I got custody of my 7 year old nephew along with his two sisters and 1 brother about two years ago. All four if them were diagnosed with ADHD and on medication. After dealing with his behaviors I feel like their may be something else going on, but am having a difficult time pin pointing it. He definitely has all of the ADHD symptoms, but some added on top. He seems totally unaware of anything going on around him and really doesn't react to discipline unless something important to him is taken away. He even smirks when being scolded. Not in an "I don't care" attitude, more like he doesn't get it. He can't seem to understand when someone is angry. He very rarely shows any emotion other than happiness or excitedness. He cannot tell when others are frustrated with him. He does not have any fear of strangers and would gladly go with someone even if they are physically harmful to him. He had no adjustment issues when going to the children's home or coming to live with us. But the most disturbing thing of all is his inappropriate sexual behavior. When we first got him he just turned six and was caught tying a hair tie around his penis. Although this was concerning to us we thought this could be considered under normal exploration seeing as though we do not believe there has been any sexual abuse. We then caught him asking our 4 year old boy to "lick his butthole" in the bath. My son immediately told us and was upset by this since that time we have supervised him much more closely and dramatically changed our privacy boundaries. It has been between six months and a year since these incidents occurred although there were a few questionable circumstances. Once he leaned up against his brothers back and jumped up and down but seeing as though he did this in the living room while playing we thought it could be meaningless and then another time he was playing on the swingset when he crawled under his sister while she was wearing a skirt. This last incident has got me really afraid that this could be something much more serious that I am not equipped to handle. My five year ok'd niece came out of her bedroom to tell us that he had tried to take her pants off then when she said no he took his pants off and touched her pension to her mouth then as she was running out to tell he told her not to. I admittedly freaked out and angrily took him to his room. He openly admitted it and didn't seem to understand what the big deal was. He did not seem upset at all about being in trouble. Nor did he understand that this was harmful to his sister. When I ask him why, he says he doesn't know, when I ask him to tell me what he planned on doing, he says he doesn't know. He does not seem nervous or afraid of getting into trouble nor does he come off as being defiant. He just knows he "wants to" I have told him in past situations how serious these types of actions are and that the consequences can be severe. His behaviors do not fit into any diagnoses I can find. Nothing seems right to me. I am desperate to help him but must protect the other kids as my first priority. I am responsible for seven and don't know how I can possibly watch him 24 seven. I'm terrified ill slip up and give him a second to harm my other children again. He is only targeting the children younger than him and he says that's because he thinks they won't tell!