Mr. Jaxon is a 5 year old caucasian boy who presents for initial psychiatric evaluation accompanied by his mother. He is in kindergatten. Mom complains that she has been told he has ADHD and he is increasingly becoming disruptive, hyperactive, cantsit still, talks alot and screams for no reason. While pregnant with him, mom reports she was on methadone.He was born prematurely at 36 weeks.He was delivered at the back seat of his grandmothers car and he inhaled meconium.As per mother he did not cry immediately and had to be resucitated by paramedics.He had to stay in NICU for six weeks and he suffered neonatal abstainance syndrome, and neonatal infections. In the office the boy was observed to be very hyperactive. He was talking alot, throwing himself on the floor and rearranged the seats.He was all over the place.The child was referred for a full psychological assessment at clarity centers in Towson for concern of an autistic spectrum disorder vs ADHD for diagnostic clarity.