Just an Accident? Or Intentional Killing?

[Meerkat]

Let me say right up front that the incident that I am writing about is very upsetting and graphic, so read at your own risk.

A girl about 10, was being treated on our unit for behaviour problems. She also had some psychosis involving auditory and visual hallucinations.

One of the major incidents regarding this child was the death of the family dog, who was found in a drawer with scissors and a bottlecap jammed down its throat (a toy breed, chihuahua size).

The girl says the dog tried to eat the bottle cap off the floor, choked, and then the girl tried to retrieve the bottlecap with the scissors. The dog died, and she panicked so she wrapped the dog up and put him in the drawer.

The mother believes her...here's the clincher...

this girl later that year pushed her older brother into a swimming pool, where he drowned. According to the mother and the girl that was also an accident.

I know you don't have alot of history to go on, but what are the chances that BOTH of these deaths were accidents? I'm skeptical, and I think the mom is in denial.

[CHATSDALE]

is there any way that you can talk with the police and determine what really happen at the swimming pool..and let them know about the dog

poor mother she really has a problem

[steelcityrn, RN]

When I first became a nurse, I ventured into psych, and have been around many, many troubled souls. Without even knowing the background of the child/family in this case, this trauma may ruin her chances of a "normal" future without long term tx. As they now know, it is the period in the life of that person at the time of the trauma that is shaken, and sometimes not overcome without much professional help.

[Meerkat]

Thanks for all the great and informative posts. I am sorry to say this, because we're all dissapointed, but the child has been discharged from our unit. She was 'stabilized', so they say. In 6 days? I have a sinking feeling we'll be seeing more of her.

Interestingly, she doesn't apparently come from a broken home. Parents are together, very supportive...but who knows what goes on behind closed doors, right?

rn/writer, I think there was one incident of fire setting if I remember correctly.

[LoriAlabamaRN]

Huh?

Moderators..... ya wanna handle this one?

[CharlieRN]

Against my better judgement I have to ask, How old was the "older brother" when he drowned? How much older than the client was he? What is the rest of the family constellation like? Any hints of sexual abuse? Was the client a virgin? Was a plevic exam done on her?

The number one suspicion when a female child acts out is sexual abuse. It is very common for female children to become the identified patient, when the family is dysfuntional.

The report that the child had both auditory and visual hallucinations briefly that seem to have resolved on their own, is troubling. Visual Hallucinations are extreamly rare in psychosis, with auditory hallucinations being far more common. The common cause of visual hallucination is chemical intoxication, ie: DT's. One place auditory and visual hallucinations do come together is in dissociative states. Dissociative states often follow from being a victim of child abuse...

Of course as they say, "when you have a stick, all the world looks like a kneecap". Dissociative d/o and treating sexual abuse survivors has been my specialty, so maybe I see signs of them even when they are not there. The incidence of sexual assault/abuse of female children is about one in three. Mostly the perps are NOT "strangers".

[Meerkat]

Against my better judgement I have to ask, How old was the "older brother" when he drowned? How much older than the client was he? What is the rest of the family constellation like? Any hints of sexual abuse? Was the client a virgin? Was a plevic exam done on her?

The number one suspicion when a female child acts out is sexual abuse. It is very common for female children to become the identified patient, when the family is dysfuntional.

The report that the child had both auditory and visual hallucinations briefly that seem to have resolved on their own, is troubling. Visual Hallucinations are extreamly rare in psychosis, with auditory hallucinations being far more common. The common cause of visual hallucination is chemical intoxication, ie: DT's. One place auditory and visual hallucinations do come together is in dissociative states. Dissociative states often follow from being a victim of child abuse...

Of course as they say, "when you have a stick, all the world looks like a kneecap". Dissociative d/o and treating sexual abuse survivors has been my specialty, so maybe I see signs of them even when they are not there. The incidence of sexual assault/abuse of female children is about one in three. Mostly the perps are NOT "strangers".

Thanks for the interesting answer. There was no hint of sexual abuse. Of course that doesn't mean anything...could still have happened. Family is intact. The drowning was attributed to horseplay. The audio hallucinations are apparently of the brother's voice, and you could hear this girl talking back to him. Laughing and giggling. The parents say she is absolutely traumatized by his death. I don't really know much about the visual hallucinations, but I think they were of the brother as well.