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Is there a way to curb impulsiveness?


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I mean like at home, anything we can work on before we actually get referred to therapies or prescribed meds? This is about to get me.

 

Today, DS was in trouble three times in 2 hours. We were at the pool and the kids were playing a diving board game called chicken. One of the stunts was a toe touch, and this other little boy did a really good one. One of the girls commented "You want to see a boy do a good toe touch that was it!" Well DS is naturally gifted at that sort of thing so he couldn't wait to prove how good he was and get them to ooh an aah over him. He took off down the board and jumped...almost on top of the other boy! I called him out and reminded him he needed to wait until the other swimmer is well out of the way. At that point he got mad and said "I'm not playing that stupid game anymore" and sulked off to the shallow end. Those sulking fits never last long because he can't stand to not be part of the action, so five minutes later he was back.

 

The next issue was that a much younger boy was throwing a ball and jumping in to get it. DS takes off when he throws it and dives in and gets it. Honestly it was like watching a Labrador, he cannot NOT go after a ball. Again, I call him over and tell him not to do that, the little boy wanted to play alone and did not want him going after his ball.

 

The last incident was another not looking out for other swimmers thing. It might have been at least partially my fault. I told them it was time to go and they could do one more thing before we left. Dd was working on her dive and I wanted her to have a chance to practice one more time as she was doing really well. Well, DS doesn't even wait on her to surface, he jumps on the board, runs to the end, and sails off in a cannon ball. Right on to DD. I was furious. We literally had the "Look before you leap" talk less than 30 min prior. It may have been partially on me as I said "once before we go" and maybe he was trying to rush to do it, though I hadn't been hurrying them. I went and got him by the hand and made him walk with me to the chair and gather his things to go. I restated that he HAD to wait on the person before him to clear the area. I'm just flat out without any ideas how to teach him patience and get him to assess situations before acting. Honestly, this has only recently become a problem at the pool, he has always been better than this. you can actually see him just spring into action without any thought. It really IS like watching or trying to restrain a lab puppy when someone is throwing things, it's like his body can't hold still and he has no time to restrain himself before he is already into action and unable to stop himself. It is wearing me out!!

Edited by Ghee
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How old is he? Have you tried eliminating all artificial colors/flavors? it made a huge difference on my youngest's behaviors. Well, then we also ended up off dairy and gluten, and you dont want to go there!

 

I do find for my difficult boys that if we are going to a place where they often have trouble controlling themselves, to have a talk before we get there. I'd remind him of the look-before-leap thing and tell him AND ENFORCE that if he jumps in too close to someone who is already there, he'll sit out of the pool for 5 minutes. If he is at all capable of controlling himself, this should bring it. My youngest CAN control himself with this kind of 'motivation', my oldest could not. My oldest ended up on medication. (not adhd, he had different issues)

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He is 3 months shy of 9. He gets no sugar or dye, we are on a pretty restricted diet. Some of his motor skills got way better with a dietary change, but behavior is a see saw now. He doesn't like, thus get, much dairy at all.

 

I will say this - it appears to me to be 100% about needing the focus on himself. When it is just US at the pool (we go early to a private membership pool and often have the whole thing to ourselves) he is good as gold. He is even pretty much ok if there are a few people there, doing other things. The problem comes when they are interacting with him. He goes bonkers, it's like their attention stimulates him into a frenzy and he does more and more outlandish things to keep them watching him. At that point he doesn't process anything, the filter shuts down, he just does whatever comes to mind without thinking it through.

 

Okay, I was typing on my phone (ack!) so I got on the laptop and came to edit and add this:

 

