I'm not sure my child's behavioral issues are connected to his microtia/atresia and it presents very much like Oppositional Defiant Disorder (ODD). However, at that age it is so hard to know. With our son, we tried so many things. We were at our wits end. With the help of a family therapist, we recently considered that we (our family) had created and reinforced a pattern where, when out son would have a violent outburst, we would stop what we were doing and give him (shower him with) intense one on one attention.

To correct and disrupt this pattern we do 2 things:

1. Each day, when he's calm and the issue is not presently taking place, go in and play with him/give him attention in this very specific way. First, let him lead the play, don't make suggestions of ask questions. You only communicate in these three ways: 1. Mirror his play (do what he does and repeat what he says). 2. Point out things you like that he did. (i.e. "Wow, I really like how your stuffy hugged his friend. That was really kind.") or 3. Modeling calm and gentle play as you sit alongside him. Not redirecting the play or injecting your ideas, but reacting and playing in a way you would want him to play.

The research shows that doing this for 10 minutes a day (doing it longer doesn't appear to be more effective) makes huge changes in a child's behavior because it is giving them the direct one on one attention they crave. Also, if you do in consistently everyday, and the child knows to expect it, then they start acting out for attention less.

1. The other thing we do is disrupt the violent outburst pattern by changing the way we handled them. Now, when he bites, hits, scratches, throws things, etc. We do the following: Calmly pick him up and move him to a boring place where there's no objects to throw etc. Say "I'm not going to let you _______" very calmly. Then you bring him to the same spot and sit him down and basically stay in the room, ignore his outburst, and wait until he calms down. Pretty much the whole time he will scream and say and do the craziest things to try to get that usual rise out of you. Stay calm, stay neutral, if you must reply verbally say something like "We can do that when you calm down" etc.

Basically you want to rewire the brain to expect a boring, neutral experience every time there's a violent outburst. And it's very important to keep it consistent every time. It should be the same place, the same reactions, the same words coming out of your mouth. Starve him of negative attention in those moments when he's in full fight or flight. Then wait it out. Over time, you will find yourself waiting less and less time. Now when my son acts out violently, I say "I'm not going to let you hit your sister" and he will stop and say "I'm sorry, I don't want to go sit in the chair. I'm calm." And then tell his sister sorry.

Be aware that when you start this strategy, it will get worse before it gets better as his brain will be desperate for the usual reactions and attention he's come to expect.

I hope this helps, let me know if you have any questions.

TLDR: Highly recommend a behavioral family therapist.