Hello, I wanted to share my experiences with others in hopes of getting further insight as to what might be going on with my son. My boy is 6 years old and is an identical twin. Both he and his brother were diagnosed at 4yrs with Sensory Integration Disorder (Sensory Integration Disorder (SID)). This was first brought up in an evaluation based upon their week fine/gross motor skills. Therefore, and understandably, they can get easily frustrated when pushed to do something they feel is challenging. Countless hours of Occupational Therapist (OT) and PT have help this greatly. However, each of the two boys has had issues with attention and outbursts in school, thus we put them, at the recommendation of our pediatrician, on ADHD medication. Boy #1 responded very well to 5mg Focalin and is doing great in school. Boy#2 did not. He has tried Focalin 5mg and 10mg, Concerta 18mg and 27mg and Intuniv 1mg with no success. He is the boy I am trying to figure out here, with the help of this forum. We have had boy#2 evaluated by a psychologist...for which we got a diagnosis of ADHD. He was also assessed to have an IQ of around 125. He is very verbal/articulate and has been from the age of 2. He is 6yrs old but is graded at reading at a 5th grade level. He does have interests..but nothing i would call an obsession. He has difficulty making eye contact, but can and will when prompted. He can be very loving at times, but when he is in disagreement with us (adults or teachers) he is very defiant...saying things like "No...I refuse", "You are not the boss", "You can't tell me what to do", "I hate you", I'll kill you", etc. Believe me...it is shocking. He will hit, kick, bite and throw when attempting to discipline him. At other times, he can be sweet and compliant...even thoughtful We are having some real problems at school and have removed him from his regular mainstream classroom and have been driving him to an alternative school that accommodates kids with special needs, offering him a smaller classroom environment. I am unsure of what I am looking at: What does through my mind, changes from week to week. Is it ADHD? Is it Aspergers Syndrome? Is it ODD? All of the above? Been to a developmental pediatrician..but got no sort of diagnosis. His regular pediatrician says that he is "Spectrum-ish", but referred us to a pediatric neurologist. The PedNeur says that he has a mood disorder, having only seen him for about 30 minutes. Hoping that the collective insight of this board will help me figure him out.