While there are many issues that can cause behavioral problems, I am not aware of any including a large square head. I have never seen a square head. Have you asked the parents about the large square head? Do they have large square heads?
If you haven't gotten his parents involved, you need to ASAP. There may be things going on at home causing his behavior and his parents need to be involved. There are conditions that cause square heads, but if he was fine last year, and now has changed, then something has happened to change him, and it has nothing to do with his head. I don't think you should be doing anything without the parents being involved, they may be able to enlighten you as to what has happened, and the they can get a social worker involved to help him, which will not take but a phone call.
Yes, get teh parents on board and have a meeting and come up with a plan to deal with these behaviors, has something happened at home, etc?
Thanks for your remarks. I also have a social work background and do not suspect that anything un-to-wards has happened at home.The parents are as bemused as I. We felt if we could identify a cause he has a better chance of getting early and appropriate treatment.Someone has now offered this suggestion.
Attenuated MPS I (Hurler-Scheie Syndromel Scheie Syndrome)
If development is normal at age 24 months and if moderate somatic involvement is evident, an individual should be classified as having attenuated MPS I. Onset of disease in individuals with attenuated MPS I is variable, usually occurring between ages three and ten years.
Although development may be normal in early childhood, individuals with attenuated MPS I may have progressive learning difficulties.
Craniofacial and physical appearance. The physical appearance of individuals with attenuated MPS I varies. Coarseness of facial features is less obvious than in severe MPS I. Findings can suggest development including a short neck, broad mouth, square jaw, and micrognathia.
Also individuals with MPS I are associated with development of difficult to manage aggressive behavior.
Have you looked at google images for that syndrome? There is definitely a very characteristic "look" to the children - I think you could initially sort of rule it out or in just by appearance.
Also, besides this one mention of aggressive behavior, I haven't seen it mentioned again in the articles. Usually other things are noted - joint problems, enlarged liver, etc.