Q. We don't know what to do with our 7-year-old son.
A children's hospital says he has severe separation anxiety and recommends a two-week in-house therapy and testing program, but I think they want patients. A consulting pediatrician says he needs play therapy and counseling -- but not in the hospital -- and the family pediatrician tells us our son just needs us to put our foot down.
The boy won't stay in his room unless an adult is near and he constantly calls "Mom" to check if I'm there. He follows us to the kitchen or wants me to quit fixing dinner if he decides to play Nintendo on the other side of the house.
He goes to school but often complains of stomachaches. We make him go anyway and tell the school not to call unless he really vomits or has a bad fever.
He says he's scared because he saw monsters in a television program that his father was watching one night (my husband likes alien movies).
When we moved into our new home 18 months ago, we thought it was the cat who was urinating all over our new carpets, the clean laundry, the toy boxes and the television, but it was our son. He said he did it because he saw the cover of a video movie at the store and it had a "monster/alien" coming out of the toilet.
He does use the toilet now, but makes us stay in the next room, and though he bathes without complaint, we stay nearby because the 3-year-old sometimes joins him.
He also doesn't listen. He does not obey. He taunts his little brother, he does the opposite of whatever I ask and he has a 2-year-old's tantrum if I give him time-outs.
This child is pretty spoiled with many toys and games, and I'm trying to change that. I threaten to punish and never really follow through, but recently I was so put out I took away the Nintendo for a week. He didn't complain and it seemed to work, even with the 3-year-old.
This child is driving me crazy and I can't afford to pay for therapy.
A. You can't afford not to pay for therapy, but that's only part of the solution.
There have got to be some serious changes in your house, for all of your sakes. A child needs boundaries almost as much as he needs love and at this point, your son needs protection too.
Television, horror movies and Nintendo affect some children much more than others, and your little boy is one of them.
He's had so much exposure to the frightening side of fantasy that he's begun to think it's real. And since he knows he can't cope with real, live bogeymen, he can't cope with moving and school either. These events unsettle any child, but they can traumatize a fearful one.
If your husband must see alien movies at home, the television -- and the videos -- should stay in your bedroom, and he should watch behind closed doors, preferably after your son has gone to sleep. Even a trip to the video store is too much for your child right now and so is Nintendo. Put it away, not as a punishment, but as a precaution.
Discipline is your main problem, however. You and your husband have to be firm. As you've discovered, if you let one person in the household play the rogue, everyone else will suffer -- but no one will suffer as much as he does.
It has made him push to test his limits, and he almost panics when he can't find them. This has only made him push harder, and act more defiant, until by now he's carrying more pain, and more anger, than he can handle.
Your little boy needs a great deal of help, and so do you.
It will take an experienced child psychiatrist or psychologist to make an assessment, based on interviews with your son and psychological and perhaps some physical tests, but try to get the work-up done on an out-patient basis. Institutionalization, even for two weeks, is very hard on a child, particularly if he's afraid to be away from his parents.
Family therapy will be necessary, too, to teach your son how to express his feelings without hurting others, and help you and your husband set -- and keep -- limits. And when you feel like caving in, read "The Parent's Handbook" by Don Dinkmeyer and Gary D. McKay (Random House; $9.95), a sensible account of the STEP program -- for Systematic Training for Effective Parenting. A free STEP support group would be very helpful too.
You'll find that neither punishment nor bribery is wise -- although every parent resorts to them sometimes -- but positive reinforcement will make him start to change, for children like to do whatever makes their parents notice them most.
An invitation to take a walk "because you've been such fun today" will change him a lot quicker than a new toy. In fact, bundle up most of those toys and have a yard sale. Think of it as a down payment on the therapy bill. For the rest, see if you qualify for the county's mental health program or a United Way agency. You can't get through this problem on your own.
Questions may be sent to P.O. Box 15310, Washington, D.C. 20003.