Also, I've done the five minute out thing. It worked GREAT with my older two kids. Not as well with ODS as DD, but at least enough that he remembered for the rest of that DAY... It backfires EVERY time with YDS. He does one of two things. Either he will become irate about what was going on (like when he said he wasn't going to play that "stupid game" anymore) OR he will go off on a tangent about something totally unrelated (dragging out "You know so and so? They are mean to me." even if the kid isn't there, or "I miss daddy. When is daddy coming home? Waaaah!") I can never get him to focus on this happened and so now you are sitting down for X amount of time. It's like his brain won't make it click, it jumps onto something else. I liken it to when NT kids try to shift blame by saying "Well so and so did it" or "But he hit me first", but sometimes what he jumps to is so bizarre and unrelated (or, in the case of the game, he enjoyed it up until he did something and got in trouble and then the GAME was bad) that it doesn't seem exactly the same. Also, sometimes, depending on how wound up he is, he will start self harming behaviors like slapping himself or pinching himself and howling. Talk about a bad scene in public :( And once THAT starts, there is no way to redirect him. It has to play out, and it will, but it is so embarassing in the mean time. Any trying to shush him or remove him only escalates the behavior. I've wondered if he knows it embarasses me and tries it as a ploy to try to get me to say "Oh, okay. Stop it and go play." The thing is A) I never do, not once in 8+ years and B) he really seems like his brain has gone on auto pilot at that point. He truly appears to not be rational.

 

Meds. I would almost happily try one at this point, but I want to know I'm treating the right thing, KWIM? I want a diagnosis of ADHD before I give meds for it as I suspect perhaps some SPD or ODD and I've seen people treat ADHD when it was bipolar and Oh.My.Goodness it was bad. I want to feel reasonably sure that I know what the problem is. Also, I think he needs some therapy (I know he needs an SLP and most likely will need OT...Perhaps even some sort of group therapy for this sort of thing?) in addition to meds. I'd like to use meds, if necessary, as a way to keep him level to benefit from working on the issues, not just dope him up to the point he can't annoy. FWIW, I'm NOT saying that's what anyone else has done - I think some kids truly only need a little "help" from the meds. I just think he has more going on than any med, alone, can fix.

 

I'm looking into 5HTP, I'd like to try that FIRST if meds are prescribed and, if it doesn't work, then we can try the pharmaceutical. Can anyone tell me how to determine dosage, and do you split the dose (like breakfast and dinner) to keep it level in their system? Also, how long would you give it to see if you are seeing the maximum results it can produce (or determine there won't be any?) We've tried high EPA fish oil, and it was OK but certainly not enough to be even close to ideal.

 

I should also add, because I forget that people may not know where we are at this point, that we are in the process of having him evaluated. We have had 1 appt and then go back for a second in a couple of weeks. I'm not sure how many times he will want to see him before he diagnoses any issues with a label, his problems seem pretty complex, so I'm thinking 3 or 4 might not be out of line. He is aware of the impulsiveness and self harming behavior, I gave him a list of issues that we've had since birth, in our intial meeting.

Edited by Ghee
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Until it gets under control whether via supplements, diet, medication, or behavior modification, I suggest finding a babysitter he can stay with while you take dd to pool so that neither of your children nor any others there end up with permanent injuries, paraplegia, or even death from being jumped on or from leaping before looking. Possibly that would also show him that his behavior is a serious matter in a way that your words and time-outs are not doing.

 

ETA: You likened him to a lab, and recently I was watching a lab pulling a large, ripped 6 foot guy as the dog made lunges toward a lake (and eventually the dog won the tussle). However, given the typical situation at a pool and as you describe near misses, or even actual landings on dd, I think your situation might more be likened to a lab about to pull its owner and itself into a heavily trafficked 6 lane highway. Sounds like a potential tragedy could easily happen.

 

He may need to have his hand held and be led through all activities in a very controlled way until you find what will work to help him to control himself, because even though you can keep him from going to the pool, it is likely that he is doing similar things in other places that you have to be--such as your own home. I have had to do that with mine at times. For sure in the circumstance you have described, I would at least keep ds by my side, held onto so he cannot jump into the water, if you went to the pool with him, control him as I would a two year old since that seems to be about the level of caution as to the safety for self and others he is capable of.

Edited by Pen
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Possibly, and I have done that before. The thing is we usually go really early and it's just us and he's fine then. We just hit a wrong day as another family tried to do the same thing ;) I do feel like the swimming curbs the hyperactivity for the rest of the day and I was using it to settle him before school. I will stop allowing him in the deep end if anyone else is down there, though.

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Pen,

 

Yes. I have him on a short leash. Honestly, at home, he's bad but not AS impulsive. Or if it is just family at the pool, or he isn't actively playing with other kids (beyond his brother or sister). I know it doesn't matter (big picture) WHY he becomes so impulsive when playing with other kids, it just has to stop, I am curious as to the why. It's like their attention is crack and he HAS to get a hit. He is THE ULTIMATE class clown when in a group setting. He wants, no needs, to have all eyes on him. It's very frustrating and tiring, because, like you said, he acts like a 2 year old.

