Greg has always been a friendly,affectionate,confident child.Recently,he has been very irritable,sleeping poorly,and having numerous nightmares.Recently,he does not want to spend time with his friends.When his mother is taking him to the after school tutoring program,he often forgets his notebook and tells his mother that he does not need tutoring anymore.He also was seen riding his bicycle dangerously down the steep hill near his house.When his mother told him that she was scared he would get hurt or killed riding his bicycle like that,Greg just told her that "it didn't matter anymore." The reason for Greg's behaviors may be

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Greg's sudden change in behavior, irritability, nightmares, withdrawal from friends, and disregard for his safety may indicate sexual abuse. The fact that he does not want to go to the after school tutoring program and forgets his notebook may also suggest that he is trying to avoid being in the same place as the abuser. It is important for his mother to investigate this possibility and seek professional help. A conduct disorder involves antisocial behavior, aggression, and disregard for the rights of others, which do not seem to be present in Greg's case. Poor school performance and fear of being referred to special education may cause stress and anxiety, but do not account for all of the changes in his behavior.

Greg Has Always Been a Friendly,affectionate,confident Child