Expert: Valerie Herskowitz - 5/29/2009

Question
QUESTION: I need help!, my 9 year old daughter has recently been displaying more & more aggressive meltdowns. I've not had a problem with these types of meltdowns since she was around 3-4 years old. So it's been a complete shocker. It all started this past new school year. She got a new teacher, her old teacher left after 3yrs in her classroom. But little did I know that she was having meltdowns lasting from 30mins - 2hrs. She would cry, kick, bite, fall to the ground (dead weight) almost everyday. Her teacher failed to inform me of the incidents. It then got to the point where my daughter stopped wanting to go to school. This lasted for 1 1/2 months. I would take her everyday to school, and she would immediately cry and tell me "no". I have since dis-enrolled her and have been home schooling her for the past month. Since then she has displayed aggressive behavior at the drop of a hat. In public areas and at home. So we've just been avoiding going anywhere until I can be certain that she would be alright again. We attracted attention of on-lookers and the police. When she has a meltdown she is usually protesting because she cannot get her way, or to get out of an assignment (when she was @ school) but now she will meltdown when we're @ walmart (her fav place) she will not want to go in, but will not want to leave, she'll look at the ground like she's telling me "get ready, im going down". My daughter is non-verbal, she has limited vocab, cannot make sentences or conversation. And cannot answer a direct question. She is going on her 4th month pres of Prozac, only med she is on. 20mg dose 1x a day. I've heard that Prozac can actually have the opposite effect of calming after a certain period of time, and that it's best to only give 1/3 of the recc dose? I'm just asking for an outsiders views on what might be triggering the meltdowns?

ANSWER: Hi Nette
I know the heartache you are going through only too well as my son, who is 18, suffers from aggressive behavior as well.

I am not a doctor, but I don't think Prozac is the medication that most doctors use for aggression. My son takes Risperdal, Inderol and Lithium and on occasion, needs Ativan for a really bad episode.

You need to find a qualified neurologist or psychiatrist who deals with these issues and get her stabilized. I go to a great doctor in Florida. It took me awhile to find him. I used to travel all the way to UCLA in California.

Where do you live?

Valerie Herskowitz, MA CCC-SLP
valerieherskowitz.com

---------- FOLLOW-UP ----------

QUESTION: I would like to know more about what Ativan is? I have had instances when she is in a public place and I need to remove her from an area where she might hurt herself. But doing so takes roughly 5 people. And to answer your question about where I live, Albuquerque NM.

Answer
Ativan is an anti-anxiety medication that can be given when she is having a meltdown. I find it very effective and it works quickly in the system. Ask your doctor if it would be a good choice for when you are out in public and she has a meltdown.

Valerie