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What Causes Persistent Hallucinations In An Autistic Child?

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Posted on Wed, 9 Dec 2015
Question: This is related to the earlier question answered by Dr. Seikhoo Bishnoi.Child Psychiatrist .My son XXXXXXX who is 11 years of age who is Autistic and currently suffering from very frequent urine and stool sensation at every 10 to 15 minutes also has a fear of dogs . He keeps asking often of a imaginary dog he feels is at home . He is extremely afraid . When he was a child of 3 years he had a dog chase him which fear still remains in him . (Has this Autistic symptoms started due to this ? Because these symptoms also started roughly at the same time . I will like some child Psychiatrist to address this issue . Preferably Dr. Seikhoo Bishnoi.
The earlier question and answer is attached for perusal .
Regards XXXXXXX
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EARLIER QUESTION AND ANSWER
Hi My son XXXXXXX 11 yrs old who is autistic is having a problem of going to the toilet for passing urine or stools every 5 to 10 minutes . This started 2 months Back where the intervals was every half hour now it is 5 to 10 minutes . We took his urine routine test



Only puss is showing little high . We are giving anti biotic last 5 days . No changes it has only got worse . We met a urologist .who says if he is not going at night should be psychological . Can you help ?
Asked by Me , 16 hours ago
Doctor's reply to your question above...
Brief Answer:
Psychological stressor could be the cause

Detailed Answer:
Hi, thanks for asking from HCM for your health related doubts
I can understand your concern. Poor bladder and bowel control in a child of autism can occur due to a number of reasons. Poor motor control or urological causes are common possibilities but as you already consulted urologist and nothing found so we are left with psychological causes.

In a child of autism underlying psychological stress is one of main factor for abnormal behaviour. Some children experience stress due to inability to cope with normal children and they are also being ridiculed by other children. All these things increase stress and the child might pass spontaneously. Try to find out any psychological stress in him and if there is any significant cause then try to remove it.
Other possibility is some compulsive behaviour coupled with poor toilet training. A lot of children suffering from autism have associated mental retardation and this cause poor learning and lack of toilet training. Some times the child might develop compulsive, repetitive behaviour which might result in passing of stools and urine in compulsive basis. A proper psychological evaluation might help to find out the exact cause of this problem.

Low dose antipsychotics especially Risperidone along with proper reassurance and toilet training with effort will help to improve the situation. So please consult a psychiatrist for his evaluation.

Pus might occur due to some minor urinary infection but this can't cause spontaneous passing of stools and urine.

Thanks, I hope this is helpful for you. Please don't hesitate to ask again for more doubts.

Take care
Replied by Dr. Seikhoo Bishnoi , 15 hours ago
doctor
Answered by Dr. Alexander H. Sheppe (32 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Thank you very much for your premium question.

I have reviewed your earlier questions and I have a good understanding of your son's situation.

First, I'd like some more information. When and how was your son diagnosed with autism? Was there any intellectual disability diagnosed? Has your son undergone neuropsychological testing? It seems to me that in addition to autism, he may have intellectual disabilities, or a primary psychotic disorder given his concerns about the dog.

If your son has not had intellectual or neuropsychological testing, this is the first thing that should be done. If this testing shows any evidence of intellectual disability, he needs cognitive behavioral therapy to work through his behaviors and hopefully help him be less afraid, as well as to toilet properly. As you say, his medical workup has been reassuring, so this is a psychiatric issue that can be treated with ongoing therapy. However, I would recheck a lead level, as coriander does not treat lead poisoning, only intravenous chelation therapy.

I think there may also be a psychotic or at the very least a significant behavioral problem here stemming from this dog attack. A medication that can help with both of these is risperidone, an atypical neuroleptic that is often used in the United States for these issues. Alternative medications include olanzapine or quetiapine.

Please get back to me with the additional requested information.

In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (http://health.usnews.com/best-hospitals/rankings/psychiatry). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Alexander H. Sheppe (38 minutes later)
XXXXXXX has not had intellectual disability diagnosed and neither the neuropsychological testing . I will arrange to have these tests and revert back to you . XXXXXXX was diagnosed for Autism when he was 4 years of age when he had a wandering mind and was suffering from Adenoids growth and we thought the mind wandering and inattention was due to the Adenoids . He found it difficult to sit still in the class room at that time .
Best Regards XXXXXXX
doctor
Answered by Dr. Alexander H. Sheppe (4 minutes later)
Brief Answer:
Followup

Detailed Answer:
Excellent. The results of these tests will be very important. They will tell us if he indeed has autism, intellectual disability, or something else entirely. Consider having him evaluated for use of risperidone while awaiting the results of the testing. I look forward from hearing from you when the testing is complete.

Please remember to rate and close this thread.

In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (http://yyyyyy.yyyyyyyyyyyyy.com/yyyyyyyy-hospitals/yyyyyyyyyyyy/yyyyyyyyyyyy). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Persistent Hallucinations In An Autistic Child?

Brief Answer: Consultation Detailed Answer: Thank you very much for your premium question. I have reviewed your earlier questions and I have a good understanding of your son's situation. First, I'd like some more information. When and how was your son diagnosed with autism? Was there any intellectual disability diagnosed? Has your son undergone neuropsychological testing? It seems to me that in addition to autism, he may have intellectual disabilities, or a primary psychotic disorder given his concerns about the dog. If your son has not had intellectual or neuropsychological testing, this is the first thing that should be done. If this testing shows any evidence of intellectual disability, he needs cognitive behavioral therapy to work through his behaviors and hopefully help him be less afraid, as well as to toilet properly. As you say, his medical workup has been reassuring, so this is a psychiatric issue that can be treated with ongoing therapy. However, I would recheck a lead level, as coriander does not treat lead poisoning, only intravenous chelation therapy. I think there may also be a psychotic or at the very least a significant behavioral problem here stemming from this dog attack. A medication that can help with both of these is risperidone, an atypical neuroleptic that is often used in the United States for these issues. Alternative medications include olanzapine or quetiapine. Please get back to me with the additional requested information. In the future, for continuity of care, I encourage you to reach out to me at my direct link below. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (http://health.usnews.com/best-hospitals/rankings/psychiatry). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers