Support for aggressive/irritable 10 year old
February 2, 2023 6:14 PM   Subscribe

My super awesome pre-teen 10 year old boy has mini-meltdowns on an increasing basis and I want to help him.

He is on the spectrum, ADHD has been ruled out. He is fully verbal and his only support need right now really is coping with irritation. Unfortunately he can be aggressive (screaming, getting really close, but not hitting or throwing.) He is triggered by disagreements, losing games, etc. It is all with his peers and not at home (in part because I keep home very calm and positive for him and titrate demands.)

We went months with no outbursts and now they are coming back. It was really, really bad when he restarted school after covid closures. So there seems to be a relapsing/remitting pattern. Interestingly and I’m sure relatedly, he has had a sort of explosion of social growth in the past few months - real friends, totally new interest in joining in at recess, participating in the 5th grade intrigues.

The school is supportive and kind with a strong IEP on paper, but not a ton of additional resources to add. Right now he’s doing talk therapy and group executive function therapy (Unstuck.)

What can we do to help? I feel so bad for him, worried that this will get in the way of his growth. I feel like everyone is concerned but nobody is drilling down to figure out what will actually work, including all the professionals he is working with already.
posted by haptic_avenger to Human Relations (19 answers total) 3 users marked this as a favorite
 
We went months with no outbursts and now they are coming back. It was really, really bad when he restarted school after covid closures. So there seems to be a relapsing/remitting pattern.

There's a clear external trigger here that you have identified yourself: restarting school after covid closures. The explosion of social growth requires an immense amount of cognitive processing, which is putting him closer to the "edge" of overwhelm, so that said overwhelm is triggered more readily.

The solution is to reduce overstimulation. Does he have sensory accommodations (noise-cancelling earphones, safe food, some kind of shielding from classroom lights if they bother him) at school? Are the extracurriculars (talk therapy and group EF therapy) consuming too much of his cognitive resources, and can they be cut back? Are there other demands that can be reduced so that he has the necessary headspace and downtime to self-regulate? Can he spend more time on his intense interests or the sensory things that help him self-soothe? Can he reduce the amount of time he spends with his peers (e.g., maybe limit it to one recess per day, or 4 days out of 5, or something like that, but let it be his own choice)?

The real skill-development here is probably going to be something like him being able to take note of when he is starting to get overwhelmed and to have explicit social permission to "tap out" and take a break from the social interaction.
posted by heatherlogan at 7:03 PM on February 2 [5 favorites]


I have no qualification or experience in this area…but…was just chatting with a friend yesterday who has a similar aged child with similar sounding circumstances. She felt that her child had the ability to control his behavior, but just wasn’t doing so. And the outbursts were becoming more frequent. They saw a counselor who gave surprising advice. Rather than punish for undesired behavior (she was removing electronics time), try rewarding good behaviors. So, the child receives a “point” if he is able to stop himself from descending into an uncontrollable spiral. After earning 5 points he gets a Lego set, toy, etc. Friend was wary of the message she was sending, but was desperate and so gave it a try (with spouse on board, also reluctantly). It has totally worked!! Caveat - you said that these incidents happen at school not at home, so it may be harder for you to help (eg remind the kid that it is possible to step back and not enter the downward spiral). Best of luck to you in this tricky situation.
posted by leslievictoria at 7:17 PM on February 2 [1 favorite]


One other thing I thought of: are the peers your kid is playing with friends, or "friends"? Make sure that the other kids are not pushing your kid's buttons on purpose to make him lose it for their entertainment. This happens to autistic kids and is a terrible insidious form of bullying (made worse when adults punish the autistic kid for a situation engineered by the other kids).
posted by heatherlogan at 7:19 PM on February 2 [15 favorites]


It sounds like triggers are fairly well identified. You say he has a strong IEP on paper--what does it look like for these behaviors? Do you need to call an IEP meeting and get some behavior goals in there? Is there a behavior PLAN that spells out how adults will attempt to intervene and de-escalate when they see a problem on the horizon? Right now it sounds like he could really use a paraprofessional to support him in some of those disagreements or when a game isn't going his way to actively remind him of his coping skills, options like taking a break, etc. The IEP is not strong if "nobody is drilling down to figure out what will actually work".
posted by epj at 7:51 PM on February 2


Nthing positive reinforcement.

you said that these incidents happen at school not at home, so it may be harder for you to help (eg remind the kid that it is possible to step back and not enter the downward spiral).

