This post is part of a series where our team of child mental health professionals answer real questions submitted by readers like you. It deals with subjects related to ADHD and aggression. Please take care when reading.

We recently received a question from a parent wondering why their child was experiencing angry outbursts. Here’s the question, and a response from our team of child mental and behavioral health professionals:

“For the past year and a half, my child’s behavior has become increasingly concerning. We’re having to constantly remind him to do things. He seems lazy, and has angry outbursts. Two years ago, he tested negative for ADHD. I believe it’s strictly a behavioral problem, and we need behavioral therapy.

Can you offer any pointers or ideas for what we can do?”

- Anonymous

Thank you for your question. I am sorry things are difficult right now, and I am glad you had your son formally assessed.

It would be important to know your son’s age. Depending on when he was evaluated, certain behaviors or symptoms may have been more emphasized or prioritized, as they can be developmentally appropriate depending on age. The behavior you describe, “needing constant reminders, laziness, and angry outbursts” is generally consistent with ADHD, but these symptoms are also common in other mood challenges, or even in normal behavior, especially if your son is a teenager.

If you believe your son’s difficulties are due to a behavioral problem, then two things become important:

1. What is driving the behavior?

2. What is maintaining it?

You need to observe his behavior to ascertain if his ignoring, laziness, and angry outbursts are an attempt to avoid something undesirable (e.g., chores) or an attempt to obtain something desirable (e.g., attention), keeping in mind that sometimes it can be a combination of the two. It is also important to note that behavior does not exist in a vacuum.

There are reasons why his behavior persists—it is working for him at some level. Part of a behavioral therapy intervention will be to identify what factors contribute to the maintenance of his behavior.

I would recommend starting with some behavioral interventions to see if your hunch is right. Working with a child specialist, you will gain additional information regarding your son’s behavior, and they can also provide an opinion about an ADHD diagnosis. If this is not helpful, another evaluation with a more comprehensive scope may be warranted.

Please note that Little Otter could be a great resource for you. We offer parent coaching, which could support the implementation of behavioral interventions, and we also provide referrals for further assessment as necessary.

Additional Resources

• All about ADHD

• “How Can I Respond to My 7-Year-Old’s Temper Tantrums?”

• “How Can I Help My 9-Year-Old Deal with Anxiety and Aggression?”

• 5 Tips to Help Your Child Deal with Back to School Anxiety During COVID-19

• Back-to-School Mental Health Toolkit

Do you have a question you’d like to ask a child psychologist?

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