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Bipolar Disorder (Children and Adolescents)

Dealing with Behavior Issues

04/27/2004

Question:

My neice is 4 years old. I am very close to her and her older sister, and I am worried. To be as brief as possible, I will give you a short background. My 4 year old neice has had a behavior problem for a couple of years, if not longer. We always said it`s because she is the baby of her family and her parents baby her, and let her get away with too much. Or that she is not being diciplined, and so on. She does not listen, she is completely mean to other children, (spitting and hitting). She can be so sweet and loving one minute, and just the complete opposite the next. She also is not developing her speech as she should. She cannot hold a conversation. She can say most words, but when you try to talk to her she goes off into garble type talk. Doesn`t make sense, and you cannot understand her. The reason for my worry, is that recently she had an episode where her sister was playing the piano, and was not listening to her younger sister, and that made her mad. She proceeded to get a knife from the kitchen and swung her arm back, and then lunged it forward to stab her sister in the back. There happened to be a friend right there that stopped her literaly in the nick of time. She has been telling friends of hers that she is going to kill them, and has stripped naked in front of these 2 young boys that are her friends, and touched herself and then tried to touch them with the hand that she touched her "private area" with. There has just been some unusual behavior lately that has scared us all, but her mother is so sensitive about it all, that it makes it difficult to even talk to her about the 4 year olds problems. Does this type of behavior seem like a reason for concern, or is it just a child that has bad behavior? Thanks for your insight.

Answer:

The behavior you described is not typical behavior for a four-year-old. Rather than seeing it as "bad behavior," I would think of it as behavior that has great potential to hurt others and the child herself. So, yes, this behavior is a reason for concern.

You obviously care a great deal for this child and are concerned about her and others` future welfare, so I encourage you to share this with her mother in that context (i.e., you don`t want anyone to get hurt). These types of behavior don`t typically go away on their own accord and need intervention of some type before someone gets seriously hurt. Additionally, these behaviors may be a sign of some other serious problem that needs addressing. At the least, I would encourage mom to talk to a mental health professional who specializes in childhood mental health problems. I hope that is helpful.

Best wishes.

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Response by:

Mary A Fristad, PhD, ABPP Mary A Fristad, PhD, ABPP
Professor of Psychiatry and Psychology
College of Medicine
The Ohio State University

Nicholas   Lofthouse, PhD Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University