Early intervention, occupational therapy, child psychology: help, my head is spinning!

We have an extremely strong-willed, big emotions, boundary-testing 2 1/2 year old. She has been this way from the get-go ~ every. single.thing. is and has been a struggle with her, despite our attempts to "choose our battles." There are times when it seems that she looks around for some source of provocation, that there is something deep-seated that is causing her discontent, and that no matter our approach or our embrace, she has been born to this life of struggle. But that is the dire and pessimistic side of me talking; she can also exhibit great joy and positive energy, is exceptionally bright and capable, but it is all so overshadowed by the "negative intensity" as one child psychologist termed it.

At this point, we have tried many approaches and modalities to assist her (acupuncture, dietary interventions/food sensitivities and allergies, homeopathy, herbs). None have really made a dent, and our family dynamic has been overwhelmingly overshadowed and dampened, really, by her presence. We love her and want to help guide her through the tantrums, the anguish, and the overall dissatisfaction that has characterized her existence thus far, but we are at a crossroads.

The following have been suggested to us: "early intervention" by the likes of Children's Hospital or another entity; play therapy; occupational therapy (though this seems more suited to those with sensory integration issues, and this does not really appear to be the case with our daughter); parent child interaction therapy; a small home-based daycare with a supportive and warm caregiver; family therapy. We feel overwhelmed by the process of selecting one of these approaches and finding an appropriate and effective practitioner, and daunted by the time and expense that might take. I am looking both for general counsel from those who have "been there" and specific recommendations and/or names of professionals who might be able to assist us.

Thank you!

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I would make an appointment with the best child psychologist that my insurance could afford and start to dig in.  From personal experience with a cousin, I really sympathize with you and I am wishing your family recovery. It can be so overwhelming. 

Your daughter may or may not qualify for Early Intervention services; she will need to be assessed and determined to have developmental delays, or some other qualifying criteria. It’s not just a “choice” on your parts. I’d get her assessed to see if she qualifies for EI; even if she does, it’s not a full-time program (or, was not when our daughter received those services). So if she needs daycare, you’ll be choosingthat separately. Back in the day, Bananas had a program for “spirited children”; our daughter is a college student now so I’m not even sure if that’s the terminiology used anymore. As it turns out, our little one has ADHD; it’s likely too early to have that assessed, but I’d keep it in mind once she begins school. If you suspect she might, an earlier diagnosis is helpful. If the school won’t test her (even though they should...), have her doctor or a specialist do the test for that. Best of luck. Oh, and Early Intervention services are free. 

I'd suggest you run, not walk, to your local Regional Center- tel. 510-618-6100 - and get a (free) assessment and get EI if they are still able to offer it at her age. It's a free and comprehensive program that will wrap around whatever other service or setting she is receiving. 

Best Wishes,

 Hi there! It sounds like you have your hands full! I’ve been there and know how you feel. I would suggest that you do two things to try to lock down what is best for your wonderful daughter. First off, contact the Regional Center Of The East Bay. They will do and evaluation and see if their early intervention services would be of benefit for your daughter. Second,  find a good developmental & behavioral pediatrician. This doctor will be your resource guide to help you with your daughter’s care. Although a nurturing home care center sounds really lovely, typically they don’t have the skills and resources needed to best suit a child who pushes a lot of boundaries. Please feel free to contact me if you would like to talk.

We have a very strong-willed 6 year old and he has been that way ever since he was born.  Our daycare director summed it up perfectly when she said there were three words to describe our child - he is extremely social, physical and impulsive.  We have tried a number of things as well including sacro-cranial therapy, OT, etc. you name it.  What helped me the most was a positive parenting class I took with Wellspring Educational Services in Walnut Creek.  (http://www.wellspringeducation.org/behavior-management-course/).  Part of the class involves taking video of your child's tricky moments and Robin Hague helped me figure out ways to deal with the situation.  She also pointed out triggers or things in the environment that may be causing the behavior.  She teaches from the perspective that a child is not purposely misbehaving but that there's something either physically or internally that they're struggling with that is causing them to behave that way.  And so she provides you with a toolkit with the premise that you can figure out which tools work best for you as every child is different.  I won't lie and say everything is perfect now but I feel like I'm more capable of handling these situations and am not as stressed about them as I once was.  

