He lives with his parents and sister in a "normal" middle class home. There is no history or evidence of abuse, drug use, alcohol abuse or any event that would lead one to suspect PTSD. This includes invitro.
His medications include Abilify, Intuniv, and Prozac. I'm quite sure that the doses he is taking are significant. We have attended appointments with the parents and the psychiatrist trying to give him the best information we can looking for the best therapy that we can get for the student and for the parents. Other than the medication, he has been little help. You should see the child un-medicated. Holy crap!! Needless to say, he would be totally unmanageable without medical intervention.
We are reluctant to use the criminal justice system at his young age, but we're not so naive that we don't know that it's only a matter of time. Our goal has been to "cure" him or give him the appropriate coping mechanisms to help him integrate into the school society. He shows no interest in getting along within the school, but only want the school to get along with him: His time, his preferred activity, his schedule, his way.
I know that I am describing a narcissistic personality disorder and potentially sociopathic tendencies. I had one of diagnosticians review what I put in my original description to make sure I was being accurate. She sad that if anything I was understating the symptoms. So, I'm pretty sure of my own conclusions, just not comfortable with them.
I, too have spent a great deal of time working in a juvenile detention center. I was the school principal in a detention center for boys aged 10-16. We had everything from rapists to capital offenders. I can't imagine this little boy being there, but like you, I don't see any other options. There is so very little assistance with this type of mental health issue in my area that I don't know where else to turn. Other than the juvenile justice system, do you have any other recommendations for therapy or some other avenue that maybe I haven't explored?