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Thread: Anger Fits, Behaviour

  1. #1

    Default Anger Fits, Behaviour

    Hi,

    I found out our 11 year old boy has tourettes about 2 years ago. Within the last year, I am struggling with his temper and anger. It doesn't matter what is asked of him or if something is said wrong, he flys off the handle, yells, slams his door, throws things in his room. When he is calm enough, I try to talk to him about it but it becomes either another round of anger or crying and he finally will talk to me. He doesn't like having TS and finds it hard to understand it. He doesn't like not understanding why he gets mad and I find it hard to decide when and what to disapline. I have explained that damage to anything in the house or room will be disaplined and he will pay for. I have taken away his game boy & playstation 2 games. He seems to be a bit happier when he has no games but a couple days later it starts again.

    Does anyone have any ideas, can relate to this or is this just bad parenting? I'm at my end because I miss my happy boy!

    Anything is appreciated, Thank you!!

  2. #2

    Default Hi Stacy

    I am a mother of a nine year old boy diagnosed with TS, OCD, and anxiety at the age of six. One of the toughest things I have found in handling these disorders is what to discipline. My rule is simple: If the behavior hurts himself, others, or things around him it is wrong. My son had rages for about two years. He was very angry and had a hard time handling stress. Any changes in his life would trigger these rages(even come for dinner). I am sure you know where I am coming from. I do understand that my son has tourette syndrome and that this makes it difficult for him at times. He hates that he has TS and doesn't like any one knowing about it. I don't believe that excuses this behavior though. Here are some of the things that worked for us in our home. First, I changed my attiude and way that I handled him. I tried to keep as calm and quiet in tone as I could(at times this was very difficult). I also learned to pick my battles wisely. Second, I changed the disciplines. I made the punishment fit the crime. I turned the punishment into a chance to teach him how he should behave. Third, when things were good we would role play. I would pick something that he was having a hard time with and together we would find ways to fix it. Fourth, rewards worked very well. To earn his allowance he had to have good behavior. At first, he would get rewarded for the littlest good deed and we worked it up from there. I kept the rules very simple at first. As he became better and more able to cope I increased my demands. Fifth, I gave him a safe place where he could go and rant and rave. As long as he did not throw things he could go off and deal with his frustration on his own and then when he was ready we would deal with what had happen. And last but not least, I never power struggled with him. I found I could never win. I had to out smart him so to say. I don't know if your child just has TS but with the OCD they can get stuck. My son can get stuck on something for a very long time and spiral down very quickly. I would not debate him.
    Once the rages slowed down a bit I started to teach my son ways to help him relax and ways to know when he is stuck. We talk quite a bit and I help him work through things now when he gets stuck. Try to keep in mind that your son is probably having a hard time out side of the house. People can be very cruel. You want to be understanding and a soft place for him to fall but you don't want to let these behaviors go.
    I understand where you are at. Know that other have been there and there is light at the end of the tunnel. Remember to take time for yourself if you can. If you wish to talk further you can email me.

  3. #3

    Default Anger Fits, Behaviour

    Thank you very much for the helpful info. I am going to take these suggestions and try them out. I'm not sure about the OCD. I looked it up for some info. His biggest thing is these game boys and play stations. He feels he must complete these games. He can stay on them until 8 hours in a day. We have taken them away from him and he actually seemed to be a lot calmer for a while. But the anger came back over something else. He does struggle with other kids in class and around the neighborhood so I like to be able to give him options to keep him busy. Unfortunately he gets stuck on these games and doesn't like to give them up for anything.

    Again, thank you for a start on something new. I do appreciate it. As there seems to be no one else in Lloydminster that I have found to talk to, this seems to be the best!

    Stacy

  4. #4
    Join Date
    Mar 2005
    Location
    Ontario
    Posts
    962

    Default Games and timing

    Stacey,
    My 11 yr old son is suspected to have TS, he also has ADHD & ODD. He expresses most of the worse signs of the disorder.

