Just a quick post to see if you've checked for possible triggers for changes in behavior, such as:
- changes at school?
- academic difficulty (ranging form bored, to lack of support, even a sense of unwanted competition)?
- social problems in learning environment?
- friend move away, or ill and out of school?
- new teacher?
- new seat in the classroom? Sometimes a well-behaved child is moved to break up chronic misbehavers.
- any possible exposure to sexual conduct or contact?
- illness/death of a grandparent or other member of support system?
- changes at home such as new sibling, separation/divorce, parental job change, tight budget?
- changes in what foods are offered and eaten?
- HALT (Hungry, Angry, Lonely, Tired), as mentioned in this SENG article?