IATNAT (I am totally NOT a therapist), but it seems to me like having him tell you about instances where he expressed better behavior at school might also be helpful. Just talking about it could be cathartic and educational for him, but having to identify and remember the events to be able to relate them back to you could also serve to help his ability to recognize the feelings that lead up to these outbursts and get them under control earlier.
posted by SquidLips at 7:57 PM on February 2


Can his IEP include that he is allowed to leave a classroom activity to go to a soft play/cool down area in the corner of the classroom if he needs to? A lot of kids with autism find this very helpful.
posted by chariot pulled by cassowaries at 9:42 PM on February 2


Is he in the same school he attended back in September?

That school sounded pretty rough in some respects, and there could have been considerable self-protective value in being willing to go from zero to screaming rage in a matter of seconds.

If he’s still there, he could still need it, and his task might be to fine tune it and resort to it only when necessary, which would mean developing better discrimination between situations that might become dangerous and those which probably won’t.

If he’s at a milder school now, his reactions could be a holdover, and he could possibly use some discussions about the different environment he’s in now, and the different ways he should act to get along.
posted by jamjam at 10:16 PM on February 2


One of my kids also had this struggle, and I also work with a lot of kids with this issue. It can be a simple enough fix: you need for him to practice losing in a safe way, generalize the skill, and build his confidence in these moments.

So, maybe you start with checkers (or any game where you can confidently rig it to lose), play with him, and you purposely lose and model losing, i.e. "Wow, I thought I did really well here, now I'm kind of frustrated. I think I'll get some juice, do you want some before we play again?"

Gauge his reaction and when you think it's safe, play again but have him lose. Work with him through his feelings so he can express his reaction safely.

I would also reach out to the IEP Team about the work you're doing and ask them to please be cognizant of the peers they're putting him with. If they can pair him with certain peers and practice game playing in a safe environment, it's likely this behavior will change.

Having said all of this, some people do not do really well with games of luck or chance because they're a little rigid in their thinking. My son gets annoyed when playing Monopoly and does better with chess and strategy-based games. Now that he's grown he no longer throws the board when he loses but he also will not play luck-based games because he knows how annoyed it makes him. So that's a win.

Last thing is that this type of growth is actually good; it means he's developing typically (although it's hard to watch). Figuring out peer interactions is generally a positive step forward!
posted by yes I said yes I will Yes at 3:10 AM on February 3 [2 favorites]


Is he getting less sleep than usual lately? Does he seem tired? Is he irritable first thing in the morning before you settle him down?

I’m not sure this is it, but nobody else has mentioned it. It’s a totally apples to oranges comparison, but if our 6 year old starts dragging out his bed time by even just a half hour+ for a few days he starts to get very cranky and easily frustrated. As soon as we make sure to get him to to bes on time it starts to clear up.

Maybe also make sure that even if he is going to bed on time that he’s not lying awake thinking about school.
posted by cali59 at 5:00 AM on February 3


Response by poster: Thanks to all for the amazing answers. Some replies below, and I will keep going after school drop-off! <3

The solution is to reduce overstimulation. Does he have sensory accommodations (noise-cancelling earphones, safe food, some kind of shielding from classroom lights if they bother him) at school?

This is a good observation. He tends to the more under-sensitive than over-sensitive side, but I forget that he does get overwhelmed by noise. I'm usually not with him in those settings. When he was younger he also had more pull-out time at school 1:1 with professionals he really liked - maybe restarting that once a day so he can have a safe space at school would help.

try rewarding good behaviors.

I am a HUGE believer in positive reinforcement. We did a modified PCIT course when he was 6 for aggression at home and it literally worked magic, just like your friend. We tried to get the school to do it at one point, but they are more oriented towards punishing "big" behaviors and it was hard to get them to track good behaviors. I wonder if a more simplified system where he gets tokens in realtime could work so nobody has to be filling out forms constantly. At the same time, I'm not sure this is going to work that well because his responses are so very extreme to irritation right now. It's on-off and it does not really seem to be under his control, so I'm not sure what we would be rewarding.

