Behavior Problem Solving-Anxiety and Explosive Behavior

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Mama_to_Grace
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07 Aug 2012, 4:12 pm

My daughter is 9 and I fear I have been lazy with regard to parenting properly! I think I have been merely trying to reduce meltdowns at any cost. Now that she is 9 I need to figure out some effective ways to deal with some issues we have always faced.

I think I can basically narrow down our issues to two major ones: Anxiety and Explosive Behaviors. They affect each other. She can be anxiety ridden-fearful of leaving the house, fearful of talking to people, fearful of anything outside of her narrowing comfort zone. If I allow the anxiety to control both of our lives and we do nothing but mandatory things (which isn't possible anymore!) she stays on a fairly even keel.

However, if something occurs outside of her comfort zone-people visiting, school changes, doing homework and being frustrated, even something as simple as being hungry or her eczema flairing up or having to brush her teeth when she doesn't want to-she can go into first refusal shut down mode and then into explosive mode-screaming, hitting things, putting holes in walls, etc. for hours on end. I can avoid the explosions if I back down on the requirement-but that is allowing her to control what she does and when she does it-which isn't always possible.

I have tried various methods of dealing with the explosions. This has been going on for many years. Basically, anything I try merely INCREASES the intensity of the explosion. The only thing I can do is leave her to thrash about and explode and walk away. This does not always work either as sometimes she will chase after me. I think she does that because of the anxiety---she fears being alone during these episodes.

If someone is in our home she can deal with it for a short while. After that she will begin screaming that "people are in her house!" Very loudly. This has just made no one want to ever come to our home. Which is fine with her-but horrible for me as my life is shrinking into only being defined by being her caretaker.

As is common, she can "hold it together" for brief periods at school or with other people. She will start to lash out almost immediately upon being alone with me. This has caused many people-friends, parents, therapists-to point the finger at me as if me + her = some horrible combination! While I intellectually know this cannot be the case (as she is perfectly fine with me when there has not been an anxiety stressor event) it is wearing on me. I sometimes feel my bad parenting has reinforced her behavior-as she is getting paid off by her explosions-people are leaving her alone which is EXACTLY what she desires.

I do so much for her in the need to keep her on an even keel. Though lately I have started enforcing things a bit more. When she was diagnosed 3 years ago they told me to tackle behaviors one at a time. And I did-successfully-get the unsafe behaviors changed. But these two areas of behavior get stronger and more pronounced instead of getting better. Simpy having a bath, brushing her teeth, or eating can be triggers for an explosion. I have backed down on these things being necessary in the past to keep the peace which now I realize probably wasn't the best tactic. Now that I am enforcing these things as "musts" we are having lots of explosions-probably around 3-5 each week.

None of the "parenting" books describe a child like mine. They state if I make her follow through on things she will eventually comply. I feel like my daughter will never comply. Making her comply causes worse issues--like hours of screaming and hitting things. And that doesn't cause her to think twice or change her reaction the next time-it's the same time and time again.

I have removed privileges-she says she doesn't care! She will be miserable during the lack of privilege but takes it out on me and blames me for being "mean". She cannot or will not associate her behavior with the consequence.

So, is there a persepective on this I am missing? I feel like we will not be rid of the explosions until we conquer the anxiety but we have tried everything-counseling, meds, breathing, etc and nothing seems to help. She is so fearful all of the time. Just going to the bathroom causes panic some days.

She doesn't like feeling this way and I am struggling to find ways to help her. Any ideas are appreciated! I feel like I have written this same post so many times already----sometimes things get to a point where I just need to see if anyone has an idea I haven't yet tried!



zette
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07 Aug 2012, 4:30 pm

Have you tried getting help from a BCBA (board certified behavioral analyst) in your home, or ABA therapy? I think this is more than you can solve on your own.



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07 Aug 2012, 5:26 pm

Our situation is similar in that anything outside of DS's comfort zone leads to paralyzing anxiety and difficult behaviors though not as intense as you are experiencing. FWIW here is what we are currently doing. After trying various means to try to get a handle on his anxiety, a few people suggested to me that we try talking with a naturopathic doctor. So we did. I know that none of what I am about to say has been scientifically tested in the manner that FDA approved medications get tested but it is working for us so far. DS takes Calms Forte for kids, 2 tablets in the am, at least 15 min. before eating and 4 tablets before bedtime plus one dose of frutol (fish oil high EPA/DHA) and 2 doses of GABA a day. All of this is available OTC.

