Joe, a thirteen-year-old Asian-American boy, is enrolled in ninth grade at a public high school located in the inner city of a large metropolitan area. Since kindergarten, his teachers have reported increasing levels of concern about his behavior. In elementary school, he was described by his teachers as immature and argumentative with authority figures. In middle school, his behavior escalated to include verbal and physical aggression toward classmates.

Recent reports indicate that he disrupts the classroom often by arguing with his teacher, talking excessively and loudly, and disobeying classroom rules. During breaks or when outside the classroom, Joe associates with a group of boys who tend to get into trouble. He tends to become angry often and easily and has gotten into many fights. Some of his classmates have reported that Joe has threatened them. He does not seem to feel guilty when he gets into trouble. He rarely finishes his schoolwork and is getting poor grades. Beginning this year, Joe’s teacher has reported that he seems easily distracted.

Testing completed by the school psychologist indicates that Joe is intelligent and creative. Results do not support the presence of a learning disability or a developmental disability. The school psychologist indicates that Joe lacks sufficient motivation or desire to complete his work thoroughly or carefully. Joe’s parents report that he refuses to follow rules at home, is often angry, and tends to blame his siblings when he gets into trouble.