In Shaunee's second week in first grade, she had already been sent to the principal's office twice. The first time was when she got off the bus in the morning and instead of waiting in line with the rest of the children to enter the school, Shaunee walked in front of the bus and across the road to the playground so she could play on the swings. The second time was during afternoon quiet time. While the other children were resting with their heads down, Shaunee kept tapping her pencil on her desktop. After the teacher asked Shaunee for the third time to stop. Shaunee threw the pencil at the boy next to her and hit him in the face. At home, Shaunee was often reprimanded for jumping on the couch, jumping on the twin beds in the room she shared with her sister, and for not going to sleep at bedtime. Shaunee said she couldn't sleep because she "wasn't tired," but instead of lying quietly like her mother asked, she would sneak out of bed and whisper to her younger sister until she woke her up. Then they would giggle and play until their mother came into the room to separate them. Shaunee had always been an active child. Her mother said it seemed like she was the Energizer Bunny because even on vacation, after a long day at the beach and the playground, Shaunee would still not be tired at bedtime. Her mother told how one time when Shaunee was 4, she woke up while everyone was still asleep and walked to the neighbor's house. On the way, she picked all the neighbor's flowers and then rang her doorbell. It was 6:30 in the morning. That was also the year that Shaunee was asked to leave the preschool she had attended for only 6 weeks. She never seemed to hear the teacher's directions, she couldn't stay in her seat without squirming and twisting, and she would run around her desk whenever the children were asked to settle down. Shaunee's mother didn't quite know what to do to help her daughter. "I was just like her as a child. She's just a free spirit," she told the preschool administrator. But when Shaunee was asked to leave preschool, it caused a lot of problems for her family. Her mother had to take time off from work until she could find childcare. Her sister was mad because it was unfair that Shaunee got to stay home while she had to go to school, and her parents were starting to have a lot of arguments. Shaunee's behavior and history reflects symptoms of attention deficit 58 hyperactivity disorder-predominantly hyperactive/impulsive presentation.