I don't have an answer but am struggling with this same question. I posted years ago when my grandson was 7 - he is now 12 and totally out of control. I have been saying all along that it is something physical, from birth, as he had many abnormalities over the years. He had very loving and supportive parents, but never showed love, empathy or the ability to understand others' feelings. He always flew into rages and could never accept blame or responsibility. When his brother was born six years after him, he gradually became mentally and physically abusive to him. Over the past 6 years the whole family has fallen apart from the constant tension of trying to deal with this out of control child - his parents are divorced, the ex -husband is acting extremely irrational, my younger grandson is traumatized. They have seen therapists but never get anywhere. He's now on Abilify and Risperdol, which at least keep the outbursts under control somewhat at school, but his father wants him off the Abilify due to possible diabetes connection (he gained 50 lbs on it.) The psychiatrist thinks it's parental, yet these issues had been going on for years and years and the parents only got divorced a few months ago. I would love to find someone to do an MRI, as I've seen studies where there are brain abnormalities in some children with ODD, but I don't know how to find a doctor to do it and if we had the information, don't know if there is anything that can be done to treat it. It is now to the point of survival - my daughter is struggling financially and has to work 2 jobs, and my ex son-in-law is suffering from erratic anger and depression. While they share custody, my grandson is getting extremely hostile towards his mother. She has no control over him at all, and it's getting scarier the bigger he gets. He's very smart and was in the gifted class, but now he refuses to work and is getting horrible grades. I am worried he will start with CD, as I have little hope for him getting the proper support he needs from his parents. (We don't live in the same state so our help is limited.) I would love to have him get an MRI just to validate that I wasn't crazy all these years witnessing disturbing and abnormal behavior. Thanks for letting me ramble on. If you know of any psychiatrists or place to get answers, I'd appreciate it!