difficult child - possible neuro atypical behavior?

Seeking advice on possible neuro atypical behavior This is regarding my sister’s son. My sister has 9 years old twin boys. They both are hyperactive, however, one of the them is different from other kids I have seen. He gets offended at small things. And if something happens against his wish, he starts crying like a child and I can tell his crying is different than other kids I have seen. His facial expressions change and he rolls on the floor. He says things like kill me and all. In such situations, he also sometimes locks himself in a closet, room or garage. He just cannot tolerate if things don’t happen as per his wish. If he goes to school, his behavior is better. However, if he is home, this happens everyday, sometimes multiple times a day. He also mimics adults and can be mean to small kids sometimes. He is a very smart kid otherwise. He is very curious and creative. He is doing good in school, however, occasionally there are complaints about him fighting with other kids. My sister is a stay at home mom and gets very little household help from her husband. Her husband is not able to spend much time with kids because of his work. My parents suggested that my sister takes her son to a doctor, however, my sister is afraid doctors will prescribe medicines. She does not want her son to take any medicines and hopes his behavior will improve in few years after he is an adult. I can see my sister feels very exhausted and depressed because of her son’s behavior. I have also seen her hitting her son sometimes. I am very worried about my sister and nephew. What advice do you have for my sister or her family? Have you come across such kids? What has helped?

Hinge Health tringPin May 6

This seems to be a sign of being on the autism spectrum. Not a doctor but better to get an evaluation for him. Remember the spectrum is really huge. Do not worry too much, since getting a diagnosis for someone on the spectrum is important to make sure they'll have a happy life. The support they'll receive will only allow them to feel really strong and independent.

Palo Alto Networks dbdbdjl May 6

This seems like case of autism. When child don’t know how to express himself if things not going as per his wish they do this. Going to doctor is important as they will evaluate the child and recommend what therapy child needs to catchup with normal kids. The more delay they do, difficult it will be for the child to catch up.

Salesforce FJjm78 May 9

Not all kids need medications, as he seems to be doing good at school, I would expect therapy should be enough. There are also books which at his age he can read by himself about regulating emotions, appropriate behavior, showing sympathy to others. You can refuse medications it's not mandatory. Husband is also responsible for kids! Dad needs to spend time with kids for them to grow up properly. Your sister can look into outsourcing some household work so she can focus on this kid without hitting. Hitting isn't going to help, only patience with such kids will work.