One other thing I thought of: are the peers your kid is playing with friends, or "friends"? Make sure that the other kids are not pushing your kid's buttons on purpose to make him lose it for their entertainment.

This is something that worries me too. But I have seen him with his friends at home and these boys are astonishingly sweet and actually help him calm down. When they aren't joking about balls, they really seem to be nice boys. One is on the spectrum as well. I think this could be more of an issue in MS. But the fact is, his reactions to being provoked are scary (LOUD screaming, fist shaking, lunging) that I don't think kids do it for fun now.

Right now it sounds like he could really use a paraprofessional to support him in some of those disagreements or when a game isn't going his way to actively remind him of his coping skills, options like taking a break, etc. The IEP is not strong if "nobody is drilling down to figure out what will actually work".

Sigh. You're right. I'm kind of in denial about the IEP because on an individual basis, everyone in the school has been so wonderful and kind with him. They all know him really well. But they are stretched incredibly thin. And our district is "famous" for denying paras as a rule. They just want to put kids into self-contained classrooms instead. But yeah, I need to reopen the IEP. They never provide any autism expertise for the IEP drafting either, and I have to push for that. I am so tired!
posted by haptic_avenger at 5:10 AM on February 3 [2 favorites]


Response by poster: Also on the IEP note - our district astonishingly does not give any dedicated time to teachers for IEP meetings. So the IEP meetings all come out of their own planning time, or they have to cobble together someone to cover their classes. So I always feel bad about calling for one, and it's hard to really have a good discussion.
posted by haptic_avenger at 5:13 AM on February 3


My family is in exactly this situation now, except with a 9yo. Kid is really struggling with angry incidents and outbursts at school and is having difficulties with peers and in the classroom (and like you, we don’t see this at home because we’ve adjusted our home life to accommodate for a lot of sensitivities). I don’t have real solutions because we are working through the same questions/issues as you in real time (including calling for a Re-evaluation of the IEP we have) but some thoughts:

You mentioned it has gotten worse - is it possible the trigger is winter (assuming northern hemisphere)? We are considering SAD as a real possibility and trying to keep up vitamin intake. For us the frequency also returned after the holiday break - it seems like in retrospect, the holidays were likely overstimulating on their own with travel, extended family, etc. and the break from school messed with our kid’s momentum and routine and they haven’t been able to get back into it. Not saying the fall was that much easier, but we started the school year very positively and it feels like our kid’s energy and reserves are now tapped out.

School ideas - the peace corner/ area to go to if kid is feeling overstimulated is a great idea, and something our school offers for lower-grade kids. We are going to ask for something similar in our kid’s class even if the school thinks they should have aged out of it by now. For recess / lunch (where many of the incidents occur), the school also has started sending our kid to “mentor” or buddy with pre-K kids at that time a couple days a week. It boosts self-esteem and takes them out of the most stimulating and stressful part of their day. Our school is also pushing for a para, although we have been in denial about needing that too. Also, not sure if applicable, but we have gotten snacks in the classroom as an accommodation, as something for self-soothing.

This is hard, and for our family, one of the hardest times we’ve ever dealt with. You’re not alone (and nice? to know we’re not alone either) and wishing you and your child better times ahead.
posted by icy_latte at 7:25 AM on February 3 [1 favorite]


Does kid's therapist work on distress tolerance?

As someone who (still, sometimes) experiences meltdowns--no, they're not controllable, and that's really scary to experience especially for a kid! It feels like your body is thrashing around on its own and you are trapped inside. Distress tolerance skills are really helpful for internalizing a sense that "this is bad and scary but also normal and will pass". They're also helpful for overstimulation.
posted by capricorn at 8:21 AM on February 3 [2 favorites]


Another accommodation you should press the school for is a sensory room where Kid can safely go to "ride out" a meltdown. Distress tolerance can also help teach him to recognize when one is coming and get to the safe place.
posted by capricorn at 8:24 AM on February 3 [1 favorite]


Response by poster: Alright /cracks knuckles/, here we go:

having to identify and remember the events to be able to relate them back to you could also serve to help his ability to recognize the feelings that lead up to these outbursts and get them under control earlier.