    He enjoys the gameboy and game cube a lot and yes he gets frustrated at times.

    We found limiting the time to play helps and offering outside activities. These include bike riding, going to the park to throw ball (larger then average) swinging and even walking a paper route together.

    Exercise seems to make a dif with the fits or rage. He seems trapped sometimes inside himself not understanding why his temper peaks. It got so bad that we removed his door to the bedroom from damage when we were still learning how to manage. We also learned how to pick our battles.

    Once we got to the issues that really set him off and he realized that we understood, he would not peak as much.

    The games are good but we found must be selected carefully. Some are just to advanced for the thinking process. The screen and lights seems to make a dif too. If you are able to borrow a game for one day from a school friend it might help to see if it is the right one to buy for long term enjoyment. We've tried this and it works, I spend the time with him and check out the game and let him explain how to play. This helps tell me if it is a good one.

    We limited his time to twice a day for 1 hour. Breakdown (30 min Gameboy, 30 min computer games and one hour tops on the cube.)
    If he is on the computer playing simple games or learning games he is always off before 7pm. This works for bedtime prep.
    He seems to appreciate walking away from them and doing something else for a while.
    You are not alone in this and I hope all goes well for you.
    PJK

  5. #5

    Default anger

    Hi I'm a 38 yo with ts. It came on suddenly and strong at ten with alot of rage. MY SON IS 8 AND IN LOVE WITH X BOX AND COMPUTER GAMES. I REALLY AGREE WITH PJK AND SHEENA ABOUT GAME TIME AND DISCIPLINE. A BALANCED APPROACH I THINK IS REALLY IMPORTANT WITH TS.
    I FEEL MY RAGE WAS ACTUALLY A RESULT OF A BUILDUP OF ENERGY-STRESS AND THEN A TRIGGER,COULD BE ANYTHING, WOULD RELEASE THAT ENERGY. I STILL FEEL GUILTY ABOUT SOME OF THE THINGS THAT I DIDNT MEAN TO DO. I ALSO THINK THAT DURING MY RAGE EPISODE MY BLOOD SUGAR LEVEL DROPS. THIS MAY BE A GOOD TIME TO BRING YOUR CHILD SOMETHING TO DRINK LIKE JUICE. TELL THEM U UNDERSTAND THEY CANT HELP IT AND HAVING A DRINK OF SOMETHING GOOD MAY HELP THEM FEEL BETTER. DONT THINK OF IT AS A REWARD FOR THIER BEHAVIOUR AND THEY SURE COULD USE AN ALLIE.
    CHECK OUT www.tourettesyndrome.net ARTICLE:TREAMENT OF 'RAGE ATTACKS' MEDICATIONS AND NON-MED APPROACHES LESLIE E. PACKER,PHD. SHE RECOMMENDS VITAIMIN SUPPLEMENTS AND A CHANGE OF ENVIRONMENT. I REALLY AGREE, WHEN I TAKE MY VITAMINS I HAVE MORE ENERGY AND FEEL MORE BALANCED. I THINK THE B VITS REALLY HELP WITH STRESS.
    BEST WISHES SCOTT

  6. #6

    Default Anger Fits, Behaviour

    Here is an excerpt from the chapter on TS out of a book I bought last year from my Asperger Specialist. Since I have both TS and AS, I read this chapter first. It gives a good explanation on why kids with TS (who may also have AS) misbehave, and why rewards and punishments may not work very well.

    Collaborative Problem Solving (CPS) by Trina Epstein and Jennifer Saltzman-Benaiah, taken from the book ?Children, Youth and Adults with Asperger Syndrome?

