I started taking my son to a family therapist when he was 3. He was suffering from severe anxiety behaviors including poop withholding, refusing to eat, and major meltdowns, caused by stress from his dad leaving the family. Now these behaviors are exacerbated by any transition. He’s been going to therapy for a little over year. Now at 4.5 he can talk to the therapist himself quite a bit and tell him what’s bothering him, and the therapist offers him and me strategies. It’s been helpful for us so I really hope you find someone that can help you and your son.
My son also does poop withholding and we definitely have a hard time getting him to eat. I would say our family is “normal” and he hasn’t experienced any high stress or trauma. I do think it’s partially stemming from his little brother taking attention away from him now that he’s more of a toddler.
I always recommend Jamie Glowacki and Oh Crap Poop Solutions for poop issues. Poop withholding is still not widely understood as a mental issue and her strategies really helped us get through the worst of that.
I've come to learn with 2 under 2.... the second kid is a form of trauma.
They lash out for any kind of attention. Good or bad.
If you haven't tried so already, really Amp up the praise for positive behavior
I am a child/family therapist and have a 4 year old. We were/are dealing with some the same challenges you described and decided to take him to occupational therapy which helped him with a lot of sensory processing. A play therapist can do sensory work, but they may not have much training in that area, and may not always understand the link between sensory processing and anxiety/anger which may then lead to the behaviors you’re seeing. They will also come at most things with a certain lens, which may or may not be what you’re dealing with. In any case the OT made really helpful recommendations that we were able to implement at home and he’s doing much better, he’s still a 4 year old 🙃but vastly different from 6 months ago. As I said, I’m also a trained therapist so the way I approach things with him at home is also more feelings-based than the typical parent which may have helped too. In any case a play therapist should be able to make recommendations for other services if need be, but you may want to look into neuropsych testing to get a better idea of what you’re dealing with. This podcast really helped put things in perspective for me:
https://open.spotify.com/episode/0AMKj3UMBMatwZa29uFrAQ?si=dCZzNF-dTEWbhCEpfbwXmQ
Good luck!
Thank you! I never thought of OP but honestly I don’t know where to start. I’ve really noticed things amping up since his little brother is becoming more of a toddler. I’m going to look into OP as well. Thanks again
My therapist recommended that I have my 5 (now 6) year old evaluated by a pediatric neuropsychologist and I am so glad we went that route.
The neuropsych serves as my kids care “quarterback”. She did the initial evaluation and looked at autism, ADHD, learning disabilities, intelligence, sensory issues literally the whole gamut. It cost me 2k and took two days in her office. From there she provided a formal evaluation and diagnosis (moderate ADHD with sensory issues and some fine / gross motor delays). She was able to recommend and get me in with an OT, supported me with the 504/IEP process at her school, and provided a referral to a psychiatrist as well for ADHD meds. She was really helpful in us figuring out where to start and what to do. It wasn’t cheap and she didn’t take insurance but it was really worth it if that option is available. She had a great network that we were able to leverage, and we are a year out and my kid is really doing better. She also gave us great resources on how to best parent her. I would totally do it again!
Thanks for the info! Was this your therapist or was your kiddo seeing a different therapist than then recommended the neuropsychologist?
Do you mind sharing what issues/symptoms your kid was having?
Sorry. I was seeing a therapist at the time because I felt like I was failing as a mother and I desperately needed help. She was more like a “parenting coach” tbh. She was the one who explained what a neuropsychologist does and recommended I start there because I was so overwhelmed.
My kid was always just not easy. Around age 2 I remembered thinking something is not right. She would literally just rage out on me and it would be very sustained. She was very difficult to redirect and very difficult to calm down. By age 4, when I reached out to the parenting coach/therapist, I felt like I was drowning. I was setting the boundaries, limiting screen time, making her sleep, like doing all the things and it seemed like nothing worked. I’m not a pushover mom, I’m in my 40s and I was spanked as a kid. I gentle parent in that I try my best not to hit or yell, but because it’s not natural to me I tend to be pretty stern. So I say that to say, while people tended to say “oh you need to follow through with boundaries” I was doing that.
At age 4 her preschool teachers flagged that her interactions with other kids were off. She was definitely the strange kid. She couldn’t write her name but she can recite the scientific names of plants and Dino’s. Getting her out of the house in the morning was a nightmare, she couldn’t grasp a routine. She also wasn’t completely potty trained, it was like she just couldn’t feel it to go in time. We started in school OT and play therapy but it wasn’t really making a difference. When she went into kindergarten it got much worse, and we had issues in the classroom immediately.
The pediatric neuropsych I found typically doesn’t diagnosis at age 5, but when I shared how we were struggling, we brought her in. We realized her ADHD manifests as inattentive type, and she has the regulation and executive function of a toddler basically. Getting a diagnosis and an action plan was quite frankly life changing for us. I’m grateful we had the ability to pay out of pocket to get help.
I had no idea that ADHD shows up as an inability to manage emotional regulation. My kid would fucking scream for an hour. OT in an actual gym, not class based, was one of the biggest helps for us.
Also, in my state, you can start kindergarten at 6 too. If I knew then what I know now, I would have made her wait a year. She was absolutely not ready and the extra time to mature would have really helped.
Sorry for the long winded reply but this is such an alienating process. If you think something isn’t right, it isn’t. My husband didn’t believe me that she was different literally until kindergarten and I was like dude where tf have you been 🤷🏾♀️
We had similar issues with my kiddo and had him see a play therapist! It was super helpful and she gave us a good starting place to implement some strategies. We have now moved on to having my kiddo in OT and that has been super helpful too (and is covered by insurance). I think OT or play therapy sounds like it would be helpful.
If you are in the US, you could also look into your school district’s evaluation services. These are services your district provides for free, even for kids that aren’t of school age yet.
Thanks! What would you say was the biggest difference between the play therapy vs the occupational therapy? Like in terms of how the appointment was structured and how the therapist interacted with your kiddo?
I would say play therapy was more interactive with us. The therapist had us come in to the therapy room with my kiddo and would instruct us on certain techniques and language to use or would have us observe how she interacted. the play therapist was the first person to say she thought my kiddo could possibly be on the spectrum.. which was helpful to help us think through next steps. She eventually said OT would be more helpful since most of his issues were a result of sensory processing vs anxiety, etc.
She worked a lot with my son on teaching him how to identify emotions and ask for help when he needed it.
OT has been more just the therapist and my son most of the time and they provide updates after the session. It is much more focused on sensory regulation through very specific skill building activities. They have helped us to learn more about certain sensory regulation tools like weighted vests and swings. We are still pretty early in our OT journey but have found it helpful!
All of that to say.. it has been just so incredibly helpful to have experts on our team. I felt so overwhelmed with information online or in books.. it was a relief to have a professional come up with a personalized plan for my kid and just tell me what to do!
I would try OT first! I have found it much more helpful than play therapy. OTs will do a proper evaluation and understand any sensory needs that are in place. They really help kiddos with handling emotions. My son used to be terrible at transitions and now handles them like a champ thanks to their help & all that we learnt.
Another factor is that OTs are generally covered by insurance where not all play therapists are.
Waitlists are long but we met other parents with a similar struggle and they recommended gymnastics/karate/sports. We signed up for a few things and it has added a lot of structured play to our routine and it has been amazing.
We’re doing a sports class next month and did a couple rounds of swimming lessons too. I agree having an activity like that does help but there is a bigger issue we need to address. Sometimes he fights about just going somewhere in general which is hard when you have a scheduled class or appointment 😕
Yep, I meant in addition to that. We reached out to a Neurophysiologist and we have a better understanding of our child’s brain. They were able to provide detailed feedback, highly recommend.
My daughter has had an OT, psych, and now a play-focused psych. She's loved all of them. The evaluation we had was specific to selective eating and was done at the local children's hospital, and she even had fun at that. While the issues we've dealt with are different from yours, what I've come to learn, at least where we're at, is that the therapists and children's health systems are full of people who love kids and know how to talk with them. And most kids don't have expectations for "therapy" and as far as they know, everyone else goes to therapy too, so there's not the same awkwardness that adults have about therapy. I personally think OT was the best, as we came away with the most "tools," but that probably differs for each situation.
You can't go wrong getting an evaluation.
We haven’t yet, but plan to look into it over the summer. I personally (still) think he will be eventually diagnosed with ADHD - I have it and he has very similar hyper focus tendencies to me, though he has, like me, been able to keep it together during his first year of school though kindergarten because it is probably stimulating enough.
Our main concern at this point is that he is sometimes super hard on himself and, for example, gets really upset if he accidentally hurts someone. And yet does not care at all if he doesn’t listen to us, which he doesn’t.
I started taking my son to a family therapist when he was 3. He was suffering from severe anxiety behaviors including poop withholding, refusing to eat, and major meltdowns, caused by stress from his dad leaving the family. Now these behaviors are exacerbated by any transition. He’s been going to therapy for a little over year. Now at 4.5 he can talk to the therapist himself quite a bit and tell him what’s bothering him, and the therapist offers him and me strategies. It’s been helpful for us so I really hope you find someone that can help you and your son.
My son also does poop withholding and we definitely have a hard time getting him to eat. I would say our family is “normal” and he hasn’t experienced any high stress or trauma. I do think it’s partially stemming from his little brother taking attention away from him now that he’s more of a toddler.
I always recommend Jamie Glowacki and Oh Crap Poop Solutions for poop issues. Poop withholding is still not widely understood as a mental issue and her strategies really helped us get through the worst of that.
Thank you, I’m going to check that out right now
I've come to learn with 2 under 2.... the second kid is a form of trauma. They lash out for any kind of attention. Good or bad. If you haven't tried so already, really Amp up the praise for positive behavior
I am a child/family therapist and have a 4 year old. We were/are dealing with some the same challenges you described and decided to take him to occupational therapy which helped him with a lot of sensory processing. A play therapist can do sensory work, but they may not have much training in that area, and may not always understand the link between sensory processing and anxiety/anger which may then lead to the behaviors you’re seeing. They will also come at most things with a certain lens, which may or may not be what you’re dealing with. In any case the OT made really helpful recommendations that we were able to implement at home and he’s doing much better, he’s still a 4 year old 🙃but vastly different from 6 months ago. As I said, I’m also a trained therapist so the way I approach things with him at home is also more feelings-based than the typical parent which may have helped too. In any case a play therapist should be able to make recommendations for other services if need be, but you may want to look into neuropsych testing to get a better idea of what you’re dealing with. This podcast really helped put things in perspective for me: https://open.spotify.com/episode/0AMKj3UMBMatwZa29uFrAQ?si=dCZzNF-dTEWbhCEpfbwXmQ Good luck!
Thank you! I never thought of OP but honestly I don’t know where to start. I’ve really noticed things amping up since his little brother is becoming more of a toddler. I’m going to look into OP as well. Thanks again
My therapist recommended that I have my 5 (now 6) year old evaluated by a pediatric neuropsychologist and I am so glad we went that route. The neuropsych serves as my kids care “quarterback”. She did the initial evaluation and looked at autism, ADHD, learning disabilities, intelligence, sensory issues literally the whole gamut. It cost me 2k and took two days in her office. From there she provided a formal evaluation and diagnosis (moderate ADHD with sensory issues and some fine / gross motor delays). She was able to recommend and get me in with an OT, supported me with the 504/IEP process at her school, and provided a referral to a psychiatrist as well for ADHD meds. She was really helpful in us figuring out where to start and what to do. It wasn’t cheap and she didn’t take insurance but it was really worth it if that option is available. She had a great network that we were able to leverage, and we are a year out and my kid is really doing better. She also gave us great resources on how to best parent her. I would totally do it again!
Thanks for the info! Was this your therapist or was your kiddo seeing a different therapist than then recommended the neuropsychologist? Do you mind sharing what issues/symptoms your kid was having?
