(Hadley Hooper for The Washington Post)

Quesetion: I’m concerned about my active, headstrong 4-year-old grandson. He is as cute as a button, but he has had behavioral issues since he was 18 months old despite getting timeouts and limits. His speech is delayed; his fine motor skills are poor; his impulse control is shaky; he can be rough with smaller children and he often ignores people when he’s playing with a toy. And he has many, many toys.

My daughter, an at-home mom, is worn out and worried, especially about autism. Family and friends give her their opinions; his teachers asked for an evaluation; and his doctor says he may need medication. This freaks me out, because I don’t think a growing brain should get Ritalin.

Also he has touched my breasts several times and those of a 12-year-old family friend. This mortified my daughter because he knows that breasts are for breast-feeding and that he must keep his hands to himself.

My grandson has many positive qualities, too. He dresses himself, goes to the toilet alone, sleeps at least nine hours a night, eats many foods (and a little chocolate), doesn’t drink soda and hasn’t had any allergies or unusual illnesses.

He plays outdoors, reads books; goes to pre-K; knows his letters, numbers and colors; counts to 99 and enjoys the family’s two dogs. He never mentions having any friends, however, although he plays with the 6-year-old girl next door.

My grandson did have some big changes this year. Although he quickly adjusted to his new house and to the long hours required by his dad’s new job, he’s been scared of loud noises ever since a smoke alarm went off one night.

The biggest change was the arrival of his baby sister seven weeks ago. We give him extra attention, but he wants more whenever she is being breast-fed or even held. Should the parents medicate my grandson? Get a private evaluation? Please point us in the right direction.

Answer: You’ve saved the best for last, haven’t you?

Your grandson does have some problems, but his little sister is his biggest one. A new baby always shakes up an old baby, especially if he has behavioral issues. And why not? She gets presents, she gets picked up when she cries and she enchants everyone he loves. This boy must feel as unloved, unwanted and unnecessary as an old shoe.

Your grandson will feel better about himself — and keep his hands away from your breasts — if your daughter asks him for help before he asks for her attention and if she tells him that he is the best present his little sister could get. He rocks her cradle better than anyone, fetches her diaper faster and he can even teach her to talk. And the more time he spends with her, the more she will adore him.

Show him how to sit next to her, face to face, and say the same word over and over without taking his eyes away from hers. Once she sees how his lips and tongue work, she’ll try to move her lips and tongue the same way and she’ll soon try to make the same sound. He will feel important and like he has a role in this new family dynamic.

His parents will still have to work on their son’s behavioral problems. Medication may suppress them, but look at his diet first. The wrong foods probably cause more trouble in children than anything else.

His behavior fell apart when he started eating regular foods, so that might be the culprit. Because 62 percent of “regular” foods are processed, cut out all additives, preservatives, oranges, tomatoes and other salicylates in his diet for five to six days to see if he acts better. If not, look at his dairy intake. Lactase dissipates in most children around the time they’re weaned, and then they might not be able to digest the lactose in dairy products. His parents should switch him to lactose-free milk and have him skip ice cream and cheese for a month. If he still acts up, let him go gluten-free for as long as two months. If he’s unable to tolerate gluten, he might feel and act miserably.

And if he still misbehaves after these home evaluations? Have him examined by an experienced ADHD tester.

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