ConnectingDots, you make good points. We've hesitated for years to be more aggressive with treating his issues as 100% pathological, because he's never been in an educationally appropriate environment. Meeting that need is so important, in my opinion, to see which of these problems might resolve themselves if he is challenged appropriately. Our district has a gifted accelerated program that begins in 4th grade. As a 3rd grader, my son was tested this year and he was offered a spot in that program. There are roughly 3200 3rd graders in our district, and only 70 offers for this program were extended, so I was a little surprised that our "only" moderately gifted child was actually one of the top qualifiers, but he was. He apparently gave his absolute best effort on all of the testing, which is consistent with his uber-competitive personality. Anyway, since he entered public school we've been in a kind of holding pattern, waiting to see if he'd qualify for the accelerated program and then how he does after adjusting to that program (he will attend a different school, it is a BIG change). And at home we've tried to offer opportunity for growth without just requiring him to do more work. It has not been easy, not at all.