Hello,
Given the severity of the behavior and how long it has persisted, t will be important for you to have your daughter evaluated by a psychologist. I would visit your pediatrician to discuss your concerns as well as to rule out anything medical that could be causing irritability or problems understanding/communicating. As she is in
headHead and face reconstruction
Head injury
Head lice
Indications of head injury
Radial head injury start, I am surprised that no one has suggested referring her to your local school system's early intervention program. Your county public school can evaluate her speech-language, hearing, and physical capabilities for free. She may qualify for free services to help you manage her behavior or place her in a class that will better meet her needs.
Given the complexity of your daughter's problems, I would seek a private psychological assessment to learn more about her cognitive and emotional functioning. Your pediatrician can refer you to a psychologist or neuropsychologist who accepts your insurance. You can read my Medhelp articles about developmental assessment and ADHD to learn more.
It sounds like you have tried many techniques of behavior management. These techniques can be very effective when done correclty. What I often find is that it seems easy to use these techniques (such as sticker charts or time out), but it is very common for parents to make mistakes that sabotage the whole thing. It can be hard to get them right so they will work for a more challenging child. A psychologist can help you avoid these mistakes. Additionally, though it seems like explaining to her what she has done wrong would work, this is not a very effective way of changing her behavior. Children that age want to please, but they do not understand many of the concepts we try to explain to them, such as right and wrong, long term cause and effect or how their behavior impacts other people. She may be able to recite back to you what you have explained and seem like she really understands it, but at her age she probably comprehends very little. So try to avoid giving commands of more than three to five words at a time whenredirecting her (e.g. Hands off! or Feet on the floor!).
It is great that you have kept trying and avoided resorting to harsh punishments, which would be most likely to increase her aggression. Prior to meeting with the psychologist, get the book The Kazdin Method by Dr. Alan Kazdin. This is the best practical guide to implementing behavior plans I have found, and it will give you a different way of looking at behavior that will help you determining what is keeping this behavior going. You may also want to get Dr. Ross Greene's The Explosive Child.
Best Wishes
Rebecca Resnik
Disclaimer: This Medhelp post is written for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This Medhelp post is not intended to create a patient-clinician relationship, nor to give or rule-out a diagnosis.