My wife & I adopted our son at 2 days old. He just turned 5 on 9/11/13, and is an only child. He was about 4 weeks premature, and tested positive for stimulant exposure, but showed zero signs of any effects from it at birth, and thereafter. He was the perfect infant: Slept through the night at 3 weeks old, Ate a wide variety of food, regularly, without trying to overeat, Developed on target (other than being a little small, because of being premature (he's up to size now)). As a toddler, he was 1,000% "boy" - always on the move, a total Tazmanian Devil. Always happy. He has always been extremely verbal (even more than any girls we've seen), and very bright (hate saying that as a dad, but I promise "its not just me" saying it). He's the total "class clown" type, despite not being in school. He is the most fearless, gregarious kid I've ever seen. He walks straight up to kids he doesn't know on the playground and will organize them into some sort of game. He is very physically agile & strong as well. He loves our 3 dogs, and 1 cat, and 1 horse. His favorite thing in the world are sharks - he listens intently while I read non-fiction books about sharks. My wife & I are both professionals, and have lots of very accomplished, intelligent friends - some with kids of their own, some without. They all think that other than being 1000% boy, that our son is amazingly bright, charismatic, and a total charmer. They don't get to see what happens when he's NOT in a fun, social setting, however. Now the bad. Since 3, we've essentially been waiting for an "ADHD" diagnosis: He never stops moving - you have to physically hold him to get him to stop moving. Its not involuntary, or a tick or anything like that. He just NEVER STOPS. He only stops talking when he's engrossed in something he enjoys. Otherwise, he's a chattering little monkey. He's smart - he'll ask a non-stop stream of questions about what I'm doing, showing an understanding of what I'm working on well beyond his years. When he's stressed, or tired, he still sucks his thumb. He will destroy just about anything, once he becomes bored with it. This has included an iPad, an iPhone, most of his toys, etc. He only focuses on things that he enjoys - TV (of course), legos, books (looking at pictures & making up stories) - anything else, its like dealing with a caffeinated spider monkey. He started a Transitional Kindergarten program in August (2 months ago) at a public school. Transitional Kindergarten is a 2-year Kindergarten program for kids who would otherwise be the youngest kids in their class - the equivalent of holding him back a year, to make sure he's mature enough to keep up in standard Kindergarten. In the last 2 months, we've had the following problems with him at school: He hides under tables or behind bookcases anytime he doesn't want to participate in the class activity. He runs out of the room anytime he is told he can't do what HE wants to do (versus what the class is supposed to be doing). He has bit his teacher once (when she was trying to call the Principle to come get him, because he was being disruptive). He has stolen "Mountain Lion Notes" (tokens the kids receive for being good citizens that day - redeemable for a treat when they accumulate 10) when he's told he hasn't earned one that day. He has thrown chairs, tables, stuffed animals, books, or toys when he has gotten frustrated. He doesn't throw them AT anyone, just throws them randomly. Unfortunately, he has hit a couple other kids, and the teacher, during these episodes. He has refused to participate in group activities, instead wandering off to "read" by himself, play in the mock-kitchen, or simply lay down & pretend to sleep (complete with snoring). His Kindergarten teacher is actually really good with him. She was frustrated & aggravated by him for the first week or two. Now, she actually really likes him, but she admits that in 23 years of teaching Kindergarten, she has never seen a kid like him: she's had a kid with legitimate psychosis (who heard voices), lots of ADHD kids, and even some ODD kids. Her assessment is as follows: She believes he is exceptionally bright, He is above "grade level" in most of the assessment areas, He doesn't have rage or anger issues - instead, he simply knows what will get attention & keep him as the center of attention (she says this because he can "turn it on & turn it off" on a dime - even in mid-sentence - if some alternative that he likes is made available). She thinks he does fit the "ADHD" criteria, but isn't a run-of-the-mill case. She has no idea what, if any, the "comorbidity" issues may be, but she doesn't believe he's ODD - mainly because she believes he can control his conduct & emotions - she thinks he CHOOSES to act that way, as a means to and end. The first time his teacher tried to assess him, he just said "I don't know" or made up gibberish answers to every single question. She told us that if she just scored the results & moved on, he'd definitely be classified as "developmentally delayed". So, in order to actually assess him, she had to take him to the playground 1-on-1 with a bag of Skittles. She would let him play for 2 or 3 minutes, then call him over and tell him he'd get a Skittle for each question he could answer correctly. He would then proceed to ace several questions, getting a Skittle for each one. When she could tell he was starting to lose interest, she would tell him to go run & play by himself for a bit longer. Rinse & repeat. He then scored "Above Grade Level" on almost everything, and "At Grade Level" on the rest. He is an enigma, wrapped in a riddle. He has seen all of the following: Pediatritian - same one since birth. She finally gave a formal diagnosis of ADHD about a month ago (after the first month of school). Family friend who is retired from the Gesell Insititute of Child Development (http://www.gesellinstitute.org/), about 2 years ago, when he was about 3 years old. She actually thought he wasn't ADHD or ANYTHING: "he's just a really, really rambunctious boy - he'll probably grow out of it." Pediatric Neuropsychologist (about a year ago). At the time, she said he was too young to diagnose with anything, but she ruled out Autism spectrum (including Aspergers), sensory integration, and developmental delays. Child psychologist - about 3 weeks ago. He assessed him for about an hour, but if our boy said "I don't know", or answered in gibberish, he would just move on. SO, he though he had developmental problems. His recommendation was that we need to work on his learning to read much more aggressively, and instead of raising our voices when he acts out, try to "negotiate" with him, so that we show we care about him & his needs. Psychiatrist. He won't give a diagnosis apart from the ADHD diagnosis that the pediatritian gave. BUT, he wants us to put him on 1mg of Abilify (1/2 of a 2mg tablet). The school is in the process of putting together an IEP - we meet with them again on 11/18/13 to hear their plan & either approve or disapprove it. I would love to hear any thoughts. Before we went tot he psychiatrist, I had brought myself around to the possibility of a stimulant medication, for the focus & attention issues (hoping that the acting out issues would resolve if he could settle down & focus on the class's task of the moment). But, when the psychiatrist came back with Abilify (which I had never heard of), and I read up on it . . . I am SCARED TO DEATH to put a 5-year old on something like that unless I'm 110% convinced its necessary . . . and thus far, I'm not. PS - If I left out any information, ask - I don't know what may or may not be relevant. I'll clarify or add anything that would complete the picture.