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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child faced physical and verbal abuse. Not coming to normal. Suggestion?

I am the Grandmother/Foster Parent for my three grandchildren. The Childrens Division removed them from my daughters home in November 2011 due to neglect, drug and alchol abuse and domestic violence. There are three parents involved all of which are not currently working the service plan set forth by the Childrens Division therefore the court has started the process of termination of parental rights and we have agreed to adopting all three. With that said the oldest child is my Grandson who is 9, he has lived with us off and on his entire life due to the parents chaotic lifestyle. He started having problems in preschool (living with my husband and I) easily distracted, inability to focus and stay on task and fidgety. Once in Kindergarten in the public school system the problems seemed to escalate and we were referred to a psycologist. My grandson did not have a good repoir with her and they're session were never uninterrupted always distractions. She performed some type of computer testing from which she determined he had ADHD and asked that the PCP prescribe retalin. After three days of pulling him literally off the ceiling we threw the script out and tried a more structured and timely scheduling. this seemed to help and then my daughter removed him from our home (we didn't have custody yet). He lived with them for about a year in a half and in this time we found out that the step father had been physically, mentally and verbally abusing him only him and not the other two children which were his biological children. Once they were placed in our custody we imediatley put the two older children in therapy. Both were diagnosed with PTSD, they began weekly, then biweekly, then monthly and after a little more than a year both were released. My grandson continued to have major issues in school still unable to focus, sit still, speak out of turn, keep his hands to himself and was bombing socially due to not respecting others space. Learning is also a major issue for him, we asked that the school test him and it was found that he is learning disabled in reading, math and has language issues. He has a querky way of speaking for example he will say "hey grandma you didn't know" instead of "grandma did you know" and if you say for example describe a bird home instead oa saying "nest" he will say "well really high up in a tree birds will carry all sorts of materials and start to put them together..." you see where this is going. Besides all of this he had an episode at school where he fabricated this huge story that children were bullying him on the playground and went into great detail. I was really upset and wrote his teacher a three page note sent it to school with him and he knew what the note contained he gave it to his teacher and she asked him who what when and where and when she asked who he pointed to a picture on her wall of a student that she had in the class 3 years prior and that he never would have had play time with him. This was very unlike him to lie and to this extreme so I put him back in therapy. This was toward the end of the school year he was very bummed tired of school etc.. Our therapist asked a colleague to perform a psyc evaluation and from the report we were given a diagnosis of axis I schizophreniform disorder.axis II borderline intellectual functioning axis V GAF = 51. We were then referred to a child psychiatrist who in turn perscribed the drug seroquel 25mg at bedtime. Now I have done some research and I have looked into not only schizophrenia in children but aspergers. I also believe that he is stimming, whenever he is watching something on Tv that is alot of action he will pace and flip a pencil or feather very rapidly he also does this if he is anxious or frustrated. He also can not watch anything on tv without repeating some lines and or acting parts of the scene out He is very vocal and at any time makes loud noises or shouts out. I also believe he is dyslexic and he does have an IEP at school. Heres where I am I either dont want to believe that he is scizophrenic but in my heart I really believe he has aspergers and I am very afraid of the drug that they are wanting me to give him. From the information I have read this is a very adult drug and very adult diagnosis however I know that there is something and he needs help. I am looking for direction. I really like his current therapist but I believe he is getting frustrated with me in regards to the drug therapy. We also have him participating in a social skills group for boys bi weekly and weekly sessions with the psychiatrist. Please give your thoughts as to our next step. Thanks for your time
Wed, 17 Jul 2013
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General & Family Physician 's  Response
Hi
Thanks for choosing HCM
There are multiple overlapping features in your grandson. Firstly he has Dyslexia and ADHD which is why he is hyperactive and fidgety. Continue that treatment. Some amount of attention seeking is there which is causing all the lying bahaviour. What you need to do is counsel him to bring out his positive traits, be supportive even of his mistakes. Make him realise he can do anything if he works for it. Aspergers is a very unlikely diagnosis. Schzophrenia on the other hand is a possible differential diagnosis. Keep a close watch on his behaviour. Ask him if he sees people or hears voices when no one is there. Is there any sudden behaviour change. What about his emotions ? is he expressing them normally? If these are in negative then schizophrenia is very unlikely.
Hope this helps you
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Child faced physical and verbal abuse. Not coming to normal. Suggestion?

Hi Thanks for choosing HCM There are multiple overlapping features in your grandson. Firstly he has Dyslexia and ADHD which is why he is hyperactive and fidgety. Continue that treatment. Some amount of attention seeking is there which is causing all the lying bahaviour. What you need to do is counsel him to bring out his positive traits, be supportive even of his mistakes. Make him realise he can do anything if he works for it. Aspergers is a very unlikely diagnosis. Schzophrenia on the other hand is a possible differential diagnosis. Keep a close watch on his behaviour. Ask him if he sees people or hears voices when no one is there. Is there any sudden behaviour change. What about his emotions ? is he expressing them normally? If these are in negative then schizophrenia is very unlikely. Hope this helps you