Calms is a very mild calming agent, I would hesitate to call it a sedative though it is intended to help kids fall asleep. It may seem odd that the doc told us to take it in the morning but it seems to help slow his brain down and makes getting through all those morning transitions much smoother. The dose of Calms in the morning has made a big change in the getting ready process for us. Some of this is, I think, simple maturation but I also think the supplements are helping. He gets dressed by himself 75-80% of the time. Before we started this routine, I would lay his clothes out on the floor and then I would have to stand over him as he got dressed most days. Now he is getting the clothes out of the drawer himself (he even took it upon himself to make labels for the drawers and tape them up) and is getting dressed with only one or two prompts.

GABA is an inhibitory neurotransmitter. Basically our bodies make neurotransmitters that excite the neurons (e.g. adrenalin) and those that inhibit neurons (e.g. GABA). In many kids with autism and other related conditions, there seems to be an overabundance of excitation and too little inhibition. We are taking 1/4 of a 250 mg tablet of GABA in the am and 1/4 in the pm. The first day I gave him 1/2 a tablet and he seemed a little loopy so I cut it back. Again, it does not have a sedative effect but seems to slow his brain down enough that he gets a lot more of what is going on around him. Other than the first I have not noted any side effects. When I called the doc about his reaction the first day, she thought that because his brain is always going 500 mph that slowing it down to what is probably more like a "normal" state probably felt a little odd for him at first. The effect with this is far from night and day but I have noticed a big increase in his ability to verbalize how he is feeling. This is a huge help because then we can address his fears and such head on, I am not trying to fricking guess what is bothering him.

The fish oil, I don't know, I've read from several sources that the high levels of EPA and DHA are beneficial for brain function. We started with the Calms and the fish oil and then added the GABA after 4 weeks. I saw a bit of improvement with just the Calms and fish oil but a definite improvement with the addition of the GABA.

We saw the naturopath again a week or so ago and she noted that he was calmer and responded more to things that she and I said to him. The best thing is he LOVES her so getting him to go to her office is a breeze. I'll be the first to admit that we also have had a much reduced stress level compared to the school year so the real test of whether or not any of this is working will be coming up soon. What I can say is that his angry outbursts have reduced. He is much more able to verbalize how he is feeling and is ok getting out of his comfort zone once in a while. We went camping for the weekend (waaaay out of his comfort zone) and he enjoyed himself a lot. When we were getting ready to leave, he told me he was glad we were going home but that he had a good time. That he was able to tell me that is HUGE.



Mama_to_Grace
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07 Aug 2012, 5:54 pm

Wow Bombaloo, that's a lot of pills! How do you get him to take them all? I am willing to try this if I am able to get her to take this # of pills. If it is not liquid that tastes good or a VERY small pill with no taste or smell we will have issues.

Sounds promising though!



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07 Aug 2012, 6:15 pm

I read this post as I have similar problems with my 4yo daughter, although nowhere near as bad.... yet! I will bear this in mind for the future, not heard of using Kalms before! Im not sure what I would think of medication (not got that far with the diagnosis yet) but OTC stuff is not ruled out when shes older :) At the moment just the idea of taking one spoon of kids sweet liquid medicine can make her vomit before we have even poured it out!

Does she have somewhere "safe" she can go when she feels like this? Like Temple Grandin had her squeezebox which gave her some relief, I saw on a programme the other day where a boy would hide under his bed and had the quilt dangling down to cover the gap between the floor and the bed, it was enclosed and felt safe for him. Just a thought, Im not an expert still a newb at this game!



Bombaloo
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07 Aug 2012, 8:36 pm

Mama_to_Grace wrote:
Wow Bombaloo, that's a lot of pills! How do you get him to take them all? I am willing to try this if I am able to get her to take this # of pills. If it is not liquid that tastes good or a VERY small pill with no taste or smell we will have issues.

Sounds promising though!


