Rage attacks in young child, please help

[mysticmomma]

A young child in my family is having trouble, and I'm hoping someone can offer some ideas. She is almost 7 years old. She lives with her grandmother and younger sister. Mother is. Ot in the picture. Father is in jail. She is homeschooled because of anxiety (and grandmother is a conspiracy theorist regarding public ed... So am I to a point). She is socially awkward, and what I consider to be average intelligence. She does a lot of acting out towards her grandmother, but not when in my care, nor when in another grandparents care. Grandmother is awaiting an appointment with the Kennedy Kreiger Institute, the two grandparents think she has aspergers. I disagree. She is having rage attacks. During these attacks, she just screams. About nothing in particular. If grandmother approaches her, she kicks, and punches and pinches. She screams that she has to pee, but cannot. After the meltdown, she has no recollection of the behavior. I saw a video of her during a fit, and it almost looked like a night terror to me, although she had not been sleeping and was walking around. My first thought was that she's having a seizure. Then I remembered seeing this:

and it was very familiar to what was on the video of my family member.

 

Please add thoughts.

[SKL]

Possible attachment and sensory issues due to lack of permanence and constancy (changes in custody, not able to have the normal expectations children are supposed to have of their parents).  I would seek counseling with someone who has experience with foster kids, adoptees, etc.

 

It sounds pretty serious.  Good luck to them.

[Nemom]

Have you done any research on PANDAS? Raging is very common. Maybe Grandmother she reacts with is a strep carrier? The urge to urinate frequently is also a symptom.

[mysticmomma]

Thank you. Keep em coming. She is in counseling. They are doing an asd eval soon.

[SKL]

If she had a seizure disorder, would it not occur regardless of who the caregiver is?

[mysticmomma]

I'm not sure. If they are psychogenic (non epileptic) then not necessarily. I have seen her have emotional meltdowns where she suddenly drops and cries for nothing, just never this screaming stuff with violence.

[SKL]

A book I'm working through (my kids are adoptees):  Learning the Dance of Attachment by Holly van Gulden.  It is very simple and helps to highlight developmental stages that kids might need to revisit because they missed them due to unusual parenting / custody changes etc.  The same author also has other books along a similar vein.

[wapiti]

.

[mysticmomma]

The custody situation is not new. I'm not discounting the effects, but they have been with grandmother for almost 5 years now legally, and she has been with her most if her life before that as well.

 

 

They have had strep, however it's not correlated to the timing of the symptoms.

[Ottakee]

SO many possibilities.

 

I would suggest a full physical with blood work to check the basic things----liver and kidney function, basic CBC, thyroid, etc. as well as a strep test and a urinalysis.  From there likely a neurologist and/or pediatric psychiatrist.  I have seen kids like this where seizures were a trigger.  For others it was bipolar/mood disorder.  Lots of possible issues but obviously not normal behavior.

 

Is there any family history of mental illness?  Was the child prenatally drug/alcohol exposed?  Any genetic disorders in the family?  ADHD?  Drug/alcohol abuse?  Sometimes family history is a good clue as many things have genetic basis.

[mysticmomma]

Mental illness, yes. Depression, gad, bipolar, addiction. Her mom is a drug addict, so she certainly could have been exposed to benzos or opiates(moms fav) in utero.

[wapiti]

. 

 

[Pronghorn]

I would look into post-traumatic stress as a possibility. Her meltdowns may be flashbacks. Also, the fact that she has more trouble with her primary caregiver indicates possible attachment issues. Kids with attachment issues feel threatened by close relationships and often act out mostly (or even only) with their mother or closest caregiver. In getting her help, be sure that the professionals are knowledgeable about attachment. (Many counselors are not and end up doing more harm than good.)

[mysticmomma]

FWIW, unfortunately we are finding out that PANDAS can be much more complex than that. In particular, other types of immune triggers (infections and so forth and possibily being as multifactorial as to include other types of stressors that might trigger the immune system), as well as later undetected episodes of strep, can cause the symptoms. In other words, it isn't strep itself that's a problem but rather an immune system response... rheumatic fever of the brain, if you will.

 

But yes, as Ottakee describes, you'd need to consider the entire big picture of possibilities.

Nimh says "PANDAS is considered when there is a very close relationship between the abrupt onset or worsening"

 

This does not fit.

[SKL]

The custody situation is not new. I'm not discounting the effects, but they have been with grandmother for almost 5 years now legally, and she has been with her most if her life before that as well.