    An approach to treatment that has been helpful with the AS/TS population of children is one that has been developed by Dr Ross Greene, a psychologist at Massachusets General Hospital (Greene 1998). Greene?s approach, called Collaborative Problem Solving (CPS), was not designed for the AS and TS population per se, but rather more broadly for ?inflexible/explosive? children. However, CPS fits well with the types of difficulties faced by these children.
    While CPS has a direct impact on the child, the focus of the intervention is on the parents and/or teachers who are managing the child?s behaviour. CPS offers an alternative to traditional behaviour management approaches that are based primarily on rewards and punishments. The CPS approach stresses understanding the underlying reasons, or ?pathways?, for a child?s inflexibility or explosion. For instance, a child may experience frustration because of a deficit in his language pathway that impairs his communication. Anxiety or obsessiveness may contribute to frustration, as may low mood. Executive dysfunction, such as planning or shifting set, can contribute to explosiveness. Weaknesses in understanding social cues can lead to misinterpretations of interactions that can, in turn, result in frustration and explosive behaviour.
    By definition, children with AS are impaired in their social pathway. Children with AS are also typically rigid and obsessive, as are children with TS. Of course, many weaknesses along many pathways can contribute to explosiveness, and although knowing a child?s diagnosis can give us some clues about the pathways that are implicated, diagnosis does not provide all the answers.
    Regardless of the pathway(s) affecting a given child, Greene argues that children who display inflexible or explosive behaviour are impaired in the domain of frustration tolerance for which the behavioural manifestation may be internalized (e.g. crying) or externalized (e.g. yelling, hitting). It is proposed that a deficit in frustration tolerance is no different from any other skill deficit, such as a weakness in reading or math. In this way, impairment in frustration tolerance can be thought of as a learning disability. In much the way that rewards and punishments are unhelpful in remediating a reading disability, it is argued that these approaches are equally unhelpful in ameliorating an underlying deficit in frustration tolerance. Simply dispensing consequences for disruptive behaviour or offering rewards for the absence of behaviour is not helpful and will not teach the child the requisite skills that are lacking.
    For instance, a child who has difficulty changing from one activity to another (i.e. shifting set) may throw a tantrum when his parent asks that he stop a favourite activity and come to dinner. If we believe the tantrum is because of a difficulty shifting set and managing the frustration that comes with this weakness, then punishing the child will not have an impact on her future behaviour. Punishment does not accomplish the goal of teaching the child to shift set more easily. Similarly, offering the child a reward for coming to dinner when asked will prove equally ineffective because the child does not have the shifting set skill required to comply. Parents with children with this difficulty often report frequent utilization of reward and consequences without any demonstrable learning. Parents of children with AS and/or TS may find this example familiar. It is important to recognize that the reason little learning occurs is that, in developmental neuro-psychiatric disorders, cognitive difficulties have a neurological basis. Of course, this does not mean that children are incapable of learning, but it does mean that they require explicit instruction and repetition to do so.
    Parents trained in the CPS model are reminded that rewards and punishments work well at increasing motivation when the child already possesses the underlying set of required skills. Such strategies also work well when teaching a simple skill. Few would agree that skills such as shifting set and managing emotions in the face of frustration are ?simple? and that they can be taught merely by using rewards and consequences.
    Accepting the CPS model involves making a philosophical shift from ?my child is having a tantrum to be manipulative? to ?my child is having a tantrum because he cannot cope in the face of frustration?. This philosophical shift is sometimes difficult for parents to make since the deficit presents as behavioural. Greene reiterates that the deficits are cognitive but are expressed in behavioural ways. He suggests the mantra ?Children do well if they can? as a replacement to the preconceived mantra that parents often uphold: ?Children do well if they want to?. That is, he takes as the starting point the fact that typically children are already motivated to do well since the meltdowns are as destabilizing for they child as they are for the family.
    Once parents come to believe that their children are not exploding as a means of getting their own way, but rather are behaving inflexibly because they lack the requisite skills to problem solve in the face of frustration, parents are encouraged to use preventive approaches to keep the child from experiencing frustration. CPS advocates a proactive rather than a reactive approach.
    At the same time that parents are working preventively with their children, they are also attempting to teach the lacking skills (for instance, by direct instruction and modeling). Depending on the implicated pathways, sometimes parental coaching is insufficient. For instance, a child whose quick frustration and explosiveness is related to underlying problems with depression may benefit from a pharmacological and/or a cognitive-behavioural intervention to address the mood issue. Similarly, a medication intervention is often helpful for an underlying attentional problem since this is an area that does not respond well to teaching. Children with specific weaknesses in the social pathway may benefit from participating in a social skills group.


