Help my friend's 3y/o!

I have a mommy friend that I met on a site while TTC. Her son just turned 3 and he was put on clonidine bc he has "anger and sleep issues". Long story short, she says he is very aggressive/destructive (with toys and baby sister) and has always been a terrible sleeper! At 3 he is still up 5-15x a night for various things...a kiss, water, hug, to lay with him and she says sometimes he thinks its morning (at like 3am) and gets mad that she won't let him go downstairs to start the day.
She really thinks he has ADHD but knows at this age its hard to diagnose. Anyone go through anything similar?
After the meds, the first day they took him to ER bc it literally knocked him out and the next day she said he was much calmer and happier but the day after that she said its like it had no effect and he was back to being angry and battling with everything.

Also should add...she is a SAHM that rarely (and I mean RARELY) is away from him!

 

Is a pediatric psychiatrist involved? If not, that would be my first suggestion.

 

I agree. And maybe a consult appointment with a developmental pediatrician at a local (or as local as possible) children's hospital. I know both children's hospitals in our area have developmental ped offices that can help with behavioral as well as mental health and other developmental concerns.

 

I don't want to necessarily compare this to the situation with my son, because this could be much much more serious. But I will say my son was a horrendous sleeper, had night wakings on and off (mostly on) until 3.5. And his lack of sleep affected his behavior during the day. He was never violent or destructive. But he'd have horrendous angry tantrums. I don't think they were entirely sleep related, but getting the sleep straightened out did make a big difference. The rest of it was he just had to mature and grow up. He's been such a different kid these past few months. He accepts explanations instead of having a tantrum over it. If he's upset about something he'll cry, instead of having a raging tantrum. I find the crying so much more "normal" and easier to tolerate. I did consider taking him to a specialist many times, but never did. I did a lot of research and tried lots of different tactics. In the end he just grew out of it.

But for the sleep, you really have to be strict. If you keep giving in to his demands, he's going to keep waking up and calling for you. Sometimes it's hard to ignore, because it was easier to give in than have an all out tantrum at 3 am. And then I'd feel guilty that I was causing the power struggle that wasn't necessary if I was more willing to compromise. But once I got "permission" from the pediatrician to not give in, that it was doing more harm than good, it became easier to stand my ground, rather than going back and forth.

Actually, one thing I think that helped break him of his tantrums was to let him "tantrum it out". He'd never ever calm down on his own. One night was particularly bad and he was in his room. My husband and I took turns every 20 minutes going in and trying to talk to him to calm him down (without giving in). It was exhausting and he is the most stubborn kid in the world who can't be distracted and doesn't forget anything. ever. You can't change his mind or talk him out of anything. And when he realizes he's not going to get what he wants, he starts creating other demands of where he wants you to sit when you talk to him, where he wants you to stand, what he wants you to hold. And if you didn't do it, the tantrum would escalate out of control again. I was also advised by the doctor to ignore these too, because it was feeding his need to control you. It was so hard when you just wanted him to calm down and you knew all it took was to give in a little. But that didn't help for the next time. Anyway, we went in ever 20 minutes (he was overtired and it was past his bedtime at this point). The only thing left to do was just leave him there to eventually go to sleep on his own. It took 2 hours. We've never left him there that long for a tantrum. But we were so fed up and didn't know what else to do. That night he woke up around 2, started insisting I do something that he wanted, I refused and threatened to lock his door if he didn't calm down and go back to bed. He didn't stop, I went through with my threat, and 2 minutes later he was quiet, and in bed. Before that night, I had never ever seen him calm down from a tantrum on his own, and this fast. I went in and praised him for acting like a big boy, tucked him in and I don't remember having any major night waking issues or bad tantrums since. I know this makes it sound easy, and I hated when parents with minor sleep disturbances would compare their situation and tell me "all you need to do is X" because it wasn't that simple. They had no idea what I was dealing with night after night, month after month, year after year! But I feel like this night was just the culmination of everything, and it all finally just clicked with him.

I would hesitate with diagnosing a 3 year old with ADHD (I was already giving mine an OCD diagnosis!) or medicate them unless it's absolutely necessary. When I spoke to my pediatrician about options, she mentioned things that were much less severe than medication. Like trying melatonin for the sleep issues (I didn't even want to do that, even though it was natural). And seeing a therapist that could give us some guidance with his behavior. Like we'd meet and explain what he does in specific situations, she'd give some guidance on what we can try, and then we'd meet back to report back specifically what happened when we did that, and then she'd tweak it for the next time based on what we told her. I liked the sound of that, but he just happened to improve so fast, that we didn't need to go there.

But I don't know her situation and she may have already tried some of these things. I really feel for her, I know how hard it is and her situation sounds so much worse with the violence and a younger sibling involved. How old is his baby sister? Was he always this way, or did it maybe start as an attention-seeking thing when she was born?

 

Sounds like he's strong willed, to me. Maybe suggest a few books on strong willed kids.

 

Thanks DeniseT That was very helpful Her pediatrician prescribed the medicine and she is scheduled to meet with a therapist for his behavior as well (not sure if they've gone yet). I also wondered if being overtired made him that way as well...but like you, I'm not in her shoes and I have no idea! Baby sister is 16 months and he's always been this way. Not so much angry but he's always been a very hyper non sleeping boy! And I do believe she read the book "raising your spirited child"