 

The swimming is good for him, and it's rare for us to not be alone there, so we will keep going. However, now I know that he will have to a stick to games/situations where impulsivity isn't such a concern when interacting with others. This had really only become an issue in the last 4 months with te outside the home thing. It looks like homeschooling, getting more rest, eating better, etc would be lessening this but it's actually gotten worse. I know he craves interaction with non family members and he isn't getting enough right now. He was doing fine until the other little boy was praised for his toe touch and then it was like a switch flipped and he HAD to show them he could do this or that. I hate to never let him attempt to play with others, but then when you know this is where it can end up....sigh

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yeah, he sounds like a challenge all right. I actually wanted to avoid adhd meds for my son (the middle child) and once he was dx'd with tics, that was easy - all the adhd meds then were bad for tics. They ended up trying a small dose of risperdone for adhd symptoms - and suddenly he stopped the "hey, he made me drop that ball on purpose!" problems he was having when trying to play with other kids. I had no idea . ..

 

i didnt try meds until he was suicidal, tho, at age 9 . . . but they were a real game-changer for him. Oh, and we had 7 evaluations over a 3 year period before we got anywhere . . . he was in school and i spent SO much time at the school it was NUTS . . . only one of those evals was by the school though.

 

so good luck . . . wishing you lots of patience!

 

oh, also . . .your description of him losing his cool . . .reminds me of a book called "aspergers and difficult moments" My son ended up not getting an aspergers dx, but the description of the blow-ups in that book was great. they said you have to recognize the early rumblings, because once it blows, you just have to ride it out. nothing productive happens during the duration.

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yeah, he sounds like a challenge all right. I actually wanted to avoid adhd meds for my son (the middle child) and once he was dx'd with tics, that was easy - all the adhd meds then were bad for tics. They ended up trying a small dose of risperdone for adhd symptoms - and suddenly he stopped the "hey, he made me drop that ball on purpose!" problems he was having when trying to play with other kids. I had no idea . ..

 

i didnt try meds until he was suicidal, tho, at age 9 . . . but they were a real game-changer for him. Oh, and we had 7 evaluations over a 3 year period before we got anywhere . . . he was in school and i spent SO much time at the school it was NUTS . . . only one of those evals was by the school though.

 

so good luck . . . wishing you lots of patience!

 

oh, also . . .your description of him losing his cool . . .reminds me of a book called "aspergers and difficult moments" My son ended up not getting an aspergers dx, but the description of the blow-ups in that book was great. they said you have to recognize the early rumblings, because once it blows, you just have to ride it out. nothing productive happens during the duration.

 

Is that your way of saying "Bless your heart."? :lol:

 

Challenge....sure, we will go with that :) So you did find that meds helped your son not get so upset when something happened? I'm going to check out that book. They are right on, once the fit is in effect, it is pointless to try to turn the tide. The thing is, he's fine UNTIL he's disciplined, it isn't like I can see this heading down hill (well sometimes you know he's likely to do something that will GET him in trouble, then you can head it off) so that makes it extra....challenging.

 

If you don't mind my asking, why did it take 7 evals to get a diagnosis? I'm trying to imagine what could be going on that a neuro-psych, SEVERAL neuro-pyschs could just miss. It makes me :001_huh: about our evaluation... That may be too personal, if it is, just ignore.

 

:grouphug: It sounds like you had a rough time of it.

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There are about 5-10 different diagnosis and combinations that can fit similar symptoms. We have an initial dx, but that may change as new information develops over time. My theory on the vague or non-diagnosis is that most kids are taking that dx with them into ps so it becomes a part of their "permanent record." Doctors don't want to pin something on the child that may stick well after the hormone surges that exacerbate sympoms have settled down. (Just my theory.)

 

It may take several different medications, dosages and/or combinations to find a good fit for the child. A cautious doctor isn't going to just throw ADHD meds into the mix without evaluating for bi-polar. There are non-stimulant ADHD medications available now. But, it's a good idea to go in with a little knowledge. I don't know of any medicine that doesn't have some negative side effects ranging from mild to "I would never give my child that because..." Of course, the folks who say that usually don't have a child in a position who needs that type of medicine.

