Dysmorphic features-Aggressive behavior-Anal Stimultion=

[got2kids]

We have done genetic testing, MRI,( not psych. yet,on waiting list ) to help find out what is up with my 4 yr ,old son.  Dysmorphic features, (wideset nasal bridge, lowset ears, almond shaped eyes?), aggressive behavior recent onset (last 1 yr.),  a regression of previously learned skills, fits of rage for almost an hour sometimes, and wont sleep at times.  The problem that I am dealing with right now is putting things in his rectum.  All the time.  If he is not being watched, he is rolling toilet paper, putting q-tips, marbles, magnets, balls, toys, whatever is avaliable in his behind, at school, home, where ever.   This has been going on for almost a year and he always poops it out.  He is embarrased by this and will not talk about it except to tell me what  object he used and he doen't always tell me.  He had 4 heart defects at birth and at 6 wks old stopped breathing.  Lots of allergies when he was little (we had him tested).  Retested at three , and he had grown out of a lot of them.  Has finally stopped having ear infections, pnuemonia, colds.  Been well physically.  Just lot of sleep problems, temper stuff, weird masterbation stuff (he has an errection when he is doing his anal stimulation), oh, and has been potty trained since 2 (day/night both) has been tee-teeing in his pants at school and once at home and once in bed.  Has been in the same daycare since he was 6 mos. and we changed to a preschool program in Sept. a lot of problems started after this..we changed schools again in May.  I am seeing an adult psych. (Biploar) am I the problem?  I'm stable on topamax/lamictal. Mixed episodes.  Can't get into the pedi psych here, they are over loaded..I need to know how to get this anal stimulation stuff to stop. Its very upseting to everyone who has to clean it, smell it, walk in on it, but it seems to be vey relaxing to him, he even breathes differently when I have walked in on these little episodes.  What is this. Normal?  Maybe a phase?

[Kevin Kennedy, Ph.D.]

Probably the only way to avert this in the short run is to directly supervise him at all times when it is feasible. There is no clever technique to this. You get in the way of the behavior.

[Kevin Kennedy, Ph.D.]

No, the behavior is neither normal nor a phase. There are indications your son displays a serious pervasive developmental disorder, likely in the context of some other genetic condition. The situation certainly invites broad-reaching evaluation, including a developmental evaluation, endocrine studies, etc. You should continue with efforts to include pediatric psychiatry in the evaluation, though this may not turn out to be the most critical component of the evaluation.

[got2kids]

Thank you for your reply.  

[got2kids]

Thank you for your reply.  We are scheduled for an endocrinology eval.  Our genetic labs had to be completed first.  I wish I could get I straight answer from our pediatrician.  The geneticist ruled out fragile X, tubular sclerosis (although he has had ash leaf spots since 3mos. of age) MRI normal, and a variety of other things genetic disorders .  I am not sure what endocrine disorders they would be looking for.  He is off the charts for height and weight.  57lbs. and 48 inches tall dob 12-18-03.  Was very bright and mature until sept. of this yr. How do I get him to stop putting things in his behind?  I am constantly cleaning poop and it is such a mess and my older son and I have a real OCD problem E -coli and all. We are going crazy. Any ideas?