Aryan had several behavioral challenges in kindergarten. His teacher reported that Aryan frequently had difficulty following directions and would sometimes throw a tantrum when he did not “get his way.” He also had problems getting along with his peers. He did not like to “wait for his turn” or “stand in line” with his class. His mother reported that he displayed similar behaviors at home. For example, his mother was concerned that Aryan often “did not listen” to her or her husband. He often tried to “be the boss” with his brother—both at home and during family outings in the community. Aryan’s problem behaviors continued and escalated in first grade. For example, he repeatedly defied his teacher and refused to follow her instructions. Loud verbal arguments led to fistfights with other boys, and occasionally girls, at lunch or recess.
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