The Calms are tiny little pills that dissolve almost instantly on the tongue and have just a light mint taste. I give him these as soon as we get up in the morning and again at bedtime. The frutol is a liquid that is flavored with mangos and pineapple. I couldn't detect any fishy taste to it at all. DS was a little resistant to it at first and I got him to take it by following it up with an organic lollipop. Now he takes it without any issue, he actually asks for it sometimes. The GABA we are taking (Pharma GABA from Natural Factors) is a chewable tablet that is also flavored with pineapple, mango and banana. This is probably the least palatable one because it is a crunchy chewable tablet, kinda like a Tums but not quite so chalky, but at 1/4 of a tablet like we are taking it is small, probably could be swallowed without chewing by a kiddo who was willing to swallow tablets, mine is not yet. We also take a gummy multi-vitamin in the mornings with breakfast so I give him the first dose of GABA at the same time and he chews them up together without any problem, partly because he really likes the taste of the gummy vitamin.

If she would be willing to see a naturopath with you, I would recommend it. Unlike most of the other docs I have ever seen, our naturopath is willing to take time and talk about everything that is going on with me and DS. I don't feel rushed and like I have to spit out everything I need to say in 5 min or less. Ours is a real PHD doc, she went to med school and everything, she just has chosen to practice naturopathic medicine. FYI, you can safely take a lot more of the GABA than we are taking but again, I think you benefit from using it under the supervision of a good doc.



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08 Aug 2012, 5:30 am

Ooh that sounds good, better than tablets :)



Mama_to_Grace
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15 Aug 2012, 10:41 pm

just an update: ordered the GABA and Calms but have only tried the GABA. Gave first dose Sunday but she had a bad day. Mon, Tues, and today were notably better than usual. Waiting to see if this is due to the GABA or just a coincidence. She usually calls me multiple times at work on Wednesdays when she is with her dad all day. Today she only called me once. BTW, she hates taking them. I think they taste pretty good but it's the combo of the texture and taste that she hates. I've had to get pretty creative with incentives! She is taking 1/2 of a 200mg chewable tablet. My research is contradictory on the GABA, some say it doesn't cross the blood brain barrier, some say it does via the pituitary. Don't know enough about physiology to know which is true. She hasn't seemed notably different-just in bit of a better mood. I don't know how to make this a more scientific experiment. :?:



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16 Aug 2012, 8:19 am

Have you read the book The Explosive Child? My son had explosive outbursts all the time, and when I started following the suggestions in that book, it was like a light switch went off. He still gets wound up from time to time, but he also comes down just as fast. Really made a huge difference.



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16 Aug 2012, 8:47 am

ABA therapy is a great idea, but if you cant get it thru the district (as we cant) the cost of a private ABA is astronomical. We have one and I would like to have him come more regularly, but I would need a full time job to pay for him alone.

I feel the same as the OP. My son has been to therapists, groups, meds, interventions, consequences, for years and there is NO CHANGE in his behavior either. I also worry what will happen? When will her make the connection? When wil he get it???


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Bombaloo
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16 Aug 2012, 10:47 am

Mama_to_Grace wrote:
just an update: ordered the GABA and Calms but have only tried the GABA. Gave first dose Sunday but she had a bad day. Mon, Tues, and today were notably better than usual. Waiting to see if this is due to the GABA or just a coincidence. She usually calls me multiple times at work on Wednesdays when she is with her dad all day. Today she only called me once. BTW, she hates taking them. I think they taste pretty good but it's the combo of the texture and taste that she hates. I've had to get pretty creative with incentives! She is taking 1/2 of a 200mg chewable tablet. My research is contradictory on the GABA, some say it doesn't cross the blood brain barrier, some say it does via the pituitary. Don't know enough about physiology to know which is true. She hasn't seemed notably different-just in bit of a better mood. I don't know how to make this a more scientific experiment. :?:

I too heard someone say that it doesn't cross the blood brain barrier but I have to tell you that the first day DS took it, 1/2 250 mg tablet, I SAW it have an effect on him and I really cannot chalk that up to the placebo effect when I never told him that it was anything that would effect him in any way. I just gave it to him with his regular vitamin and told him it was a vitamin. I do think there is varying quality in the products on the market however. The one we are taking is made by Natural Factors and that is the brand recommended by our doc. Would it help if you crushed the tablet and put it in something that she would eat? My DS has gotten used to it, he didn't like taking them at first. Did you get the Calms for Kids? Those are the easy to take dissolve quick in your mouth kind. I think the adult formula is a capsule you have to swallow. I think I failed to mention that in my earlier post.

