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Children's Health

3-Year-Old Down Syndrome Child Who Gets Angry

12/06/2010

Question:

I am working with a 3 years old Down syndrome child for the second year. When I started to work with him at first time pulled my hair and bites me. He positively progressed and looked for hugs and attention. His parents told me that he eats only with me. So I made sure to come almost every day. Lately when he started to go to special school and our time decreased he regressed in his behavior. The last time that I took him after a break of 2 weeks he was acting out pulling my hair and almost biting. There was no apparent reason for his behavior and I felt sad after all the energy and love that I am giving him all the last year. It is notable that when aggression is toward a care giver it is usually because of unmet basic needs. It is very hard for me to figure out the reason for his behavior. I have a feeling that he is angry and tired. I want to mention that his mother told me about his behavior toward her but I had a wonderful year with him and he was loveable as long that he got what he needed. Over the year I did with him all sensory therapy and made sure that he was fed first (he was always eager to have food). He was happy. Lately, his mother said he acts like this toward others. He would have those angry tantrums and become violent toward others which are not the characteristic of DS. He also show more attachment toward his mother which he never had. I observed that he is scared when I pick him up and when I bring him in he hesitated. Socially regression, phobia walking in/out places and wants me to hold him up. This is weird behavior because I love him and never heart him in any way. At the session he seems to be happy and behave in acceptable ways. He is not puling or screaming. He hugs me and giggles. Do you have any suggestion? I don’t want to jump in conclusion of neglect although it was obvious that the children are not fed enough and the mother is stressed out with 5 children. I hold mental health and school counselor certificate and usually worked with older children but this case is challenging due to uncommon characteristic

Answer:

Thank you for your question. Professionals in various areas of service are mandated reporters of suspected child abuse and/or neglect. Whenever a mandated reporter suspects the possibility of child abuse and/or neglect, they must call the relevant agency to make a report. Mandated reporters are not responsible for finding evidence of child abuse and/or neglect as this is the job of the relevant agency. The identity of a reporter is never revealed to the family. An additional consideration is that children with disabilities and other vulnerable individuals have a higher likelihood of being the victim of abuse and/or neglect. Finally, negative behaviors can often be addressed with assistance from a behavior specialist or psychologist.

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Response by:

Michelle Spader, PsyD
Clinical Assistant Professor of Pediatrics
College of Medicine
The Ohio State University

John V Campo, MD John V Campo, MD
Interim Chairperson of The Department of Psychiatry
Clinical Professor of Pediatrics
College of Medicine
The Ohio State University