kdoelit-- I would be cautious of a diagnosis at four, if you think your son is gifted (he sounds like it). The exception might be HFA. Gifted, intense young boys can present as challenging (extreme).

Here's something that happened with us-- a different paradigm, just to show some possibilities:

1. DS at four-- defiant, explosive temper, extreme often aggressive tantrums at home, mischievous, manipulative, high levels of energy

2. DS at five and 1/2: deliberate defiance within normal limits, hyperactive energy only when he has not had enough exercise, tantrums still occasional sometimes aggressive, occasional deliberate mischief, difficulty making close friends

3. DS 6 1/2: occasionally deliberately defiant but extremely rule abiding at school, energetic but quite able to sit still appropriately, occasional tantrums and aggression with some insight into own behavior, no deliberate mischief, difficulty making close friendships. IQ test showed HG/EG gifted

4. Nearly eight (now): rarely deliberately defiant and never at school, can sit for long period of focus, occasional tantrums due to perfectionism and inflexibility, strong attempt to control behavior with coping strategies, no mischief, difficulty making close friendships. WJ achievement 99.9+ percentile

Diagnoses: likely generalized anxiety and social expressive receptive language disorder. Had I diagnosed him at four-- probably ADHD and ODD.

Last edited by cammom; 11/21/14 10:30 AM.