“Aggressive and Defiant Behavior”
Is it common for a 4 year old child diagnosed with ASD and ADHD to be sometimes aggressive (hit, pinch, slap, kicks when upset) and defiant (screams and back talking) toward his parents and peers? He does not take medication for his ADHD condition, and occasionally takes as needed Albuterol and Q-Var inhaler medications for asthma. How can these behaviors be prevented or modified? Thanks!
Male | 4 years old
Complaint duration: 2 1/2 years
Medications: Q-Var, Levalbuterol
Conditions: ASD, ADHD, Asthma
4 Answers
The aggressive behavior may need behavior therapy to extinguish. The albuterol can make him more hyperactive but not aggressive. If he has had oral steroids this can make him moody and aggressive
Yes, uncontrolled and aggressive behavior are the part of developments at this age. As a temper tantrum. But it should be addressed and patiently stopped. Time out for 15-20 minutes, or less and a lot of talking. No medication used for this reason. Just hard work. Good luck with this difficult issue.
Your child may only have ASD and not ADHD. The child with ASD is very aggressive, does not play with other children, has developmental delay, speech delay and repetitive movements. Unfortunately, there are few pediatricians who may have training in diagnosing and treatment of ASD. You may check with your pediatrician and re-evaluate his symptoms and have screening like MCHAT or CSBS DP, which are specific for ASD. Your child may need chromosome Microarray test to detect copy number variation, small deletion or duplication of a single gene which may cause ASD.
It's very common for children with ADHD and autism to be aggressive and defiant. They are generally quite immature emotionally and therefore they may not understand how to handle a NO. First of all, make sure your child's diet is very clean. No artificial colors, preservative and chemicals. No fast foods either. Also, make sure your child is not low in certain vitamins like vitamin D and iron as these deficiencies can sometime affect the behavior as well. Second, try putting putting your child in some kind of behavioral therapy. ABA is excellent for such kids. Also, make sure you have a good structure in the house and are consistent with the rules. Kids generally tend to be more defiant and aggressive towards their mothers because they can push the limits easily. You don't have to be harsh, just be consistent and firm.
Rubina Azam MD, FAAP, ABOIM
Rubina Azam MD, FAAP, ABOIM
