please help for 5 year old

I have 3 daughters and my middle one shes 5, has always given us problems.  Shes had colic as an infant, extreamly shy and wouldnt use the potty until she was almost 4.  She used to have horrible temper tantrums she hasnt had one in about 8 months but she seems to be in her own world most of the time.  Shes very smart and she can carry on a conversation but she doesnt seem to know whats going on around her.  If shes outside playing shell run into the street without looking even after being told millions of times.   Shell run into things just because shes not looking.  She does have vision problems.  She had surgury to correct crossed eyes and didnt need glasses anymore but when just found out the vision in her left eye is getting worse and needs glasses again.  She does not get along with her older sister at all.  Shes very mean most of the time.  I have tried everything. I dont know if this is normal or not.  I dont know how to disipline her. Her behavior is straining the family.  Please give me some advice.  Thank you mandy

[Kevin Kennedy, Ph.D.]

Dear Mandy,

Your situation requires professional attention. The first line of intervention needs to focus on the medical front. The role of inadequate vision in her problems needs to be assessed.

The relationship with her sister is not necessarily outside the bounds of normal. But if you're encountering frustration about how to manage it, consult with a child behavioral health professional. Such a person can help you (a) figure out if your daughter's situation requires specialized intervention, and (b) dtermine a systematic approach to behavior management. The clinician can also evalaute your daughter to see if her social awareness and her interaction with her environment are developing normally.

Sometimes parents see the behavioral health or mental health field as useful only in the face of serious emitional disturbance. Much of what we do is assist people to manage the normal occurrences of everyday life.