Thanks, everyone - I've set up an appointment with an MFT to discuss this through my work's EAP. I get up to three sessions, and we can identify an appropriate referral from there if we need it. My husband is able to go to the first session with me, so we can be on the same page in terms of understanding what's going on and how to work with our son on it.

I so appreciate all the support offered here - it's so validating to have people in my corner who can appreciate my concerns and help reassure me when I'm needing it. I also value the great advice here - KarenSue, I love the JUST AS GOOD thought, and Vertigo, I think People First will become a focus in our home...what an excellent idea! That underlies so much of what we try to teach & model for our kids; it's the perfect way to approach so many decisions about relationships, conflicts, etc.

I'm hoping our appointment goes well and we can get something helpful out of it. This MFT doesn't specialize in young children (none in our EAP system do), but at the least, she can provide me with a referral to someone who can evaluate him if needed. I need a starting point.

One positive is that I emailed his teacher & aide last night to give them a head's up about the negative self-talk particularly, and to see if they've noticed anything at school as well as keeping an eye out. They both replied, and neither has noticed any of these behaviors at school. I have a long relationship with the aide (she was the aide in my daughter's class for 3 years), and I trust both her and the teacher. It's a pretty nurturing school setting, so I'm glad to know that he's not having challenges in the classroom. I'm wondering is this is partially triggered by exhaustion - I'll keep an eye on the circumstances leading up to outbursts and see if there are other commonalities that we might be able to work with.