SINGAPORE, Nov 19 — First, he hit the boy’s hands, but got angry when the bad behaviour persisted.

Then he decided to take things further by using a hanger to hit the boy on the buttocks, followed by pinching his thighs with a pair of pliers.

After that, he came up with the idea of using a heated spoon to punish his son’s “thieving hands,” so that he would not “open tins of Milo and milk powder meant for his siblings."

Everything the father did in these incidents “clearly described an escalating pattern of physical punishment in response to persistent bad behaviour” from his son, a psychiatrist told the court, saying that it was not consistent with the behaviour of someone who has intermittent explosive disorder.

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Taking the stand yesterday, Dr Cheow Enquan, who is a witness for the prosecution, refuted the defence team’s suggestion that at the time he allegedly killed his son, Ridzuan Mega Abdul Rahman was suffering from attention deficit hyperactivity disorder (ADHD), intermittent explosive disorder and hypnotic use disorder, a condition where compulsive or repeated use of sedative-like drugs lead to behavioural problems or psychological changes.

Ridzuan and his wife Azlin Arujunah, both 27, are charged with murder and are said to have inflicted severe scald wounds on him between October 15 and 22 in 2016. The son cannot be named to protect the identity of his surviving siblings.

Ridzuan also faces several charges of ill-treating and assaulting the child in the family’s one-room rental flat, including confining him in a metal cage meant for their pet cat, using a heated metal spoon to burn his palm, and punching him on the face.

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Dr Cheow, an associate consultant with the department of general and forensic psychiatry at the Institute of Mental Health, told a packed courtroom that he disagreed with a fellow practitioner’s medical report that lawyers are relying on to defend the accused.

The criteria for a patient to be diagnosed with ADHD and intermittent explosive disorder had not been fulfilled in Ridzuan’s case, he added.

For example, someone with intermittent explosive disorder — which reduces the person's ability to control aggressive impulses — would react angrily out of proportion even to minor provocation.

There was no evidence to show that Ridzuan’s aggressive behaviour was out of proportion to “any provocation or stressors,” Dr Cheow said.

Recounting how the punishment for the boy kept getting harsher, Dr Cheow said that Ridzuan finally took “more drastic actions” such as splashing boiling water on the boy and locking him in the cage meant for the cat when previous methods did not work.

“It's clearly a calculated, escalated pattern of violence, and not something out of proportion.”

The boy died from severe injuries on Octber 23, 2016 from being scalded with hot water.

The psychiatrist said that Ridzuan had also admitted to physically punishing his other children, but not to the same extent as the deceased because they did not misbehave themselves as much.

Dr Cheow said that this information is not consistent with someone suffering from intermittent explosive disorder.

“If it (did), he would get angry and blow up out of proportion even to minor provocation,” he said. “So he should have been indiscriminately violent to his other children even if they didn't provoke him as much.”

The trial continues today and Dr Kenneth Koh, a psychiatrist who examined Ridzuan’s wife, is expected to take the stand. — TODAY