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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33920
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My 4 almost five year old can't stay still for more than one

Customer Question

My 4 almost five year old can't stay still for more than one second. Something on his body has to move. The body part that ends up moving the most is his eyes. Almost like a nystagmus. He will stretch his face to open eyes wider during conversation. He is very active and walks away when someone is talking to him for more than 10 seconds. He uses fleeting eye contact when I talk to him but will use full eye contact when he talks to you. When asked to look at you or look at a bright light he always shuts his right eye. He's social, but behind in receptive and expressive speech. He can be willful. Early intervention through the city and school denied him back he didn't meet any criteria. I get him speech out of pocket. Concerned with a neurological issue, Tourette's, or Defiant ADHD. What is your take on this?
Submitted: 9 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 9 months ago.

Hello,
I am Dr. Arun and will be helping you today.

Since how long have you been noticing this?

What did his pediatrician say?

Customer: replied 9 months ago.
Since he's been 3. Pediatrician stated that he has a behavioral issue and referred me to Tri-county early intervention. They only diagnosed with speech delay.
Customer: replied 9 months ago.
She is pretty good and diagnosed my older son with Aspergers when he was young. However, now my older son is typical and diagnosis has been taken out of current status.
Customer: replied 9 months ago.
Any insight?
Expert:  Dr. Arun Phophalia replied 9 months ago.

Thanks for the further information.

This can be ADHD. But many times these kind of behavior does not fell in a typical diagnosis and all his mild behavioral abnormalities may resolve gradually when he grows. Still your concern is important as you watch more than anybody. Thus I would suggest following (before starting nay medications);

1) Consultation with behavioral developmental pediatrician.

2) Behavioral modification therapy, done by psychotherapist.

3) Periodic feedback about the child's school performance through the use of standardized scales, narrative descriptions, and telephone follow-up by teachers.

These will help in regular assessment for revision of the diagnosis and if there is any need of medications.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 9 months ago.
Thank you very much
Expert:  Dr. Arun Phophalia replied 9 months ago.

You are very welcome.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 9 months ago.

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Thank you.

Expert:  Dr. Arun Phophalia replied 9 months ago.

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Expert:  Dr. Arun Phophalia replied 9 months ago.

Please let me know if I can do anything further for you.

Best regards,