From the U.S.: I know you do not diagnose, but just wondering what you think. My grandson turned three. He is a fraternal twin. The other twin is a girl. He is extremely aggressive and has poor impulse control, throws toys or anything really. Many times he throws hard toys right at his sister’s little head! He’s been described as a bully at daycare. In fact, he has been in some fights with other boys!

However, He is fine with the girls who work at the day care and they just love both the twins! He does not, will not listen to his mother at all, and usually not me either. If he’s upset or angry about something, he just wants his mommy (who is probably stressed and angry too) but if I try to help by trying to comfort him or distract him, give him some positive attention, he pushes me away, swats my hand away and won’t look at me, acts really rude (this all seems so odd to me because my son was especially easy and even tempered, so I never had to deal with this.)

To me he’s much more than your typical active little boy! You know, “boys will be boys.” Huh-uh. . . that’s not what this is! I just know something isn’t right. He is unrelenting with his anger sometimes, trying to get his way.

Now listen to this one: If you ask him, or tell him, to do something he won’t do it. But if you say “Don’t you dare pick up those toys,”(what you’d just asked him to do, that he wouldn’t do) but when you tell him the opposite of what you want, he’ll do it!! It’s like he’ll do anything to disobey or be defiant.

I have told my daughter she needs to speak to his pediatrician about this, and she says she doesn’t want her son diagnosed with mental illness at three and a half years of age; we’re a little sensitive because my son was diagnosed with paranoid schizophrenia :( three years ago. My daughter has always had a very short fuse and anger issues. I don’t know why (other than a lot of mental illness in my family (my mother’s side) my only two children have these problems because they had an idyllic childhood with lots of love! Thank you.

A: As you already know, this is complicated. I understand your concern. I also understand your daughter’s reluctance to seek an evaluation. But early intervention is often the key to preventing a problem from becoming worse (and then more difficult to treat).

The place to start is with the daycare personnel. It’s striking to me that they don’t have the same difficulties. It may be that their approach to him is different from how he is handled at home. Talking with them very specifically about what they do when the little boy is aggressive could be very helpful.

If that isn’t helpful (or isn’t helpful enough), do encourage your daughter to talk to her pediatrician. A pediatrician would not likely diagnose a child with a mental illness. That is the role of a psychiatrist. It is more likely that the doctor will refer your daughter to an expert in children’s behaviors and parenting skills. It may be that she (and you) need to learn some new ways to deal with his outbursts in order to help him.

I wish you well.
Dr. Marie