You might try talking with Summit Center in Walnut Creek.  They specialize in gifted kids and have plenty of experience helping gifted kids with their other exceptionalities.  

Occupational Therapy will help your daughter regulate her impulses. She may need help sorting out her response to stimuli. She may enjoy play-acting where she can be dramatic. Please do not consider using drugs on such a young child! My son had sensory and impulse issues until 3rd grade. OT helped him with self-regulation. But I also have to tell you that there is nothing like maturity for an over-active toddler nervous system! Give it time. We always had a more peaceful day when my son was allowed enough physical activity to be tired in the evening. My son is now 13 and has none of these issues and also did not get a damaged nervous system from drugs. And the plus side is the intelligence and strong will has turned into a positive character trait. I know you are exhausted, but it will pass. Hang in there and let her moods rule for another 6 months. She will change!


I feel you. We too have a very energetic, strong-willed, big emotions, live in the extremes type of kid. Our son is almost 4 and his twos and threes brought a whole new dimention of “terrible” into our family dynamics. We also have an older son who despite being very energetic too never has been anywhere near this. I know how incredibly frustrating this is.

Know that we’re not alone. Many parents struggle with kids with this type of energetic personality. And most of us blame ourselves because many regular parenting advices just don’t work for our kids. Time outs or taking away favorite toys for example don’t work on my little one at all.

I think the first thing you might want to find out is whether she has problems focussing. If yes, her temperament or attention skills might be in her way of optimal development. That’s something where professional help might be really helpful.

With our son I noticed that he is very well capable of focusing on puzzles, drawing, or looking at books for a much longer time than his brother was at that age. In fact, he’s capable of listening to classical music without moving for more than one hour. Afterwards he remembers the music and sings it (but he does it so loud that nobody can enjoy it).

I can’t give you THE advice but I can speak about a couple Aha moments that I had with my little one:

My first step was accepting that this is the way he is. This doesn’t mean that we give up on teaching them to find better ways of interacting and behaving. It’s about accepting their personality. Those expectations how they should have been have more to do with us than with them. This acceptance gave me a break with my self-guilt. It also allowed me focussing on his strengths: He’s incredibly persistant (also in a good way), creative, full of energy, and cognitively ahead of his peers. 

Second, try to frame her personality in a positive way. What really helped me was the book “How to raise your spirited child”. In the beginning of the book the author says: “Spirited children are normal. But they are more.” All 2 and 3 year old have tantrums. The difficulty is the intensity of the tantrum. Same goes for what you described with your girl: It’s normal for her age to try out to get negative attention from you. However, the problem is the intensity and her persistence (I assume). 

Persistence, energy, striving for independence and knowing what you want (or not) are actually great skills to have for an adult. The question is: How do we teach them to use these skills in a positive and constructive manner? They’re toddlers, they don’t have the skills yet to do that. It’s easier to use them in a destructive way. The worst would be labeling them as “the difficult child” and encouraging them to stay in this role.

I think the book about spirited children shows many great ways how deal with this. If you feel you need more help than just a book I would try to look out for professionals that have a more positive way of looking at your daughter. I’m sure she’s an awesome little personality and people will admire her for the way she is when she’s grown up!

Good luck!


From my experience, you need a diagnosis which will then hook you up with all these services.  I suggest getting in touch with your pediatrician.

Good luck.