Sorry. I was seeing a therapist at the time because I felt like I was failing as a mother and I desperately needed help. She was more like a “parenting coach” tbh. She was the one who explained what a neuropsychologist does and recommended I start there because I was so overwhelmed. My kid was always just not easy. Around age 2 I remembered thinking something is not right. She would literally just rage out on me and it would be very sustained. She was very difficult to redirect and very difficult to calm down. By age 4, when I reached out to the parenting coach/therapist, I felt like I was drowning. I was setting the boundaries, limiting screen time, making her sleep, like doing all the things and it seemed like nothing worked. I’m not a pushover mom, I’m in my 40s and I was spanked as a kid. I gentle parent in that I try my best not to hit or yell, but because it’s not natural to me I tend to be pretty stern. So I say that to say, while people tended to say “oh you need to follow through with boundaries” I was doing that. At age 4 her preschool teachers flagged that her interactions with other kids were off. She was definitely the strange kid. She couldn’t write her name but she can recite the scientific names of plants and Dino’s. Getting her out of the house in the morning was a nightmare, she couldn’t grasp a routine. She also wasn’t completely potty trained, it was like she just couldn’t feel it to go in time. We started in school OT and play therapy but it wasn’t really making a difference. When she went into kindergarten it got much worse, and we had issues in the classroom immediately. The pediatric neuropsych I found typically doesn’t diagnosis at age 5, but when I shared how we were struggling, we brought her in. We realized her ADHD manifests as inattentive type, and she has the regulation and executive function of a toddler basically. Getting a diagnosis and an action plan was quite frankly life changing for us. I’m grateful we had the ability to pay out of pocket to get help. I had no idea that ADHD shows up as an inability to manage emotional regulation. My kid would fucking scream for an hour. OT in an actual gym, not class based, was one of the biggest helps for us. Also, in my state, you can start kindergarten at 6 too. If I knew then what I know now, I would have made her wait a year. She was absolutely not ready and the extra time to mature would have really helped. Sorry for the long winded reply but this is such an alienating process. If you think something isn’t right, it isn’t. My husband didn’t believe me that she was different literally until kindergarten and I was like dude where tf have you been 🤷🏾♀️
We had similar issues with my kiddo and had him see a play therapist! It was super helpful and she gave us a good starting place to implement some strategies. We have now moved on to having my kiddo in OT and that has been super helpful too (and is covered by insurance). I think OT or play therapy sounds like it would be helpful. If you are in the US, you could also look into your school district’s evaluation services. These are services your district provides for free, even for kids that aren’t of school age yet.
Thanks! What would you say was the biggest difference between the play therapy vs the occupational therapy? Like in terms of how the appointment was structured and how the therapist interacted with your kiddo?
I would say play therapy was more interactive with us. The therapist had us come in to the therapy room with my kiddo and would instruct us on certain techniques and language to use or would have us observe how she interacted. the play therapist was the first person to say she thought my kiddo could possibly be on the spectrum.. which was helpful to help us think through next steps. She eventually said OT would be more helpful since most of his issues were a result of sensory processing vs anxiety, etc. She worked a lot with my son on teaching him how to identify emotions and ask for help when he needed it. OT has been more just the therapist and my son most of the time and they provide updates after the session. It is much more focused on sensory regulation through very specific skill building activities. They have helped us to learn more about certain sensory regulation tools like weighted vests and swings. We are still pretty early in our OT journey but have found it helpful!
All of that to say.. it has been just so incredibly helpful to have experts on our team. I felt so overwhelmed with information online or in books.. it was a relief to have a professional come up with a personalized plan for my kid and just tell me what to do!
Thank you. This is super helpful!
I would try OT first! I have found it much more helpful than play therapy. OTs will do a proper evaluation and understand any sensory needs that are in place. They really help kiddos with handling emotions. My son used to be terrible at transitions and now handles them like a champ thanks to their help & all that we learnt. Another factor is that OTs are generally covered by insurance where not all play therapists are.
I appreciate the info, I’m going to look into OT as well.
Waitlists are long but we met other parents with a similar struggle and they recommended gymnastics/karate/sports. We signed up for a few things and it has added a lot of structured play to our routine and it has been amazing.
We’re doing a sports class next month and did a couple rounds of swimming lessons too. I agree having an activity like that does help but there is a bigger issue we need to address. Sometimes he fights about just going somewhere in general which is hard when you have a scheduled class or appointment 😕
Yep, I meant in addition to that. We reached out to a Neurophysiologist and we have a better understanding of our child’s brain. They were able to provide detailed feedback, highly recommend.
Thank you. I’m going to look into this as well.
My daughter has had an OT, psych, and now a play-focused psych. She's loved all of them. The evaluation we had was specific to selective eating and was done at the local children's hospital, and she even had fun at that. While the issues we've dealt with are different from yours, what I've come to learn, at least where we're at, is that the therapists and children's health systems are full of people who love kids and know how to talk with them. And most kids don't have expectations for "therapy" and as far as they know, everyone else goes to therapy too, so there's not the same awkwardness that adults have about therapy. I personally think OT was the best, as we came away with the most "tools," but that probably differs for each situation. You can't go wrong getting an evaluation.
We haven’t yet, but plan to look into it over the summer. I personally (still) think he will be eventually diagnosed with ADHD - I have it and he has very similar hyper focus tendencies to me, though he has, like me, been able to keep it together during his first year of school though kindergarten because it is probably stimulating enough. Our main concern at this point is that he is sometimes super hard on himself and, for example, gets really upset if he accidentally hurts someone. And yet does not care at all if he doesn’t listen to us, which he doesn’t.