    They go on to tell where you can learn this CPS approach, one such place is the TSN clinic in Massachusetts (Massachusetts General Hospital, where Dr. Greene practices). Here is the link to their site: http://www.explosivechild.com/ .
    German citizen, married to a Canadian for 28 years, four daughters, one son, eight grandchildren (and one on the way).

  7. #7
    Join Date
    Mar 2005
    Location
    Ontario
    Posts
    962

    Default behavior & treatment

    Uschi:

    Thank you for posting that information. It helps make me feel like we've been better parents then some may think.
    My son is considered to have TS, at one time thought to have AS, though his previous environment caused AS to be a consideration. That's another chapter.

    My point is, we had to pick our battles and set the example for him. Grounding for something very serious and worse dangerous was normal due to bad choices he has made. Simple things like baths, stopping games and coming to dinner we never punished or rewarded. Just set the example and held our ground gently.

    The school never understood this and made it very hard for him to function without episodes in the classroom.
    I truly wish that educators had to take an entire semister of classes opening their eyes to children like ours. I also wish that counselor's working with children at schools were required to attend continued education seminars in TS, ADHD, ADD, AS, OCD, ODD and abuse to help our children advance in life and work with us without such a battle.

    The response we give to children like mine inforces or destroys their progress in developement. It is such a delicate line and so easy to loose our balance and fall off.

    Regards,
    PJK

  8. #8
    Join Date
    Jun 2005
    Location
    St. John's NL
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    Default Anger Fits, Behaviour

    Hi Uschi

    I have recently joined this bb and was just reading some of the past postings. I too thank you for posting this exert of Ross's book. I have been to two national TSFC conferences and have heard Ross speak at both. He is phenominal to listen to and this exert is the key point of his entire presentation. It is great that you offered this to everyone, sharing of knowledge makes a huge difference.

    If you ever have an opportunity to hear him speak I would encourage everyone who has kids or works with kids to attend. For those of you who have not yet attended a conference, there is usually an educators track and Ross speaks to the teachers and they always walk away with a new perspective.

    Thanks again Uschi
    Janet, mom of 4

    TSFC Homepage


    "Intelligence is always increasing; accommodation allows your intelligence to do what it has always done." Cassie Green, Washington College

  9. #9

    Default Anger Fits, Behaviour

    I unfortunately do not have any children (although Im only 21 so I think thats ok, lol) but just from experience, I think his tics are mainley stemming from the fact that he is in the "prime" of TS. From 9 to 13 are some of the toughest years for children with TS and then you top that with other kids maybe being mean (or even just asking why he does what he does) and that he is still a child and is also like every other child is going through the normal stresses of life and maturing so after you factor in all that, I can see where these anger fits are coming from and why he cant figure out why he is doing them. But it will get better with time, just hang in there.
    The other day at a local grocery store, I saw a rack with books on it and one of them said, "pregancy for dummies"............

  10. #10
    Join Date
    Jun 2005
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    St. John's NL
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    1,147

    Default Anger Fits, Behaviour

    You make a great point. Once those hormones kick in plus the pressures of trying to figure out who you are and where you fit in, this period of growing up for kids, especially TS kids, has huge curves.

    Many young people ie pre-teens and early teens, who are not already out about their TS to their friends do everything possible to hide it. This is when suppression becomes their focus and that throws off their focus and emotions.

    I have a teen in my house and I look forward to it getting better.
    Janet, mom of 4

    TSFC Homepage


    "Intelligence is always increasing; accommodation allows your intelligence to do what it has always done." Cassie Green, Washington College

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