Expert: Christine D. DeLoatch, MA CCC-SLP - 7/18/2009

Question
hello, my 2 year old has extreme behavorial problems. Whenever she cant do what she wants to do she has a meltdown...i literally just left a birthday in tears from her behavior, my embarassment and how the other adults reacted. Her first meltdown was when all the children were at the kiddie table eating and she wanted to walk around...the first time i told her to sit she let out a whiny no...the second time i was firm and she went into meltdown mode as she sat down...she screamed so loud one person asked did she bite her tongue...i explained that she didnt want to sit and i know all surrounding people heard me but they still felt the need to tell me my child was crying after they noticed i was ignoring her...i wanted to yell at them and i also felt like they were judging me...if she having a meltdown im not gonna ackowledge her bad behavior with attention...i went back and forth with myself over even going to the party because i knew that this behavior was going to happen at some point...its embarassing and she has been doing this since she was about one...her second meltdown was when i decided to leave...this time was way worse...she threw her body around and tried to pull away from me so i picked her up and she was sooo uncontrollable that i just held onto one arm and attempted to make her walk by pulling her...one 8 year old child that loves her to death asked if i wanted her to hold the other hand and i said yes and my daughter still cried but clmed down a little and walked to the car but when the little girl let go she scted out again...she swung and hit me on my leg and thats when i said enough is enough...i said to myself right then and there i will not take her to any public events until she learns how to act...now this is the strange part, at home she listens very well and rarely has meltdowns. my sisters noticed this also...i have been reading up and i think she might have adhd...she is an extremely active child and loves to be around other kids...she always bust even when at home she is all over the place but when i sit her down to go over numbers or colors she smiles like its funny and will fidget with her hands or feet... sometimes she will even try to get me to focus on something else by telling me ' mama look" . im worried..today i cried...i feel guilty because we are a single parent household and i often wonder if thats plays a role...what should i do? oh and p.s as we were leaving i noticed a couple of the adults laughing as if it was amusing and thats why i need to get this under controll, i dont want to lock us up in the house

Answer
Dear Tabaitha,

Thanks for asking me your question.  I am sorry to hear that you are having such difficulty.  It is rare for doctors to diagnose children as young as 2 years of age as having ADHD.  

I have some information for you.  I have some questions for you. I have some suggestions for you.

First the information: Usually if a child's behavior is different in the home and in public it is less likely to be related to ADHD. One of the diagnostic criteria for ADHD is that the behaviors have to be being displayed in at least 2 settings. What I heard you say was that your daughter is starting to want to do what she wants to do and is trying to manipulate you into getting her way by throwing a tantrum.  If at home she usually likes the routine she has, then there isn't a lot of times when you have to tell her to do something she doesn't want to do.  

Now a question or two: Do you use time-out when you discipline her?  Does she have to sit for 2 minutes when she misbehaves?  Do you have a time out chair or a time-out spot?  

Now the suggestions: I suggest that you talk to her about the rules.  You may have to tell her that if she screams and whines and falls on the floor, then you will leave - no matter where you are. Or she has to sit on the time out spot. You may want to tell family and friends that you are trying a new disciple plan before you do it.  

You also can look into a program called 1, 2, 3, Magic.  Some parents really like it.  I don't know much about the program.  

You could use 1, 2, 3, Go! in a playing way but also to transition her.  She may be a child that needs to told that you will be going soon.  You could tell her "Start telling the kids bye-bye and when mommy counts to 3 it is time to go."  You could count 1, 2, 3, Go! and even race her to the door. That way you make the transition fun.  You also can keep some mini oreo cookies or goldfish crackers or graham crackers in the car and purse and if she goes to the car or follows what you ask her to do then she gets a cracker with a big kiss on the cheek or a high five and "big girl."  Eventually you'll be able to stop giving her the treats.  

You have to make wanting to please you or follow the rules more important than getting what she wants.  She probably thinks she will be missing out on fun if she does what you want.  I would suggest that you start the rewards, if you're going to use them, at home with bathtime, dinnertime and storytime.  Give her lots of hugs and reinforcement for doing what you asked her to do.  Big Girl!  Yay!  High Five!  Good Job! should be your main vocabulary.  I agree that ignoring is often good, but it didn't seem to work because she had an audience - others to watch her.  

If using the cracker as a reward by itself stops working, there is follow-up strategy you can use.

After you have started rewarding her good transitions with giving her goldfish and you've said "no goldfish for screaming", (her chance to stop the tantrum and come with you) and she continues to throw a tantrum - I would say, "Oh, that's sad.  Now Mommy gets to eat the fishy!"  Mommy's a good girl.  Mommy's going to the car - no screaming.  Good Girl - mommy!  Mommy get's a fish.  That way she will start to realize that not only does she not get a fish, but you are eating 'her' fish - sometimes kids will want the fish so much that they will stop tantruming.  

So to re-cap...

1. Tell her what you expect before it happens.  Talk - Talk - Talk.
2.  Give her notice that things are going to change or what will happen next.  
3.  You can make the transition a game, 1,2,3, Go!
4.  Choose your rewards.  You can reward her behavior with edibles like goldfish, praise, like high fives, and hugs.
5. Decide on a consequence for not listening - leaving the store or whether it be Time out for 2 minutes - I suggest using a timer so that she knows when she can get out.  If she still has a crib or a play pen those work wonderfully at home. If she is sobbing - you may have to get her to calm down before she gets out of time out.  The tantrum has to really end.  There is even a bear called Time-out Teddy, and a fabric square bull's eye that says's Time out spot I believe.

Last suggestion:  Give her lots of exercise for the fidgetiness.  If she likes to do things with her hands try having her work with big lego toys and puzzles.  Give her firm massages when you put lotion on her - that helps many kids calm down.  You might also look into a book called The Out-of-Sync Child to see if there are some other fun things you can do to help her be more calm. Jumping is wonderful also.

Many Blessings to you my dear.  

Christine