Sam had a snappy dinosaur, which he used rather like a hobby horse, to bite people if they displeased him in any way. He also used it to pretend to eat the nurse doing his observations, but that was because he liked her, not because she was naughty. It looks a bit like a parrot there but it was supposed to be a T Rex.
Months after we came out of hospital, we were visiting my good friend Val. She saw what was happening. She suggested I praise good behaviour and have a generally positive atmosphere. She is a trained nanny of the old school (in a good way), and a very wise and kind person. I can remember thinking, there is nothing I can praise, they are always naughty! I racked my brains... "You put that sock on nicely" was the first one. I felt silly saying such things but I persevered, and it was a revelation. By the end of the day we had not had a single shout. It took months to repair the damage completely. I had to say how nicely he put his socks on for a long while, but it was a great relief to say something pleasant for a change! Of course we still had bad days but in general we didn't really look back.