[MenloAve]

We are adopting a little 3.5 year old girl that had some neglect in her background and was diagnosed with PTSD. We have seen her "dissapear" and have panic attacks. In addition, she can have tempertantrums when she doesn't get what she wants and/or gets a little hurt - like falling down. We can now tell the difference between a panic attack and a tempertantrum and realize they need to be handled differently.

Our question is what is the best way to deal with a temper tantrum that is pretty intense and can include, hitting, biting, kicking, scratching, spitting, throwing anything within grabbing distance, crawling on the floor, backwards dives, etc. They are usually triggered by her not getting a toy she wants, or having to leave the beach early, etc. Some are more intense than others and in some cases we can talk her out of the tempertantrum before it actually starts. Once they have started, how do you recommend getting her back in control so that she can reasonably process information? How do you teach a child that has already been taught that she "needs to protect herself at all costs" that it isn't appropriate to hit, scratch, bite, etc? We do have a slight language barrier as well and her language is more of a 2.5 year old child with the strength of a 4 or 5 year old. Since she is so strong we are kind of worried about her around other kids.

So far we have gotten to the point that she will give us kisses for the "owies" that she creates and in some cases will do it in the middle of a tempertantrum and then return to screaming. I got her out of one tantrum last night by taking her doll and having it kiss her all over her face. She calmed down as the doll gave her kisses, but wouldn't agree to let me give her a kiss until she was much calmer. Even before then, she made the doll give her kisses all over.

She is mostly a happy, lovable child that enjoys hugs, kisses, etc. - but only from us the parents. She is very nervous around anyone else really. We have seen the temper tantrums get more mild, her recognize when she hurts us and try to control the force at which she bites for instance and recognize that she did hurt someone. I should mention that she has only been with us for 3 weeks. As we work through this we wanted to get advice to ensure we don't make things worse.

For her panic attacks we stay near her and just talk her through them, telling her we love her, she is safe, it is okay to cry, and she is doing a great job crying. We'll ask her if she wants her doll, a hug, kiss, etc. At some point she will answer yes to something and we can start to bring her back to reality. She'll end up in our laps with a tight hug as she calms herself down. When she is in a panic attack we are not addressing her kicking, etc.

Thanks for the advice.

[hrisme]

Lots and lots and LOTS of physical holding & affection during times when she's not having either an attack and/or tantrum. Make touch safe, teach her that having you near is a positive thing, and hopefully you'll be able to hold her during the attacks & use gentle restraint during the tantrums to keep her safe & help her calm down.

The only wanting hugs from you & recognizing when she has hurt you and making amends (keep encouraging that) are GREAT signs. Hopefully that indicates she'll form a secure attachment in the long run.

Disclaimer: I do not advocate holding therapy, and strongly advise against any form of major restraint unless it is a safety issue (sounds like sometimes with you it is, so you may want to get trained, but use it as a last possible resort).

[ajjhmf]

Find a trained attachment therapist and start there. Those aren't what we can tantrums, those are rages. An AT is trained in getting to the core of the trauna that is causing problemsnad helping you and the child through it.

They can also train you how to safely hold a child for prevent them from hurting themselves. It's not holding therapy, but a safe restaining method. It prevents them from hurting themselves and others and does not hurt them.

But really, you need to find an attachment therapist now.

[aspenhall]

I agree, an attachment therapist will be very powerful in her healing at this point!

These are definately rages....and they can and sometimes WILL escalate if she continues to lose control of herself.

My dd would have "blackout" rages as she got older. She still doesn't recall them.

[momraine]

YOu may have trouble finding an attachment therapist that will work with her before she speaks English, but I have heard some will. M's English came along remarkably fast.

[MenloAve]

I agree we have already been in contact with two very reputable attachment therapists in our area and are scheduled to meet with them when we return to the country. We knew we needed to do this to help her get through the early neglect issues. So, I'm interested in recommendations for the next three weeks or so until we leave the country and have our first scheduled meetings with the therapists.

Thank you for the info on a potential language issue with the therapist. I will make sure I clarify that with them. However, we speak as much of her language as she does - so there won't be a deficit in communication.