 

IMO, When your child begins to hate who they are because they have no control over themselves or their thoughts, or they can't physically control themselves in the midst of a meltdown (and thus become a danger), you can't just leave them in that state. KWIM? But, only the people who are with the child every day can truly determine when that point is reached. Then those same people have to get competent advice and find the best solution for their child.

 

 

 

FWIW, the one section of my book on Aspergers that I took the time to read basically says every single thing I instinctively do as a parent to correct my child will just make it worse.:banghead: <-- Me, after reading that particular passage.

Edited by MomatHWTK
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I probably was somewhat misleading - that wasnt 7 neuro-psychs, it just was so darn frustrating to go through it all.

 

so, warning, this might be long:

first the school sent us to county mental health (i was a single mom then). We spent some time w a guy who . . . i dont remember if he actually did a full questionnaire to the school or not, but he would just go over coping strategies with my son (who was 6). But the school had already done some 'friendship skills' classes, so my son could recite the skills, but couldnt use them. When I met my husband, my son started doing a little better, so we stopped going - that guy (phd psychologist i think) said, "Not ADHD, call us again if you need anything.

 

2. The next year, (age 7) my husband's coworker said my son sounded autistic and recommended another PhD psychologist, this one at childrens hospital, who had dx'd his son. She sent the questionnaire to school, but that teacher was nuts and said he had no problems. at the end she said "Its not ADHD. Read this book on Sensory Integration Dysfunction. Call us if you need anything."

 

3. My husband started pushing for a dx because we were disagreeing on discipline so much, now that my son was 8. My pediatrician sent me to a Developmental Pediatrician at Children's hospital. He did a questionnaire to the school, one for me, and a 2-hour interview with us. He said "Aspergers, ADHD, Gifted. Get further testing for Sensory Integration Dysfunction and Non-verbal Learning Disability." He also said my son is a complex child which makes it hard to diagnose.

 

4. Went to an OT for Sensory Integration eval . . .spent a lot of time and money to find that, yes, he's sensitive to noise and touch, which i already knew, but he didnt have any balance issues and probably would have been too old to do therapy for it anyways.

 

5. Went to a speech therapist for the non-verbal whatever eval. The ST was AMAZING! She said she was really worried about his self-esteem, his non-verbal communication skills were fine, he definitely had tics. she said the Dev Ped was too busy to be available to help families and suggest I look elsewhere. She gave me a few names

 

6. We ended up at another PhD psych, but she did a MUCH more thorough evaluation. By now my son was 9. She said "Anxiety, dysthymia (mild ongoing depression), adhd symptoms probably secondary to (caused by) sensory integration dysfunction, tic disorder, PDD-NOS (milder than Aspergers but similar), processing disorder, gifted." She wanted him on meds for the anxiety before he started 4th grade, and i couldnt get another apt w the Dev Ped until december. At this point he often talked about wanting to die, so . . .

 

7. Psychiatrist - after treating him with meds - which worked really well - she said pdd-nos, tic disorder, atypical bipolar. Apparently for kids, anxiety and depression at the same time is considered bipolar by most doctors, and he responded SO well to the meds that bipolar ppl respond to, so thats that.

 

8. I guess the school evaluation came in around here, maybe before the p-doc or just after we started seeing her, but before he was fully stabalized. Also showed anxiety and depression, both at 'clinical' levels.

 

9. Actually, we did finally get an official dx of Tourette's Syndrome from a neurologist.

 

We also saw two therapists in there . . . a woman who specializes in tough kids. we mostly liked her, but didnt feel she helped much. we tried a man who EVERYONE recommends for boys, but he could not make heads or tails of my son, and i got tired of watching train wrecks.

 

So we had a really long route. Of course, this all started back in 92, and I think the medical establishment has come a long way, so hopefully it will go much more smoothly for you!

 

I guess thats my 'bless your heart' . . . 'bless your heart' was never something i said. I think it was supposed to by sympathetic, sorry if it came out otherwise.

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I guess thats my 'bless your heart' . . . 'bless your heart' was never something i said. I think it was supposed to by sympathetic, sorry if it came out otherwise.