I can very much relate to your post. We have 2 girls (7 and 3 years old). The youngest one sounds like your 2 year old.  She dominated our family life and terrorized us all. She is super engergeic, intense, grabby, squirmy, and loud and really enjoys taking things apart.  My husband and I are both physicians and we realized the importance of early intervention. We read as many books as we could find to deal with her behavior and tried various techniques, got her assessed by the public school district, Kaiser developmental pediatrician, speech and hearing testing. She is only three but she was much harder than our first child so I was convinced there was something wrong with her.  Finally a friend suggested a parenting coach which is something I didn’t even realize existed. I did some research and found Rebeccah Freeling. 

Rebeccah has been life saving for us. We are still in the middle of her her 12 session program but it has already made a big improvement for our family. She comes to your home and meets with you and your kids. She also has meetings in her office where we figure out solutions to our individualized problems. She works with you and your unique situation without being judgmental. She really enjoys these challenging children and knows how to handle them and gives you techniques to deal with every type of situation. So far we have corrected listening to us when we speak, Cleaning up dish plates after meals, our bedtime routine (it was too long and out of control), fights between siblings over toys and shared space, not destroying our property, and grabbing. She has many years of experience as a teacher and a parenting coach and I give her my highest recommendation. She is amazing and I’m so greatful for what she has done for our family. Life seems much more manageable now!

Feel free to email me andreaxdurant [at] gmail.com if you have any questions. happy to talk more  

here is her info:

Rebecah Freeling
Wits' End Parenting
rebecah [at] witsendparenting.com
telephone(614) 769-3563

I adopted my daughter when she was 6 years old, so my parenting does not encompass your experience, but I thought I'd weigh in on the value of an occupational therapy evaluation since it's been suggested to you. Occupational therapy addresses more than sensory integration. It assesses reflexes, sensory systems, visual processing, and motor skills to identify deviations from normal development. Subtle deviations in the vestibular and other foundational neural pathways that few other disciplines notice have a lot of significance in the realm of occupational therapy. Your daughter may be unhappy because of what she's experiencing in her body and negativity is her only way to express it. I would rule out any possible physical challenges that might underly her behavior before exploring psychological resources. Rita Montez and her colleagues at Full Circle Development in Oakland are very skilled. They're not going to recommend occupational therapy if their assessments don't reveal a need for it, and may have good ideas for next steps. Our family greatly benefited from their services and people they recommended to us.  

I strongly recommend Anne Honigman's work. Her practice (Berkeley 510-843-5700) is focused on kids. She does cranio-sacral work that helps the brain better organize inputs, coordination, and neutral pathways. We experienced her work with our daughter who was just dissatisfied and upset about almost everything! It was a very challenging time. The result of every session was like night and day compared to when we walked into the office. Our daughter definitely took to it.

The sessions look like head and body massage. Gentle touch. Anne doesn't force anything, let's the child guide her. We did a course of sessions that ended up being a few weeks in all. It worked wonders for our family. My daughter is not a different kid... But she is definitely the happier, calmer version of herself.

Just wanted to say that I am a couple years ahead of you with my second child and can commiserate. I wouldn't say that we're out of the woods but things have improved and the number one thing that has helped us so far is preschool. We have tried both a small, home-based preschool AND, now, a larger play-based school and both have been successful. The teachers have all loved him and he has had zero problems. Honestly, I think the structure, and activity help. I think he might be quite intelligent and the combination of developmentally appropriate activity and play with kids his age are exactly what he needs. I am so grateful that school can provide him with the positive feedback he needs to boost his self-esteem, since home life and his lean towards competing with his older sibling seem so trying for him. 

Prior to this I had really been searching for what was wrong, attempting to preserve my own sanity, and doing my utter best to support him and was constantly feeling like a failure. At this point it seems that he is not on the spectrum, he may or may not have add (though no signs thus far), but he is DEFINITELY "spirited" and difficult.

I was not fond of the child therapists we tried. Frankly, they seemed aimless. The spirited child class through Bananas with Rebeccah Freeling helped and I have decided that if we continue to struggle, getting one-on-one help with her will be our next step.