 

 

They have had strep, however it's not correlated to the timing of the symptoms.

 

If steps were missed early on, the effects can linger into adulthood if not addressed appropriately.

 

My kids are also 7 (going on 8) and they have been with me for nearly 7 years.  They still have "stuff" to work through, some of which I'm still discovering.

 

Of course it could be something else, or more than one thing at the same time.  I'd just make sure the counselor has some background with kids who have had disruptions in their early years.

[mysticmomma]

I will mention it though. She is on Medicaid, so the chances they find a doc with knowledge is small.

[Farrar]

I don't have any new ideas, I just wanted to say I think you should be open to any diagnosis and not let your preconceived notions get in the way too much - it sounds like it could be so many things.  However, I would push for ruling out physical possibilities (like the seizures and Pandas) before letting anyone diagnose anything psychological.  Good luck.

[Library Momma]

I have a friend whose dd with AS has similar rages.  She only takes it out on her mother (primary caregiver) and the longer she "holds it in" around others the worse it is.  She has started a new medication which has helped somewhat and receives a number of therapies throughout the week.  I know it can be quite terrifying for all involved.

[mysticmomma]

I'm open to anything. Grandmother is already convinced it is aspergers.

[mysticmomma]

If steps were missed early on, the effects can linger into adulthood if not addressed appropriately.

 

My kids are also 7 (going on 8) and they have been with me for nearly 7 years. They still have "stuff" to work through, some of which I'm still discovering.

 

Of course it could be something else, or more than one thing at the same time. I'd just make sure the counselor has some background with kids who have had disruptions in their early years.

I'm sure there are issues regarding this. She is seeing a counselor, but IMO needs a new one.

[SKL]

I don't think raging is a hallmark of Asperger's, someone correct me if I'm wrong.?

[wapiti]

Nimh says "PANDAS is considered when there is a very close relationship between the abrupt onset or worsening"

 

This does not fit.

 

All I'm saying is that untreated episodes of strep - which one might not even know occurred unless one tested - are typically more the issue than treated episodes of strep that one remembers and can easily identify.  (Moreover, there is no real agreement on the diagnositc criteria in spite of the NIMH, unfortunately.)  Just a possible avenue to keep in the back of your mind.  

[mysticmomma]

All I'm saying is that untreated episodes of strep - which one might not even know occurred unless one tested - are typically more the issue than treated episodes of strep that one remembers and can easily identify. (Moreover, there is no real agreement on the diagnositc criteria in spite of the NIMH, unfortunately.) For example, in the case of my ds, we tested for strep well after the onset of symptoms and found very high antibody levels as well as a positive culture, indicating that the infection probably occurred several weeks/months prior. It's very controversial. IIRC, lyme works similarly, for example. Just a possible avenue to keep in the back of your mind.

Thank you for the added info.

[SKL]

I just thought I'd add that on my adoptive mom forum, many of the moms are saying their kids started exhibiting more emotional "stuff" around age 7.  (Most of these have had custody since their kids were babies or tots.)  It seems maybe 7 is a sensitive age or something, and this just adds on to the on-going stuff.  Some kids have an increase in emotional outbursts etc., while others start asking tough questions about heritage, birth parents, etc.  Some cry for birth parents they have never met since infancy.  Not sure if any of this is relevant to your family member.

[Ottakee]

I am NOT saying this is it, but given the family history, check out the book The Bipolar Child from the library (look for newest version).  When reading it, you might say WOW, someone wrote this book in this child's home or you might say that NO, that doesn't really fit.  One thing that is very helpful either way is that there is a printable checklist of symptoms in the book where you can check if the child had the symptom at various ages and severity, etc.  Just filling that out and giving that to the psychiatrist/neurologist, etc. might help them know what to look at.  Sometimes things come up that you don't even realize are important or related.

 

Our psychiatrist was AWESOME in that she ordered a full physical with all blood work, urinalysis, EKG, and EEG for seizures BEFORE starting meds. In our case, dd showed up with anemia (needed treatment), bladder infection (needed treatment), low thyroid (is still on meds) and Seizures.................all very important things to know.  Our dd also has bipolar but without discovering and treating those other issues we wouldn't be in the good place we are now.  And interestingly, many of the mood stabilizers (except lithium) are also seizure meds so in our case we can use 1 med to treat 2 different conditions.

