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Alicia_MSW
Alicia_MSW, Psychotherapist
Category: Mental Health
Satisfied Customers: 794
Experience:  Specializing in mental health counseling
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THere is a 11yr child I work with, that has unexpected outbursts

Resolved Question:

THere is a 11yr child I work with, that has unexpected outbursts of anger and physical abuse self inflicted as well to others?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Alicia_MSW replied 5 years ago.
Hello,

I'm Alicia. I'm happy to help with your question today.
Can you tell me in what type of setting do you work with this child?
Thank you.
Customer: replied 5 years ago.
It is within an after school group of children with different disabilities, but this child usually gets one on one.
Expert:  Alicia_MSW replied 5 years ago.
Thank you for the information. I do have some thoughts about this, but just one last question - can you tell me if she has had a psychiatric evaluation and what the outcome was?
Customer: replied 5 years ago.
she has had a review by Mental Health on paperwork and not in person and the parent was told that it was not to do with mental heatlh.
Expert:  Alicia_MSW replied 5 years ago.
Thanks again. There are obviously some deeper issues here, but without seeing her in-person or knowing a specific diagnosis, it's not possible to say for sure what exactly is going on. I can give you some advice as to how you might possibly address this situation, as well as some things to consider. If she has a type of PDD (pervasive developmental disorder), then her behavior is not uncommon. I can refer you to this information for ways you can possibly address her behavior:
http://www.autism-help.org/behavior-self-injury-intro.htm

There are some good tips that you can read about regarding children with an autism spectrum disorder who self-injure.

Another possibility is that there could be some issues of abuse or mistreatment going on at home. Often children who experience bouts of severe anger as well as self-inflicted violence and violence directed toward others are expressing their frustration and anger about their home life - so it's something to be aware of. There's more information you can refer to about self-harm in this article: http://www.kellybear.com/teacherarticles/TeacherTip44.html

Another possibility is that she is experiencing a disorder such as depression or PTSD (again, you might want to refer to this information):
http://aacap.org/page.ww?name=Self-Injury+in+Adolescents§ion=Facts+for+Families)
Although you say it's not being seen as a mental issue, it's good to be informed about the possibilities here.

But without further evaluation, it's hard to say for sure. I would suggest that you discuss this behavior with her treatment team and/or her parents to see if there are any red flags that come up, and suggest (if your program does not currently offer this) that they bring her for further evaluation with a psychiatrist or a psychologist (if everyone is in agreement), as it's probable that she might need more intensive behavioral intervention and/or medication.

Aside from that, the way that you are currently handling the situation sounds fine, but it seems that the behavior will continue without more intense psychological intervention. Talking with her about her feelings and teaching her ways to self-soothe - such as taking a time out or using distraction through counting to ten, drawing or another creative activity- can help, but if there are more serious issues going on, then these will only be temporary fixes.

Please let me know if you have any additional questions.
Alicia_MSW and 3 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
This child has had a change in medication recently, but that was after circumstances had really escalated beyond our control. So we have started supporting her again, after about 6 weeks break. at first it was good but slowly the outbursts are returning. The home life has changed, moving away from dad but still has fortnightly contact and lives with mum. When she becomes angry we try to divert her away from the situation, sometimes it works but not always. Her Mind lives in a world of imaginary places and things, which we try to remind her what is real and what is not.
Expert:  Alicia_MSW replied 5 years ago.
I can imagine that moving away from her dad is having a very strong effect on her behavior. Perhaps she is feeling abandoned due to the circumstances, and she's obviously having difficulty trying to make sense of the entire situation. I think it's great that you are so supportive and concerned about her, because that's crucial for a child in her position. Distraction and re-framing, re-direction and helping her stay grounded, letting her know that there are people who care about her and love her (within the context of your program), helping her feel safe and helping her develop impulse control are all helpful tactics for dealing with her behavior. There's another interesting article about dealing with tantrums that I'd like to share with you (if, in fact, she is experiencing tantrums, which does sound to be the case here:
http://www.autism-help.org/behavior-tantrums-aspergers.htm)
You'll probably have to try a variety of tactics at times, and at others, it might seem like nothing works, in which case being patient and understanding and trying not to become frustrated is important.

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