Q My four-year-old son is angry and aggressive to other little ones. He never had liked to go to toddler groups and now that he is at nursery school he is just friends with one girl we've known for a few years (in a possessive way sometimes) and a few more from the older group. He throws tantrums when we have to go out to take my older son to school. This is every day. He never smiles or says hello to the neighbours. People think he is rude, because of the tantrums he has everywhere. But at home he can be the most loving and kind boy in the world. Is anything wrong with him? Has he got social anxiety? Or is there any other reason for his reactions?
This is a great question, and we often start to see these problems arise when kids begin attending nursery school and spending time with peers. You are doing exactly the right thing in being proactive, voicing reasonable concerns, and looking for answers. Your son’s behavior could be explained by any number of factors, including social anxiety, separation anxiety, defiance, trouble managing emotions, or difficulty adjusting to nursery school. My advice would be to bring him to a child psychologist or psychiatrist for a diagnostic evaluation. A diagnostic evaluation is somewhat like a puzzle, where the professional gathers information from different sources like behavioral observations, questionnaires, and interviews with parents, and puts the information together to better understand your son’s emotional and behavioral difficulties and determine a diagnosis, if appropriate.
One major component of an evaluation is what we call a “functional analysis,” where we consider the problem behavior, possible triggers for the behavior, and the consequences that follow it. This is actually something that you can begin to notice prior to an evaluation. You mentioned that the tantrums come up every day when you leave, and I’m wondering what feedback you’ve gotten from the teachers on his behaviors and socializations for the rest of the day. Also, what are some of the other triggers to his tantrums? For example, is it always with you, or with other people, too? In what other contexts are you seeing the tantrums? I would look for patterns (e.g., people, places, situations) to better understand the triggers and what is “causing” them. In terms of the consequences, I would think about what happens during and after the tantrum. For example, is he getting attention for the tantrum? Is he getting out of something he doesn’t want to do because of the tantrum? Is he getting something he does want because of the tantrum? These are all “consequences” that can inadvertently maintain the cycle of tantrums.
All in all, we want to be able to piece together your son’s current symptoms, history (social, educational, psychiatric, family, and medical), and behaviors in different settings, in different situations, and with different people to understand how to best help him. The evaluator will provide various recommendations that will hopefully help you manage some of these behaviors and point you in the right direction for treatment, if needed.