Your nephew is a lucky boy to have the mom and aunt he has. Something is very, very wrong. I don’t know if he was sexually abused but his behavior is of a frightened boy. He may be unable to tell you what happened to him because someone threatened to hurt him or his family if he did. Another possibility is that he is ashamed. And there’s always the possibility that he doesn’t know what is wrong. Although the pediatrician has cleared him, something may still be amiss.
To probe a little: His mom could try gently telling him that some secrets are not secrets he needs to keep; that the adults will protect him and themselves if he tells them the threat. She can also tell him that sometimes people are forced to do things they are ashamed of but that it isn’t his fault if he was threatened or forced or confused. Finally, she could share with him that sometimes people have disturbing thoughts and that she is willing to hear them if he wants to get them out. Short, quiet, loving conversations are most likely to be helpful.
He is asking for your help, both in words and behavior. The best gift you are giving him is that you are showing him that you believe him and you’re trying to get to the bottom of it. By not forcing him to go to school, you are showing him that your first priority is his safety. That’s an important message right now.
It’s hard for me to believe that there isn’t a child psychologist within 100 miles of you who has an opening. Please intensify your search. The longer he sits with this distress, the longer it will be for your nephew to recover from whatever is troubling him.
Meanwhile, missing a month or two of school is small price to pay for his psychological health. If he had pneumonia, you wouldn’t think twice about keeping him home to help him get well. Once this is over, a tutor will help him catch up. A smart and motivated kid can whip through a semester of school in only a couple of months.
I share your worry about this little boy. I hope you will make every effort to get him appropriate help as quickly as possible.
I wish you all well.