 

Mental illness, yes. Depression, gad, bipolar, addiction. Her mom is a drug addict, so she certainly could have been exposed to benzos or opiates(moms fav) in utero.

 

[mysticmomma]

Thank you.

[Nemom]

Nimh says "PANDAS is considered when there is a very close relationship between the abrupt onset or worsening"

 

This does not fit.

I would take that with a grain of salt. I won't go into our own personal experience with PANDAS but I will tell you that "close relationship" translated into over a year before major symptoms. It is a very complicated disease.

 

If she is headed to a GP soon you could ask to have her ASO & AntiDNase Titers checked just to rule out.

[Murmer]

I have a child who raged!  It was violent it was inconsistent and it was unpredictable.  We did an overnight seizure test and discovered she was having absence seizures....within a week of upping her seizure meds the violent rages ended.....she still melted like a puddle on the floor but the violence was gone....she went on within 1.5 years to get a high functioning autism diagnosis....so it is a possibility that she is having seizures in conjunction with autism....OR it could be something entirely different....at the very least if there is a suspicion of seizures have them push to do an overnight EKG....that is the only thing that found the seizures in my daughter.

[Library Momma]

I don't think raging is a hallmark of Asperger's, someone correct me if I'm wrong.?

 

No it absolutely is - This page has a good explanation:

 

http://www.myaspergerschild.com/2010/06/aspergers-tantrums-rage-and-meltdowns.html

[73349]

It sounds like she has a lot going on. Poor kid. :( Just wanted to also mention that diet could be a contributing factor, especially if there's something Grandma typically gives her to eat that she doesn't have when she's with others.

[JonesinIndiana]

Just a few thoughts from a mom in the attachment trenches since 2003.

 

In my opinion the poor child has a history of trauma: not with her birth mother and father and possible drug exposure in utero. She probably has developmental trauma, which is PTSD in children. She probably has attachment issues, maybe reactive attachment disorder (RAD). RAD is on the extreme end of the attachment spectrum.

 

There are online groups that offer support and advice. Bad counseling is worse than no counseling. RUN, RUN, RUN FROM A THERAPIST THAT WANTS TO SEE THE CHILD WITHOUT THE GRANDMOTHER IN THE ROOM. A good, knowledgable attachment therapist (AT) will have the parent/s in the room to facilitate attachment to the parent, not the counselor.

 

Since the child has anxiety the grandmother might get a diagnosis of ADHD, which can be a misdiagnosis and the medication won't work for her and might make the anxiety worse.

 

She will need to look into alternative therapies such as attachment therapy, attachment parenting, neuroreorganization, targeted amino acid therapy, among others. Don't expect insurance to pay. We've paid out of pocket for all the therapies we've done.

 

Good luck and PM me if you want specifics on groups, etc.

[JonesinIndiana]

I would look into post-traumatic stress as a possibility. Her meltdowns may be flashbacks. Also, the fact that she has more trouble with her primary caregiver indicates possible attachment issues. Kids with attachment issues feel threatened by close relationships and often act out mostly (or even only) with their mother or closest caregiver. In getting her help, be sure that the professionals are knowledgeable about attachment. (Many counselors are not and end up doing more harm than good.)

 

This!

 

A good reason the child is ok with others and not her grandmother, which is her mother figure. Really sent me over the edge when my daycare worker said, "Shes doing that??? She NEVER does that with me. "

[mysticmomma]

Thank you

[mysticmomma]

Bunp for the night crowd.

[Excelsior! Academy]

Just a few thoughts from a mom in the attachment trenches since 2003.

 

In my opinion the poor child has a history of trauma: not with her birth mother and father and possible drug exposure in utero. She probably has developmental trauma, which is PTSD in children. She probably has attachment issues, maybe reactive attachment disorder (RAD). RAD is on the extreme end of the attachment spectrum.

 

_______snip______

Almost identical to what I was going to say.  Especially the RAD part.

Not cutting because I don't agree.

[kiwik]

Lots of kids manage to keep it together when with others but feel safe enough to let it out at home. Seven is when you start thinking about youself as TRUE individual though and she may just have realised stuff about her situation.

[Pronghorn]

Lots of kids manage to keep it together when with others but feel safe enough to let it out at home. Seven is when you start thinking about youself as TRUE individual though and she may just have realised stuff about her situation.

To me there seems to be more going on, especially since the child does not remember her rages. Perhaps she HAS realized new things but also has an underlying condition that makes her response to her realization more extreme than usual.

