Out of control child: How to tell the parents I think he needs professional help?

How active are the parents in these kids lives? Especially if they had live in nannies at one point, did they do any caring at all for the children? Flipping from nanny to nanny is a lot of change in a child's life, no one to depend on. Sounds like the poor child is stressed, lonely and depressed. Maybe he wasn't taught how to comfort himself or find comfort in small things. Some children need their parents more than others for love and affection and tend to lash out constantly when feeling neglected. When he lashes like that and calms down, try asking him what is really bothering him. Encourage him t be open with you and his parents. Sometimes a child just needs someone to listen whether their problems are serious or not. Just to know someone is there. If his mom is that dismissive to you, I imagine she might be over her own child's wants as well. I feel bad for the poor guy and understand you're in a bad spot. If talking to Max and letting him know verbally he can depend on you doesn't work then I would approach the mom even if it means losing your job. If Max shares any important information about the way he feels, I would also pass this on to the parents as well.