Problems since infant. He is now alomost 6. EXTREMELY intelligent, logical, physically above average. Thinking in abstract, and also in complete sentences at unusually young age. Seems very normal when he is happy, although he talks, interrupts, and says something over and over although you tell him you have heard him. That s a brief background...SO, the problem is EXTREME defiance, tantrums still at times, and expression, almost belief that he is in charge. (unless he is happy and content) he demands, decides the rules, etc... When he gets ticked off he will hit, call names like idiot, maniac, stupid, even hit me in the face, spit, scratch , pinch. He will refuse to say I m sorry until I have said sorry first (his own mother) and even when I have done nothing to be sorry about. It can be over something small. And, the strange part is, he is SO quick to point out that the parent (me or my husband) is being mean when we are not at all being mean. He almost appears as if he totally doesn t see it. He will behave appropriately only when the strictest and most structured reward charts and the like are in place. He mostly expects a treat or gift if he agrees to change a bad behavior, rather than doing it for the sake of doing the right thing. HOWEVER, when we have gone through a few days or possibly a couple of weeks of pretty consistently respectful behavior, he can refer back to the behavior in question and you can see on his face his self approval when he has behaved properly in a situation he usually does not. He will even point out how well he did. On the other hand , he is extremely giving, thoughtful, and totally honest. One more to note, wants to constantly be going somewhere, doing something, (like ride horses, play puttputt, go bowling, play tennis, golf, guitar...big things...DAILY!)has great need for social contact, play. This is effecting him at school, summer camp. At a restaurant, one time he may be perfect, sit and color while he s waiting on his food, eat with nice manners, etc...and the next night he is throwing food, won t stop talking, laughing, won t listen to a word, playing with the salt shakers, crawling under the table, etc... oh, lastly, when he is tired, especially overtired, he gets EXTREMELY hyper, jittery, makes sounds with his mouth, lips , bounces around, wont stop talking, it s quite exhausting to get him ready for bed and in bed when this happens. whew. thx!