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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What could cause disrespectful and rash behavior in a 5-year-old in school when the child is well-behaved at home?

Answered by
Dr.
Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3130 Questions

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Posted on Tue, 13 Aug 2019 in Child Health
Question: Good day,
Please I need help with regards to me kid, he's a boy and 5 yrs 6months of age. He behave well at home, play a lot with his 7 yrs old brother. Has a expressing himself he will talk in a way you cant hear him when talking to someone, but shout loud when playing.
He is in Pre-K and can read well and write. The complain he's disrespectful, yell at others at times, get angry when he can get his way through, curse others at times, hit and pushes classmate at times when he is angry.
He is not like this while at home, he plays a lot with his brother.
My question here is what could be wrong with him, and please any idea will be helpful to us.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 25 minutes later
Brief Answer:
Thoughts on this

Detailed Answer:
Hello and welcome,

It sounds as though the behavior issues are mostly when he is at school (pre-K) and not when he is at home.

You wrote a good history here, but getting an idea of what might be going on would require a more thorough evaluation with your son present. Have you talked about these problems with his own pediatrician or family doctor who has seen him in person?

I would just be guessing wildly based on the history without being able to talk with your son, observe him (such as how he talks when one on one and you can't hear him), and ask him about times he has gotten upset at Pre-K that make him want to yell, curse, and push. Is there another child there that is bothering him? Is the school environment stressful (I don't mean academically as it's apparent he is doing well if he can read and write.)

These are some ideas to start with. If the problems persist though, and his own doctor (not nurse practitioner or PA) aren't sure what is going on, the next step would be to take him to a child psychologist for evaluation.

I hope this gives you some ideas of how to pursue the problem.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 3 hours later
Thanks you Dr. XXXXXXX One thing I did not mention was also that he eat non food stuff at times, his brother said he saw him eating pain from the wall, the other time while in the toilet pooping, we discover there was this long piece of threat coming out, we had to pull it out gradually and it was about half a meter long. He will see something even though he know it's not edible, but he will put it in his mouth.

I was reading online and learn that this could be as a result of deficiency in Iron and zinc, or brain injury. So I don't known which direction to take. Any suggestion at this time will be helpful
I know I will definitely have to take him to his Dr, for some checkup.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
Thoughts on this

Detailed Answer:
Pica (eating non-food things) is sometimes associated with deficiencies of certain minerals but it is more commonly seen with kids who are on the autism spectrum or have other developmental disabilities.

When you take him in to be seen by his doctor, I recommend a complete blood count and as he has eaten some paint too, a lead level. Usually we wait to see if a person has a certain type of anemia before we check lead level, but as he was actually seen eating paint, unless you know for absolute sure that there is no lead in the paint, might as well get that tested at the same time so he doesn't have to be poked again later for a second blood draw. I would also get an iron study (blood test).
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 23 hours later
Thank you so much Dr. XXXXXXX I will take him to the hospital tomorrow morning.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 5 minutes later
Brief Answer:
I suggest taking him to his regular doctor.

Detailed Answer:
It would probably be better to take him to his primary doctor rather than the hospital ER. That way the doctor can evaluate him based on past observations as well as now, and follow his lab results after he orders them. For things like behavior in children, it is best if it is the same doctor he has seen in the past who can compare how things were before with now.

Good luck to you - I'm sure this is nerve wracking.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 22 minutes later
Dr. XXXXXXX you are right, we are very nervous and confused too. I called his primary care yesterday but was told the earliest open appointment date is in XXXXXXX I'm taking him a walk in and its still the same hospital though not the same location. I could not wait till XXXXXXX and I can't take him to the ER either.
Thanks for all you assistance.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 19 minutes later
Brief Answer:
Your welcome!

Detailed Answer:
Yes, then taking him to a walk-in clinic is reasonable to do - XXXXXXX would be a long time to wait.

Best regards,
Bonnie Berger-Durnbaugh, MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 9 minutes later
Thanks Dr.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 minutes later
Brief Answer:
Information

Detailed Answer:
Your welcome.

I want to let you know that whenever a patient writes back, we are required to respond. So while I am grateful to receive a thank you in return, I don't want you to be charged extra needlessly. So I'm responding - but if you don't have any further information you need, I'll assume you are saying thank you even if you don't write it!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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