Behavioral Eval for 2.5 Year Old?

Hi.

I just read your previous post and I have to say that I seem to agree with your confusion over getting her evaluated...for what?? You are right that she is WAY too young to be tested for ADHD and she's, well 2, acting like a 2 year old. I have to say that after reading the tantrum post it seems to me that she's a fairly typical 2.5 year old. My daughter will be 3 in two weeks and she exhibits most of that behavior you mentioned and has for a few months. Many moms I've talked to have all said that between 2.5 and 3.5 is the worst time for toddlers. Even though this is going to probably seem like really dumb advice and what you're already doing, I think you just need to keep on keeping on and stay consistent. There have been many a night when my daughter only wants my help and when I send Dad in it results in 30 minutes of tantruming b/c she doesn't want him. It is awful, plain and simple, but, we power through it b/c in my mind it's more important to show her we aren't backing down than to give into the tantrum. This has happened over toothbrushing, opening doors, getting out of the car, putting on pajamas, cutting her meat...you name it. I doubt that the 2 of us are the exceptions to rule...I'm betting that most kids this age act like this at times. My daughter is also very verbal and sometimes I think that is harder b/c they totally get what's going on and are quite competant at manipulation or at least trying to manipulate, the situation.

I personally think things are just fine and you and hubby need to take a step back. Maybe you two can make a pact that if the other one starts getting too frustated and yelling, etc. that the other one can step in. We do time out and it works, but when she's in a super tantrum like this, it does take a while, but it works. The important thing is for you two to keep your cool and just know that in a few months (months...what?! I know...) it will be better. That's the only thing keeping me going right now! ;)

I think the other poster was just trying to help. There is probably no reason for alarm. Your daughter may be very head strong, which at 11 when dealing with 5th grade boys will serve her well, or in middle school, in high school, when she goes to college already knowing what she wants and how to get it.
I have a headstrong, a couple actually. We use timeout. I take away priviliges, (mine are 21 and 15 now).

I did use a timeout hold.
Sit down on the floor, Indian style.
Put child in your lap.
Cross her arms across her chest and hold her wrists firmly.
If need be you can use your legs to further immobilize her.
Say only, I will let you go when you calm down, very monotone, detached.
When she stops, state the rule; It is time to brush your teeth.
If she starts again do it again.

I learned this when teaching at an at risk preschool.
I used this on my very hard to handle eldest son. At 4 and 5 he would throw things at me.
She is also only 2. My favorite age is 18 monhs to 2.5. The tantrums started about 2.5 with all four of mine to a varying degree of terrible.
Good luck to you, my now 15 yo would say to me, "I CAN DO IT MYSELF!!" and if I tried to help she would tantrum. She still does everything HERSELF!! THE 21 yo is in the Navy doing very well.
It will get better.

ADHD is not the only issue that a Developmental Pediatrician could look for, but if you don't think that the tanrtums raise to the level of being severe enought to make her misserable such that you wonder about developmental issues, then you can always wait and see what happens. Even if you do not receive a diagnosis, you may find within the data a reason to seek therapy for any number of issues that could help her, from language to vestibular issues, and if one of them could cause a child to tantrum without you being able to see that her picture naming is two standard deviations about her processing speed score (for instance) which would cause frustration in anyone, let alone a two year old. Therapy is offered on the basis of the data and the symptom, not the diagnosis. Play therapy for behavior can start this early as well, and if your older daughter has ADHD, then you should probably already know a play therapist or a cognative behavioral therapist for your older daughter's treatment plan, so this would not be a huge problem to add your younger daughter to the mix.

You do have cause for concern, but only you can decide what to do next. She has a sibling with ADHD, she has one sensory issue already with her eyesight (this is effecting the way she perceives the world-and is probably frustrating) and she is having meltdowns and tantrums that are outside your comfort level as a parent of a child with ADHD (which says to me that they must be quite something!)

What I say to most parents who are wondering if their child could benefit from an evaluation when the issue is behavior, when typcial dicipline applied consistently fails, that should be cause to suspect that there is a neuralogical barrier that is keeping your child from processing information in a typical way, and an evaluation can help you sort out how to change the information you give your child, through theraputic intervention, so that they can behave in a more typical way and feel less misserable. She really wants to behave.

If you do not yet have for your oldest daughter, and if you decide it is necesary for your younger daughter, a full developmental evaluation (with data, and many, many pages of discussion about the numbers and scores of all your child's psychoeducational functioing) then I would suggest it so that you have a base line, something you hold to keep your school district honest, and a comprehensive treatment plan (based on data) so that you can access all the therapy that she/they need beyond the "functional" standard that the public is legaly required to provide you (this is a very low bar to jump) What you want for both your girls is to maximize (which schools are not required to do) thier potential, and you should hold the medical diagnosis and a private copy of all the data so that you can be sure that happens (above what the school provides) through private services in all the many areas that make up standard care for ADHD.

One suggestion too, and you may have already done this, is to see a developmental optomitrist who checks not just for visual accuity, but for things like occular motor, visusal motor, and visual skills that also can effect a child's processing such that they melt down when another sensory area is overwhelmed (like when the taste of the toothpaste is yucky) if they can't see well, or process that information. Just a thought. Your older daughter's occupational therapist can probably refer you to an optomitrist who does this kind of evaluation.

M.

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Just wondering what eventually happened with this problem because my 2.5 yr old throws God aweful fits as well. I am a single mother in school and have another younger baby and I don't have much free time. I get frustrated which doesn't help the situation but I don't know how to deal with this. They are 30 minute scream sessions. The only thing I have found that works is to shut her in her room for a few minutes then go back in there and sit down with her and hold her. She tends to calm down to where I can talk to her but I feel cruel shutting her in there. Timeouts are not working because I have to physically hold her down. She kicks and hits and screams to the point you would think she would lose her voice. I feel like everything I do will have a negative affect versus a positive. She is very smart. She has a great understanding of things around her and a great memory. She picks up on so much so I am not worried about her developmentally. I am afraid she just has anger issues. I was looking into getting her some therapy for anger management.