4 year old kicked out

amother

Tue, Feb 06 2024, 10:27 am

Hi,
I'm looking for advice with the following scenario.
My 4 year old is an adorable kid who been behaving very difficult lately, think since sukkos ish. He used to be the most well adjusted and chilled kid Sad

Now, at home he tantrums and fights with his siblings. In school he just acts very veeeery silly and disturbs the class to the point that he was sent to the principal today. He didn't care, just continued to be silly until eventually he got bored and was finally quiet and allowed to be let back in to class.
The school is being amazing, but they're at their wits end, as am I.
At home he is able to sit and color or listen to a story or tape for hours so its not a focus issue.
He is fine academically and socially. It seems to just be an impulse + lack of regulation but extreme.
I had him tested for PANDAS, mono, lyme- all negative. ASO was slightly elevated but not enough for PANDAS.
I am getting him evaluated for OT.
Any advice? Or encouragement that it's something he may grow out of?
Thanks Smile

amother

Mint

Tue, Feb 06 2024, 10:37 am

How was he until now? No behavior issue until last sukkos?
He started school in September?
Is anything bothering him in school? On the bus? Does he like his rebbi/morah?
Is it possible some older children bully him during recess? Does he have friends?
Does he eat 3 meals a day and drinks regularly?
Sorry to be asking so many questions...trying to help you figure out what could have changed.

amother

Tue, Feb 06 2024, 10:41 am

amother Mint wrote:

This is his second year in school. Last year there was some silliness but I was never called by the teacher or principal.
there's no bus. he claims to like his morah. he has friends.
he eats and drinks regularly, I can't say the healthiest but decent.
Until now he's been regular. not angelic but no outstanding issues.

amother

Tue, Feb 06 2024, 10:42 am

amother Starflower wrote:

My son wasn’t high enough for pandas but I still did strong antibiotics for 3 weeks and it helped immensely. I’d still try it honestly.

How did you get your dr on board? was it his idea? or did you push for it?
Thanks!

thatworn

Tue, Feb 06 2024, 10:43 am

My son was the same in kindergarten. Well behaved and focussed at home, off the wall at school. Do you think that too much stimulation (light, noise, regular classroom activity) is doing something to him? Do you think anxiety is part of it? More stress at school than at home.

mha3484

Tue, Feb 06 2024, 10:44 am

I have a son that didn't do great in 2 and 3 year old playgroup but wasn't awful either but he really fell apart in 4 year old nursery. The expectations got higher, the kids got more mature and he could not keep up. He had a very very hard year. He has ADHD and is gifted and some other stuff. We got him a lot of help. I didn't find OT that helpful. We did therapy where we taught him the skills he was missing. We medicated the next year in pre1a and that helped a lot. He had his bar mitzvah and we have seen major improvement. But the early years were crazy hard. If you can get on some lists for a developmental ped I really liked their approach. The one we used moved and I was so sad.

amother

Tue, Feb 06 2024, 10:46 am

thatworn wrote:

he doesn't seem anxious. Overstimulation is a possibility though he was in school already last year... can I ask what you did about it?

amother

Tue, Feb 06 2024, 10:48 am

mha3484 wrote:

what therapies did you find helpful?

amother

Black

Tue, Feb 06 2024, 10:50 am

Even though he could remain focused on reading or playing , he may still have ADHD . My teen DS was recently diagnosed based off of his impulsivity . Maybe get him evaluated to rule it out .
On the other hand there is nothing wrong with a 4 yr old being silly .

mha3484

Tue, Feb 06 2024, 10:50 am

We used a talk therapist who sees a lot of boys in the yeshiva system where I live. We took the "report card" the early childhood program sent and we went comment by comment teaching him each skill that he wasn't naturally getting on his own. The moros were amazing and really wanted to help him too.

amother

Thistle

Tue, Feb 06 2024, 10:55 am

There is no threshold for ASO to diagnose pandas. Whoever told you this is unfortunately not informed. Pandas is diagnosed based on symptoms and history and from your description it sounds very likely. The slightly elevated ASO would be an additional clue. Standard Lyme testing also has a very very high rate of false negatives.

If you want, you could try giving him dye free motrin and benadryl for 2 days around the clock. If behaviors improve, that's an indication that [brain] inflammation (caused by strep or another infection) is a culprit.

amother

Tue, Feb 06 2024, 11:01 am

amother Thistle wrote:

So interesting! Do you have experience with this (a kid being diagnosed with PANDAS without high ASO)?
Would motrin and benadryl be given together? Won't benadryl make him sleepy?
Thanks!

mha3484

Tue, Feb 06 2024, 11:04 am

Warning on the Benadryl I have a 7 year old with ADHD and he is overall A LOT but I can handle it. When I had to give him Benadryl for some hives last summer he was 10x his normal level of hyperactivity. Not telling you to give it or not but be forewarned some kids get very tired and some get the opposite. BH for my neighbor for warning me first lol.

amother

Pansy

Tue, Feb 06 2024, 11:05 am

Just as an FYI I think I have inattentive ADHD as an adult (probably as a kid too) and I was able to focus for hours on stuff like puzzles and books. (I can’t focus on most everything else though)

amother

Tue, Feb 06 2024, 11:05 am

giftedmom wrote:

Could still be adhd hyperfocus is part of it

it def could be, I have another child with ADHD and they are so so different but I guess it could manifest in many different ways.
I have a strong gut feeling it's not though. So I'm trying to figure out what else it could be.
In any event, I was told that one really needs to be 6 to get a proper ADHD eval so if this persists, I def will do that.