A 4-year-old boy was referred to the child psychiatry clinic for management of tantrums with aggression and self-injurious behavior. Tantrums were unpredictable and often resulted in severe head-butting. His parents also reported atypical social and language development, disrupted sleep, and persistent impulsivity with attempts to elope.
The patient had a complex medical history that was marked by prematurity at 32 weeks, slow postnatal growth, and severe gastroesophageal reflux. Genetic testing following an episode of hypoglycemia revealed microdeletion of the 16p11.2 region of chromosome 16. His pediatrician documented a normal neurological examination without dysmorphology or congenital anomalies.
Muhle RA, Reed HE, Aguayo P, Veenstra-VanderWeele J. Evaluation and Management of Self-injury in a Child With a Rare Genomic Variant. JAMA Psychiatry. 2018;75(5):524–525. doi:10.1001/jamapsychiatry.2017.4677
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