Expert: Christine D. DeLoatch, MA CCC-SLP - 10/31/2008

Question
ok so we live in Massachusetts my boyfriend his son, trey, and i.now treys mother did cocaine during her pregnancy so we think that might have something to do with treys problems. i feel like i should list them for you. he hits, he spits, he bites, he screams, he wont use the potty most of the time he'd rather go in his diaper, he stays up till AM, he wont listen to anything we tell him to do, if we try to pick him up and make him do something he runs away laughing, he thinks everything is a game and and basically i don't know what to do anymore. the other day he just took off while i was at work and my boyfriend was in the bathroom to his little friends apartment. I've started implementing time outs that worked for a little while now he thinks they are so funny and he just tries to get out of them running around the whole time laughing. doesn't care if i use a stern or angry voice telling him he need stop do something he just says no and laughs if i try to make him do it. i honestly don't know what to do with him any more he is 4 years old and acting like this i mean right now its almost midnight and he is up in his room watching tom and Jerry playing and if i go in there to turn the light off and make him go to bed hell run right out here screaming and laughing like its a game i honestly don't know what to do. i never thought that a kid could act like that i know that i would never have acted like that to my parents. and I've helped raise my sisters and they wouldn't do that either. I'm just at my wits end, I've tried every parenting technique that i know counting to 3, he counts with me, time out, getting out and running away is his game,taking away toys, he just steals them back when I'm not looking or convinces his father to give them back to him because he knows that his father just feels bad that he had a junkie mother so he tries to make him happy. he is just so hyper all the time it just is way above normal... he doesn't share with other kids and he fights with them too... climbs on the counter and jumps off just does everything bad he can his favorite is to throw things at me and laugh when i get mad i try to ignore it but you can only get pelted in the face so many times before you've had enough i don't know what else to do please help anything???

Answer
Dear Katrina,

Thanks for asking me your question. There are many concerns regarding this child.  First of all he has not met some of his developmental milestones - for potty training, for socialization and for emotional skills.  He also has problems regarding safety.  These behaviors need to be addressed as soon as possible.  

You are correct in suspecting a causal link between the mother's cocaine use during pregnancy - often hyperactivity is associated with that.  

Depending on what type of insurance helps cover costs for little Trey, will depend on the best and fastest treatment.

If Trey is covered by Medicaid only, then you may simple want to address these issues with a child psychologist.  The same is true if he is covered by a different type of medical insurance and you can afford the co-pay or deductible.  This is often the fastest option.

The other option if he does not have coverage, is to have his Dad go to your local school system and state that he would like him evaluated for special needs.  Put it in writing (a letter) and talk to the Resource teacher at the school.  Usually they have 90 days to do the evaluations and decide if he qualifies for services.  Some children can go into some special behavioral needs classes to work on these types of behaviors.

You also may be able to call your county health department and see if they have a program called Child Service Coordination - or a program where they seek to help at-risk children usually up to the age of 5.  

They may be able to send out someone to observe him and to coordinate other appointments or refer him on for school testing.

It will be a long process but well worth it.

He needs to be evaluated medically, and for sensory problems with an occupational therapist and with a psychologist or psychiatrist.  

I hope I have been helpful in pointing the way.

Many Blessings to you.  

Christine