Mikey is a ten year old boy with mild autism and ADHD, who was referred to me for explosive rages. The aftermath of his most recent episode, which occurred in the classroom, was captured in the photo here. The school district was insisting on a psychiatric evaluation: Was he bipolar? Did he need medication? The parents were fearful that taking this step would sentence their son to “being put on drugs.” They felt (correctly so) that his behavior could be managed if given the proper environment.
Since being male, autistic and having ADHD make one’s brain extra sensitive to electronic stimulation, I immediately inquired about screen-time habits. At home, Mikey was playing (non-violent) video games for several hours a day, as soon as he got home from school. When the family was out and about he was playing on his sister’s or dad’s iPhone. He also had computer time at school every day, and watched cartoons, which are more stimulating than other shows due to their intensely bright colors and rapidly changing scenes. Mikey had been gaming since age seven, but now played electronic games to the exclusion of all other interests. In the past year, he’d become increasingly resistant to doing homework, was more oppositional and defiant in general, and had starting escalating in his rages such that there was significant property destruction. Rages were typically provoked by being told no. There was no history of bipolar or other mood disorders in the family.
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