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My daughter was 5 when we started moving toward diagnosis. And for awhile she had totally out-of-character fits of rage: throwing toys, slamming her bedroom door, etc. There were many things we could have chalked it up to, new baby brother, new school, growth spurt, whatever. What it turned out to be, however, was totally something we should have seen coming, because her dad has it too. FOOD SENSITIVITIES.
I would very strongly urge you to get your son tested for food sensitivities. People with ADHD and/or autism spectrum diagnoses tend to be more likely to also have food sensitivities the effects of which are behavioral in nature.
My husband is sensitive to eggs, and our daughter is sensitive to eggs and dairy. The effects are not at all like an allergic reaction. For my husband, who is a very easy-going, non-confrontational personality, he becomes grumpy, short-tempered, and eventually will slump over and fall asleep. He says he is actually aware of his surroundings when “asleep”, but he can’t totally wake himself up. For my daughter, dairy made her impulsivity ratchet way up into high gear, and it also made her more likely to experience frustration and rage, inconsistent with her personality.
When we were testing/discovering this, we had to pay out of pocket, because the gut-brain connection was still not very well understood, and allergists did not believe in this (something we still have to educate them about sometimes). Now there are insurance-covered tests you can ask for at your pediatrician visit. Again, I’d urge you to give it a try. Once you identify the culprit food, the difference to the person is remarkable.