Doc Smo: Welcome to another edition of Portable, Practical, Pediatrics. I’m your host, Dr. Paul Smolen, also known as Doc Smo. We are very fortunate today to have a returning guest and psychologist extraordinaire, Dr. John Simpson, a clinical psychologist with over 30 years of experience and accumulated wisdom. Today, Dr. Simpson is going to talk about troubling childhood behaviors. Welcome Dr. John Simpson.
Interview with Dr. Simpson
Doc Smo: Question 1. Dr. Simpson, you have been practicing psychology since Moses brought down the tablets, seeing children with minor behavior difficulties all the way to severe behavior disturbance– that turned out to be real mental illness. What behaviors do you see in children that really get you worried about serious mental illness and which are just normal disturbances in behavior?
Dr. Simpson: Divide unusual behavior into two broad groups, what I call “Change in Function” behaviors and “Deal Breaker Behaviors”. Explain the difference.
-Cruelty to animals
-Fire setting for thrill. Especially worrisome if there is no remorse.
-Chronic pattern of lying?
-Older child unable to take responsibility
These behaviors often portend mental illness is evolving. Doesn’t come out of a vacuum. My radar is up for abuse/neglect/genetics that put child at risk.
Doc Smo: Can you give us an example of how a psychologist can help with these situations?
Seems like all the “Deal Breaker” behaviors are directed at hurting others. Why do these children want to hurt others children, animals, and adults? Is anger at the core of these behaviors?
Doc Smo: Q 2: What are your top “Deal Breaker” behaviors that you see frequently and do you see differences in “Deal breakers” behaviors between girls as well as boys?
Dr. Simpson: Answer
Doc Smo: can tell some stories of children whom he has seen:
-10 year old boy who lit glove on fire–severe psych disturbance as a teen
-13 year old boy who was playing with BB gun and shot himself in the leg… Lied about it until X-ray
-A few patients who were stealing even though their families had plenty of money
After seeing a lot of behavior disturbance play out over decades, I fee that the ultimate outcome depends on whether there is stability around the child. Some anchor to come back to. Children who have a strong family that is stable; well they are very very lucky. Many times the child with the behavior problem gets past the behavior issue if they have some structure and stability to fall back on.
Dr. Simpson comment:
Doc Smo: Question 2: What behavior do you put in your “Change of Function” category and what does this indicate?
Dr. Simpson: Behaviors I see often in this category are things like regression in the child’s ability to separate at bedtime, a child who starts having bowel or bladder accidents after they have been trained, refusing to dress themselves or brush their teeth after they had mastered these skills, and unprovoked emotionality. Indicators of stress, either external or internal.
Doc Smo: What kind of stress can a three year old have???
Doc Smo: Unfortunately, I make a living in this category. Sleep problems, stomachaches, chronic constipation, and oppositional behavior. Tell story of child who develops sleep separation difficulties; either stress or an emerging anxiety problem. Often find a drinking problems, impending move, parental mental illness etc.
Doc Smo: How do you turn these situations around?
Dr. Simpson answer:
Well, I think we need to stop here today Dr. Simpson. I love making these pedcasts with you and listening to your insights and humor. Please promise me you will come back again soon.
To hear Dr. Simpson talk about a host of childhood psychological topics, check out my blog at www.docsmo.com. And while you are there, make sure you subscribe so you will get an email notice of each and every new post. You don’t want to miss any Portable Practical Pediatrics. This is Doc Smo, reminding you that when your little one starts to yelp, maybe it’s time to get a little help? Until next time.