[TechWife]

I don't think raging is a hallmark of Asperger's, someone correct me if I'm wrong.?

 

It can be.

[mysticmomma]

Thanks guys

[Guest inoubliable]

My oldest had some serious issues after DH was in a horrific car accident. For a few years there was raging, fence jumping (and running home) from the PS we had to put him in, threats of suicide. All of this from the age of 6 years until...9? 10? He was in a psych hold a few times and we were told he had bipolar. Then he had pains in his joints and reacted mostly when out in the sun. And then we were told lupus. On top of the bipolar. We followed the doctor's suggestion to keep him out of the sun as much as we could and things calmed down. The bipolar diagnosis stands, but only because no doctor has felt comfortable enough with trashing it. He did respond to bipolar medications. He hasn't had any symptoms in the last four years except for getting out of control a few times with his rage, but it's never directed towards anyone and he's not destructive, and he gets very very silly and/or excited for almost no reason. Now that I have the bipolar diagnosis, his pediatrician (while we were in VA) was even more convinced that he has it and it will manifest itself again as he continues through puberty. He isn't medicated now but we'll be talking with a new doctor around his next birthday (in Sept) to get the referral to psych. 

I say all of this because mental illness is something that I think isn't considered for most kids unless it's the popular ADHD/ADD label. Reading what you wrote and seeing possible anxiety and PTSD issues... those were all concerns about my kid until the bipolar diagnosis. 

[LucyStoner]

I will mention it though. She is on Medicaid, so the chances they find a doc with knowledge is small.

???

 

Many excellent doctors take Medicaid patients.

 

I would really encourage you to not try to diagnose her. It could be any number of things.

[mysticmomma]

I'm not diagnosing her. I'm seeking ideas.

[LucyStoner]

I see "Disagreeing" that it could be Aspergers as delving into diagnosing.

 

I can't stress enough how having people (including relatives) tell me that they don't think my son has ASD or that he has something else x, y or z is both unhelpful and at times it has been hurtful. A common thing people said when he was diagnosed was "I disagree" or "I don't see that". None of them were remotely qualified to draw that conclusion.

[Joanne]

Just further notes about trauma.

 

The important part to understand on a basic level is that trauma changes the brain. It therefore changes the person that person (in this case, child) would have been. That changed brain plays out in many ways as life unfolds. It's important to know that normal developmental milestones (impulse control, for example, or management of emotion) are impacted.

 

The child you post about has had multiple traumas, going back to utero (possibly). In addition, the child's brain is already at risk/vulnerable/predisposed.

 

And, as time goes on with the child who "acts out", the caregiver responsiveness often becomes compromised which creates MORE trauma and problems.

 

I'm totally willing to believe PANDAS, spectrum, food allergies. But I wanted to add the back story about how trauma could land us here.

The trauma impacted youth I've counseled literally could not access coping skills because of their brain. A poster upthread is absolutely right; if it IS trauma, you need trauma informed care and attachment specialists.

 

[Momling]

We have a foster son who has some rage issues. Actually, we've had several kids. The reasons are multiple --- fetal and actually early childhood exposure to alcohol, neglect, poor parenting (and then in this case, overcompensation by relatives to give him anything he asked for because they all felt sorry for him), multiple disrupted foster placements, perhaps a natural personality that just rises easily to anger.

 

 

What has helped in the middle of the rage? Having him move (or moving him ourselves) to a safe place (his bedroom), keeping knives and sharp objects away from him, moving away pets and kids from his path, not trying to reason with him (especially never yelling at him), waiting out the rage, providing love and hugs and understanding and consistency afterwards, having him clean up and throw away the broken items (and not replacing them), forgiving him for hurting us or our house or objects and letting him know it's okay and he's loved and safe and can try again tomorrow.

 

 

What is helping? Day treatment where he has lots of supervision, daily therapy, and staff who are trained to handle his worst moments, successful experiences that we can praise his good behavior and other successes, total consistency in parenting, being a clear authority figure, looking for patterns that predict the onset of his rage. He is getting better.

 

Honestly though, I would try to get more people involved. Do you have programs in your county for kids with emotional problems? It takes a pretty high level of parenting skills to stay on top of his moods and I need respite too. I do not think homeschooling an aggressive child would be healthy for me.

[Catwoman]

I don't have any advice for you, but I'll give your thread a bump.