook of Preschool Mental Health: Development, Disorders, and Treatment, Joan L. Luby, editor, there is an entire chapter on ODD in preschoolers which might be helpful.

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  • Thank you for this answer. He gets one on one therapy at our home where they work a lot on structure and order, eg. First we do X, then we do Y etc... Its all about transitions. He also works with him on his speech because a lot of the frustration they believe is because he is delayed on speech and has trouble communicating what he wants. To answer your question about what leads up to tantrums it is usually just asking him to do pretty much anything he wouldnt want to do anyway. Things like using the bathroom if he wants a snack, or washing his hands before dinner Jul 5 at 17:34
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    @maple_shaft - It sounds like you have an social services/occupational therapist (?) which is excellent, but doesn't negate the need for a good child psychiatrist as well. Have you tried warning him in advance that he'll need to do something he doesn't like? (E.g. "Dinner will be in 15 minutes, so I'll be asking you to wash your hands in 12 minutes. Do you want to set the timer?) Does he instantly fly off the handle or is there a period of complaining first? Delayed speech would also make emotional literacy hard, but not impossible. I understand what you're going through. More help is better! Jul 5 at 20:31
  • Yes indeed more help is better! And yes he receives occupational therapy, i forgot the name of it for a second. We do use the timer frequently, and he will even try to barter and negotiate for a minute or two extra time which we are usually happy to give him. That is after all the most important lesson we can teach him is that if he trusts us and talks to us then we will be agreeable and good outcomes will occur. The tantrum though will pretty much start as soon as the timer goes off. Jul 5 at 21:08
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    @maple_shaft - Negotiating is very common, but it's a problem. Don't engage; instead, switch the topic to what he's feeling (emotional literacy needed for both parties.) You might give a second warning ("Two minutes, Sweetie!") and if the negotiating begins then, you'll already be talking about feelings when the timer goes off, which might decrease the intensity of the tantrum (or even the tantrum itself.) Search (on this site, it's the black bar on the top of this page, or Google) "emotional literacy" & "emotional vocabulary" for help with this skill which is critical for your child. Jul 6 at 12:16
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    Someone mentioned deafness- has he had his hearing tested? AnonGood, this is one of the best answers I've seen. Wow. Maple, it sounds like you're doing a great job with a very high needs kid. Congrats to both of you!
    – VWFeature
    Jul 8 at 19:52
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Two of my three children have extreme behavior differences, although not exactly the same as yours (or each other). Some things I've learned:

  • The idea that children's behavior is controlled or "molded" by parents is very deeply ingrained in our culture. Parents do have some effect, but much if not most of parent technique is a reaction to how kids behave, not the other way around.

  • Parents who don't have a child like yours have no clue. Our normally-behaved child is our youngest. Having her was like, "Oh, this is why people think it's so simple."

  • This is why I'm not very active with questions on this site anymore. No one ever offered anything that helped significantly. We mostly had to figure it out on our own.

  • A lot of times, when you wish you could be choosing the best thing for your child, you're actually stuck choosing the lesser of two evils. The "snap out of it" thing you described is one such decision. You're trying to maximize the family's happiness over the entire day, and sometimes making it worse for a moment is worth it to avoid hours of misery.

  • You need to base your decisions on how your own child reacts, not on how you think some hypothetical median child you don't have would react. My son who behaves the worst is also the quickest to forgive of anyone I know. Use your child's strengths.

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Sometimes its because were following through on a punishment like turning off the tv or tablet when he is using foul language or being mean to his brother. Sometimes he randomly hits his brother or the dog and we remove privileges when he does.

I think this is the problem here. I don't think punishment will make a child behave better in the future. If the child is a confident and self-determined one, he'll view your punishments as irrational and restrictive, and start disrespecting you instead of changing his behavior to not get punished.

I think you should try letting him be free, and explain to him why he should not attack other people.

I think ADHD and ODD is a made up term for kids who think a lot. ADHD generally means that the kid's mind is creative and is full of thoughts, and he views the world in a different way. So he may also tend to question traditional practices, and that's what they call ODD.

If anything, I believe the kid is strong and self-determined from a young age, so instead of punishing him, you should let him be free and explore his interests. Just make sure to let him know that other people's behavior are not within our control, and the consequences of getting violent at others. That ought to help him make a better decision and be socially calmer than punishments.

Punishments will only change someone who fears punishments.

Also, this can lead to people not accepting his behavior or blaming yourselves as spoiling the child. But it's up to you to decide whether you'd want to listen to others or let him find his own uniqueness. TV and fiction are not purely for entertainment, and children can often gather perspectives and ideas from it. Instead of cutting them off, try providing him with toys and more creative material he can invest his time in, and learn from. ADHD is also an indication of desire for adventure and change.

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    "I think ADHD and ODD is a made up term for kids who think a lot." Thank you for confirming my first sentence (kind of). On this site, opinions like that need to be supported with reliable sources, not quackery blog sites. You might Google, "Is ADHD real?" and post the question (with the source agreeing with you) on Skeptics.SE. In medicine, it's like saying Fibromyalgia isn't real (which many doctors believed in decades past.) Also, you make a lot of unwarranted assumptions. Jul 6 at 12:29
  • I would tend to more agree than disagree with your remarks concerning punishment. But you would really have to back up your claims that go against medical science. But even more so: Punishing a child for their psychological problems (which are real!) is much like punishing a deaf person for not listening properly. Jul 6 at 14:30
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    @anongoodnurse I didn't mean to say that ADHD is not real. It can be clinically diagnosed, but it isn't something that shouldn't be viewed as some serious disorder that needs brute punishment. My answer was more about not punishing the child based on that. Attention disorder is a real thing, but parents should not be too harsh on them for that, it can actually be helpful for the child's creativity if he's given good care and treatment. Jul 7 at 9:10
  • yes, but letting him get away with behaviour that, when magnified to adult situations, will see him in jail, is not doing him any favours either . I have an ODD child and you do have to do things differently but removing all restraints and consequences simply creates (in time) a physically larger adult child who fears neither and suffers the adult consequences Jul 23 at 14:31
  • @bigbadmouse That's true, but when I first read the post I felt like the family is being too conservative and close-minded and is not understanding the child's perspective. But now after reading it again, I can see that they did their best. I was slightly biased at that time, because I myself had ADHD and OCD and though I wasn't violent, I had different perspectives that people couldn't understand. So when I heard terms like ODD, I thought it might be related to the same thing, because I don't believe in traditions that are not really reasonable. It could be a similar thing here too. Jul 23 at 20:05

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