8 year old soils himself, has trouble with anger

Hello,

I am writing on behalf of a friend, so I hope the details I know are sufficient.

She has been separated from her ex husband (the father of the child) for 4 years and they have not been living together for about 2. It is unclear whether this situation directly affected her 8 year old son's behavior problems but it is assumed to have had some impact.

First, the positives; the child is very outgoing, he performs well scholastically, he exhibits extraordinary memory skills, he is very athletic and excels at all sports he plays.

He has two very distinct behavioral problems right now. First, he will soil himself during the evening/nighttime hours 4-5 times during the week. It can be either urinating or a bowel movement. He seems to be rather indifferent about this, and the fact that he never does this at school has at least initially indicated that he may have at least limited control over himself. He seems to only soil himself when he's home, at his grandparents, or other "comfortable" environments. He claims he simply can't tell when passing gas might result in "something more" but when he soils himself it is most often at least half of a full evacuation if not more.

Secondly, when confronted with extreme frustration or discipline, he will get angry. He will hit himself in the head with objects such as books, pillows, the wall, or anything around him and need to by physically restrained to the point he becomes too exhausted to continue protesting.  But it is not hard enough to cause bleeding or anything.

He has undergone limited evaluation and is set to undergo some further neurological evaluation, but we're also proactively looking for advice wherever we can. I say "we" because since the mother and I spend a good amount of time together, she has asked if I might help as I am probably the closest male influence her son currently has.

Thank you for your time.

[Kevin Kennedy, Ph.D.]

The behavior does invite evaluation. I will be surprised if the neurological evaluation yields anything that is problematic in nature. An evaluation with a child psychologist or child psychiatrist should also be arranged. It is likely that both problems you outline can be remediated through a systematic program of behavior management, but a thorough evaluation is required  before this can be certain. Do you happen to know why the neurological evaluation was recommended? Is an EEG part of the evaluation?

[TootsMcGee]

I do not know why the neurological evaluation was recommended, I can find that out.  She does not know what tests are part of the evaluation.  Do you have any recommendations based on your experience?

[Kevin Kennedy, Ph.D.]

Generally an office neurological examination precedes an EEG. The neurologist may recommend an EEG is he/she suspects it might be useful, or it might be performed to rule out any problem even if there is no suspicion of a particular problem.