Yes, I think this is right. This has become more of a therepeutic goal as he gets older. What's hard is that I know it is a long-term thing and I really feel like this is a short-term need. Recognizing feelings is hard for NT adults so I can hardly expect my 10 year old to get it right away!

Can his IEP include that he is allowed to leave a classroom activity to go to a soft play/cool down area in the corner of the classroom if he needs to?

a sensory room where Kid can safely go to "ride out" a meltdown

He needs a better place to go when he feels bad and has an episode for sure. Yesterday they stuck him in the "printer room" with a grownup who apparently did not talk to him all day. At the same time, it seems like he just gets in moods where a short break doesn't really help. Either he is totally back to normal after one blow-up, or it spirals. I would appreciate more insight from folks about how exactly sensory breaks work for themselves or their kids.

Is he in the same school he attended back in September?
That school sounded pretty rough in some respects, and there could have been considerable self-protective value in being willing to go from zero to screaming rage in a matter of seconds.


Ha, good catch. The elementary school has been very calm, but the 5th grade has been chaotic for all the kids, with increasing "big kid" fights (like, punching a kid in the face on the ground as opposed to kids shoving). I think that definitely impacts him, and you are right that his escalation may be self-protective. I'm not sure what to do with that. And for a variety of reasons we are considering sending him to middle school in the same neighborhood ..

One of my kids also had this struggle, and I also work with a lot of kids with this issue. It can be a simple enough fix: you need for him to practice losing in a safe way, generalize the skill, and build his confidence in these moments.

This is intriguing! I tend to let him win because I don't want to deal with tantrums. So yeah, I am not giving him that chance to learn, which may not be helping him.

Is he getting less sleep than usual lately? Does he seem tired? Is he irritable first thing in the morning before you settle him down?

He seems to be right in the transition to an older kid sleep schedule - going to bed later and waking up later. But he may not be getting enough sleep, you're right.

My family is in exactly this situation now

Solidarity! It's the worst to see our boys struggle. I'm in therapy in large part to be able to stay grounded and realistic about how I see the situation. Therapy is also the place where I can talk about how awesome and funny and sweet he is without feeling judged too. And to be able to formulate longer-range parenting values (like, we have fun no matter what happened at school.)

Does kid's therapist work on distress tolerance?
As someone who (still, sometimes) experiences meltdowns--no, they're not controllable, and that's really scary to experience especially for a kid!


I would love to hear your thoughts on how exactly your therapist helps with distress tolerance. I think you are exactly right - a lot of the advice I hear about helping kids with "emotional regulation" does not seem to capture the intensity of his epsiodes.
posted by haptic_avenger at 1:19 PM on February 3


haptic_avenger: I would love to hear your thoughts on how exactly your therapist helps with distress tolerance. I think you are exactly right - a lot of the advice I hear about helping kids with "emotional regulation" does not seem to capture the intensity of his epsiodes.

My therapist and I worked on strategies very similar to what's in this workbook! I think the exercises and examples here should work for kids. https://www.cci.health.wa.gov.au/Resources/For-Clinicians/Distress-Tolerance
posted by capricorn at 11:09 AM on February 4


Oh, and as for "how sensory breaks work", for me it's usually one of two scenarios:

1) I'm overwhelmed, and going into a cool, dark, quiet room will get me back to an okay level and avoid a meltdown
2) The line has already been crossed and a meltdown is incoming! I just need somewhere that I can be alone while it happens.
posted by capricorn at 11:13 AM on February 4


And ack, sorry to triple post but a printer room sounds like the worst place to send a kid who is experiencing sensory overload. They usually have very bright fluorescent light which buzzes unpleasantly and the printers themselves are hot and noisy.
posted by capricorn at 11:15 AM on February 4 [1 favorite]


So one possibility, since you say it got worse when school went back to in person, is exploring online school. Some places continue to offer it as a public school option, so worth looking into if you're in a place that's true for. (I know Washington State is, memail me anyone interested in that.)

Or alternately, home school. The thing is, being in a building with other kids all day long is exhausting, without even considering trying to learn anything. If it would be possible to separate learning from friend time, so that get togethers could take place as much during the week as he was up for, those would probably go much more smoothly. And the learning would probably be easier too.
posted by blueberry monster at 6:44 PM on February 13


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