I don't know how you make it more scientific. It has not been a night and day type of result for us, more like a gradual easing of symptoms. A greater sense of well-being for all of us! :)



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16 Aug 2012, 11:21 am

We are taking the exact one you recommended-the Pharma GABA from Natural Factors. I was confused as I could only find the 200mg chewables though. She is taking half so that is 100mg of GABA per day.

Haven't tried the Calms yet. Wanted to take one at a time so I could see what each was doing. I am seeing a slight decrease in anxiety related symptoms though. Too early to tell if it is due to the GABA.



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18 Aug 2012, 1:44 pm

We have had the same issues with our 5 year old, the "don't care" when privileges taken away, the explosive behavior(to get me to go away, then wants me back, etc. etc.). I was exasperated and frustrated and started researching online how to deal with it.

Control is seriously what it is about. The anxiety is there also, losing control of the world so to speak and then BAM! we get the brunt of it. At least thats what I have dealt with.

Biomedical we do everything(we noticed after she was on antibiotics she was better also - put her on Cedfinir, then she got sick again - yeast for sure was there, so we started up with the antifungal and less fruits/ more proteins... we do SCD diet - giving her that chicken soup with carrots/more like GAPS diet especially in the morning - helps soooo much and we have seen the difference on even how her diet changes and how she changes, she is more flexible and "agreeable" - my husband remarked on it this past week when we got her on more of those foods).


As far as the pushing away explosion..... when she says things like "go away!" etc. etc. I have told her "I will miss you" or if she starts with the "I don't like anybody! I dont' want my IPad(or whatever), I HATE my toys!" I respond with "that's too bad".... disarms her. She either does the I hate everything, I don't care - I don't react and she stops. I read about that online. I tried those methods and they worked. taking away items does nothing. I gave her a trash bag before when she said she wanted everything to go away - she just looked at me like "huh?".... :wink: Neurotypical kiddos do this as well - also we cannot react at all...... I realized when I reacted loudly it just fuels the fire - if I don't "give in" to it and just wait it out the outbursts are less and go away.

That's my experience. I hope its helpful. I was thrilled when she'd say hurtful things about not wanting to live with us, etc. etc. when she was angry and I told her I'd miss her and I love her even when she's mad. She would just get anxious/upset and just hate the world....when I told her I love her so much and miss her she broke down and cried. Then we could talk. It was a huge breakthrough for us. She gets that way now maybe twice a month. Before it was a routine and I'd dread getting up some days. Its hard as hell to deal with and it just hurts when you feel like nothing works.

Also I can say that they project us as being "mean" when we take away things..... or she'd say "Im sorry mom that YOU took away my stuff" - nip that in the bud. I'd say "No, you need to be sorry for acting the way you did" Eventually she stopped saying that.

Also, I recently got her a punching/bop bag and instructed her when she's mad she can hit it, instead of using her body to hurt she can hit that if she needs something - she loves the idea because it gives her a release. We get punching bags as grown ups so why can't kids use them too??? It doesn't promote hitting people - but we all have to let off steam somehow... rather have it be a workout. Redirection.

Oh supplement wise we have our daughter on 5htp, theanine for anxiety - the theanine I think works way better for anxiety for her vs. the 5htp. we have her on DMG, B12, probiotics, vit d/fish oil, L carnitine, along with the specific carbohydrate diet along with being casein free.

Since your daughter can read there are some really good kid books re: anxiety "when my worries get too big" and there are some others - NLconcepts.com is a great website that has social stories. She can read them on her own and maybe it can open up a discussion when she's in a calm place? Just some other ideas. I talk like crazy with my daughter about dealing with changes, sounds, etc. etc. and have even had a script type of thing running through my head and we'd talk about those things together - I think her knowing that I "got" what she was experiencing(mind you I am on the spectrum myself..... so I can forecast what might set off her anxiety) helps her knowing we are a team dealing with "life".