“Javier” is an 8-year-old boy with a complex psychosocial history presenting for a developmental-behavioral pediatrics consultation because of concerns regarding hyperactivity (affecting safety) and developmental delays, including “lack of independence.” He is not yet toilet trained and in his mother’s words, “he has the mindset of a child that is much younger than his actual age.” Javier’s family emigrated to the United States from Central America a year ago to seek asylum. During his family’s…
