Lately I've become more and more concerned about behavior I've been witnessing from my nephew. The more time I spend with him, the less convinced I am of the diagnosis my sister keeps feeding me for his issues. I'm worried for her as well as my 2 year old niece. He's always had anger issues and we've done our best to work through them but the behavior had seemed to escalate. Recently it's become very apparent that the child has excellent control of his temper, he just chooses to let loose on the weakest adult in his mind, his mother. Just a few days ago his tantrum was so out of control he left her with cracked ribs and freaked out neighbors who could hear his swearing and screaming. The child is 11. Ontop of that though are other signs of problems. When he gets truely and uncontrolably angry his entire body will start to twitch as he attempts to hold back. Meetings with his teacher reveal that he has an almost aspergers like aversion to change causing him to lash out each day when their block schedual changes to a new class, a new subject, a new teacher. He's begun to act out against other students, scaring them with his odd behavior, strange noises, and almost seizure like body movements. When the teacher asked him why he would do that to them, he had no ready answer almost as if he didn't realize it was odd. He even refuses to befriend any of the children, even lying about their attempts to befriend him. But worst of all, and this is something that worries me the most, the child has absolutely no empathy. He just can't seem to understand anyone elses point of view and doesn't want to. He can't seem to grasp that others feel just like he does. The things that he says and does are sometimes just shocking. He's becoming increasingly more manipulative and the way he acts when he thinks he's alone is just scary yet when adults that he fears or respects are present, he's the most perfect angel you could ever meet.
I don't know how to even express these things to my sister. When I try to bring up that perhaps her child needs counciling it sends her into defense mode. I don't even know what it is she's actually dealing with. This definately isn't normal 11 year old behavior and it surpasses 'anger issues' by a few miles. I have no idea what to do for him or her. Has anyone delt with this in their own children? Is there a diagnosis or a way to work through this before he's too old? I don't want him to turn into a sociopath or for his anger outbursts to end up doing real unrepairable harm to his mom or his sister.