What is wrong with my ficus tree leaves? I have been using Neem oil and nothing is working.
The real cause of the issue is Weeping ficus thrips, Gynaikothrips uzeli. The thrips feed on expanding leaves causing purplish red spots on the lower leaf surface. The leaves become curled and galled, and prematurely drop. Treatments must be applied to protect leaves while they are expanding. Once damage has occurred and populations are developing in tightly curled leaves, adequate coverage with insecticides is extremely difficult.
There are no specific recommendations for this thrips, however, pesticide recommendations for other types of thrips feeding on ornamental plants may work. Some research suggests drenching with dinotefuran (Safari) or acephate (Orthene) provided good control but I realize you are reluctant since you have a toddler and want to reduce any pesticide exposure to the child.
Tip pruning of infested plants will remove the food source of the thrips in addition to any thrips and eggs present on these new shoots. These thrips are commonly preyed upon by a predatory bug, which many times causes the populations of thrips to drop. However, your plant is enclosed in a patio and will have little chance of getting a predatory insect.
You may continue to treat it but you might consider removing the plant and throwing it away. If you decide to destroy the plant, consider placing it in a large lawn bag and tossing it in the garbage. I would not allow other landscape plants to be exposed to this pest. This information comes directly from the UF/IFAS Tropical Research and Education Center.