We have become better at sorting out: panic attacks, "rages", temper tantrums, pouting, and "disappearing". I'm comfortable with the advice I have for panic attacks and disappearing. I even think we have come up with a way to handle the "rages" that works.

It is the temper tantrums that haven't yet escalated, but yet we can't let just go by because they involve something that she needs to learn either not to do, or needs to learn the importance of listening (like running off of a sidewalk into the street). Unfortunately, the temper tantrums will appear to the outside world the same as a "rage" except the fact that she has complete control and the intensity is very different.

We are giving her lots of hugs (which she readily accepts), using doll play to teach her how to be gentle and caring, and making sure that she apologizes for the owies she creates. We are trying to give her choices and explain that no isn't forever, it us just until ..... We tell her she is safe, she can cry, but can't hit (except a pillow). But, what do you say the moment you are bitten, or scratched, or hit? Anything? Do you wait and do doll play later?

[momraine]

For the hitting and bitting and scratching, I would grab her hand (or gently grab her chin for biting) Look her in the eye and tell her 'NO" in English and Polish. Not yelling, but firm. Hold it for a few seconds. Then give her a hug and redirect her attention to something else. Remember she is still young and everything in her life is changing.

[PabloandCarlosMama]

You are doing great to be identifying the different triggers and issues, and problem solving after such a short time.

It takes a while for the hitting and kicking to pass. Everything is still so new and scary to her. I'm wondering if some of this is also a form of dissociative, ptsd like behavior for her? My younger son did this during his first three or four months home. At first I thought it was a tantrum, because it was being done in that context, but as I got to know him, I realized it was more of a PTSD response--it was way out of proportion to what was really going on. He has since said that when he first came to live with me, that he felt like he was "fighting for his life", because he didn't know what I would do to him (he was 7 at the time), and he'd often get confused when he was angry, and think he was seeing the cruel orphanage director instead of me. As he has become more attached, and felt safer, this behavior doesn't happen like it did in the past.

Be patient, but firm with her that hitting is not ok. Let her hit her pillow (kicking empty cardboard boxes is a popular thing to do at our house), use her words, and affirm acceptable ways of showing anger. Initially, I rewarded non-violent displays of anger, and that helped reinforce what's ok and not ok.

Also, both of my children came from an orphanage, and they would go bonkers if I tried to take something away from them. I learned pretty quickly to substitute the remote control for a hot wheels car, or something so that they didn't experience that terror of losing something. (it's like a toddler's reaction) I still do it with my 14 year old, and it's become a little game that has defused many potential fits.

My children didn't speak English when they arrived, and I actually started with the attachment therapist first just to get some coping strategies on how to parent them, and within a couple of months, the boys were working with their therapists. Attachment is more sensory oriented than language based anyway, so hopefully your therapist won't be intimidated by the language differences.

[MenloAve]

Thank you for you input. Quick update.

I've been using your suggestions to give her safe outlets for her hitting, kicking, biting, etc. So I got her a teether to let her bite on, she can hit the pillow or give us "high fives" and kick the bed. For the scooting - the whole family had a race across the room to see who got to the other side first. She wasn't upset by the time she realized we were all scooting on the ground.....

We haven't seen biting since we got her the teether and she doesn't use it much anymore. She is still hitting and kicking, but they are less directed at us and more just her being mad. She is pinching us hard (no scratching now) when we wants to let us know she is mad (like we didn't already know with the scraming.) She will stop very quickly though when we say "no hurting". So we are making progress. We still get the tempertantrums, over very stupid things, but they are shorter, more in control and we can talk her through to the end of them - sometimes to see that it really didn't make sense to scream for - whatever it was.

These tempertantrums, although frequent, are much more doable, understandable, and one can see how ongoing love and family time will help her gain the trust to react a bit more like a 3.5 year old in a family.

I also have a reference check to do with an attachment therapist in our area. Even without attachment issues I still need a therapist to help her with the PTSD issues that she has/had - so we will see someone that can handle both.

Thank you and any other recommendations are always welcome.