 

:grouphug: Oh, no, it didn't come out as anything but sympathy. It was sort of a joke on my part, it's a Southern thing (a joke about "Bless your heart" being equivalent to something worse but a nicer way of saying it ;)) Actually, everyone has been really nice and helpful about this. It's....draining, I guess, is the best word. It isn't like this is all I have going on, KWIM? I have 2 other kids, a husband, LIFE...and then there's this, and so few people here (locally) can begin to relate. If I knew *someone* who had BTDT and come out of it having made some progress, I'd feel like I had a path to follow. As it is, I feel like I'm forging my own with a dull machete. I can relate to what you mean about it being a frustrating process. My oldest had 2 evals, 5 years apart, was floundering in school, and the closest I've heard of a diagnosis for him was "Kind of ADHD, like most boys his age". I couldn't even GET the school to evaluate my youngest, I filed paperwork and made verbal requests repeatedly, but was always told "Not now, next month/9weeks/year". It took me for.EV.er to find a private NP for him, even our family dr was no help on that.

 

In fact, our family dr offered to put both boys on ADHD meds without even having a diagnosis. That really turned me off. What if they could be helped without meds? What if they needed MORE than meds alone? What if we were giving them meds for this but it was really that? It felt like he was offering me a bandaid and a pat on the head. It's just VERY common here to put kids on an ADHD med at a teacher's recommendation or a parent's request, they don't really mandate a diagnosis to get it.

 

Thank you for sharing your story. I know it can be painful to do so. I posted my OP for two reasons: 1. I really need some input, I'd love to hear "Well, we do x,y, and z which seems to help some" so that I could try those while waiting on the end of evals and 2. Maybe someone will search the forums later for something similar, see my post, and say "Hey, I'm not alone!"

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Meds can give kids an "pause" button where they have a brief moment to THINK before they ACT.

 

We started meds after my daughter ran full tilt across a parking lot with no regard for cars and said once we caught up to her "you dont' have to watch for cars EVERY time".

 

You are right about ruling out mood and other issues but a good psychiatrist or neuropsych should be able to help you.

 

We love meds here.

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We started meds after my daughter ran full tilt across a parking lot with no regard for cars and said once we caught up to her "you dont' have to watch for cars EVERY time".

 

That sounds frighteningly familiar :glare:

 

FWIW, we went to the pool again today. We were totally alone, except for DD, the first 45 minutes and he was fine. Good as gold.

 

Then a big family (six kids, 2 adults) showed up. I could SEE the switch flip. He was like a panting dog. I took him aside and reminded him that he MUST not act wild. I told him what to do in the deep end, then made him repeat it back to me. This was like pulling teeth. It went like this:

Me: When you get on the board what do you look for?

Him: Someone

Me: Someone WHERE?

Him: In front of the board.

Me: If someone is there, what do you have to do?

Him: Wait

Me: Wait for WHAT?

Him: For them to swim.

Me: For them to swim WHERE?

Him: To the ladder.

*headdesk* Am I the only one who thinks that conversation should have been more like "What do you need to do?" and "Look to see if someone is in the water and wait for them to swim out of the way before I jump."??? Honestly, he was so busy tracking them as they found chairs that I had to really work to keep his attention on me.

 

Anyway, he came to the shallow end at first and boy was I glad. Those kids were WILD and LOUD. It took him a few minutes to get himself under control because that sort of behavior from other kids inspires him to be wiggly and bouncy and just all over the place like a ping pong ball. He did come to me and ASK if he could go to the deep end with him, and I let him but went with him (reminding him AGAIN of what he had to do.) The other parents came down there eventually and organized a game with their kids, so the kids were taking turns rather than running and jumping pell-mell. I still stayed down there to make sure he didn't line cut or knock someone down in his haste. Also, because they were letting their kids do stuff I won't let mine do like jumping towards the sides of the pool instead of out to the middle, barely jumping off the board and coming dangerously close to hitting heads, doing cartwheels on the board... and I wanted to make sure he didn't get swept up into that. He did really well. I'm not sure if he just managed to find a calm place before he got down there or if it was having several adults in the vicinity. I do know I think that is WAY more hand holding than an almost 9 year old should have to have, so I think something has got to be going on (well, I already knew that....but this sort of thing strengthens my resolve.)

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