Hello all As a quick little background, my daughter is actually my step-daughter. Her mother walked out when she was 18 months and relinquished her rights (she doesn't know her). I came in the picture when she was four and her father and I have raised her together since then. She has always had traits that weren't quite normal but we shrugged most of them off. When she was younger she had issues in school with following directions, staying quiet, following through, organization and impulse control. She also has issues sharing attention. When she was younger these traits would come in waves. We'd have one or two bad months and then things would calm down. She was a straight A student and generally a delight at home (though exhausting ). Current: When she was in the fourth grade, she started a down phase and hasn't come up since (now in 6th grade). She's gotten far worse than ever before. She's failing all but one of her classes, is constantly in trouble and has moved her way through her school's discipline step system faster than anyone else (is close to being expelled), she was once in gifted classes and has been removed because of conduct, she's very angry and lashes out at teachers and friends (she called her teacher a b*tch two weeks ago), has purposefully hurt our dog "just to see what happens", she bullies other kids (suspended from the bus twice this year), is very disrespectful at home and screams, tells us no and has temper tantrums, her hygiene has to be micromanaged or she won't brush her teeth and take a shower, she has issues with repetitive sounds (fans clicking/dishwashers, etc) to the point of breakdowns, doesn't seem to learn from mistakes and repeats them, steals and lies from us and others and is just quickly falling to rock bottom (if we aren't there already). We tried multiple different rewards/punishments and nothing has curbed the behaviors. We've also tried getting her involved with various sports/activities and she been removed from them. We eventually realized something may be going on medically so we began seeing a psychiatrist who started her on vyvanse for ADHD which was a complete nightmare. While on it her anger issues went through the roof - screaming, throwing objects, refusing to move (sat outside in the dirt for 6 hours straight), etc. She was taken off of vyvanse and put on Paxil to help with the anxiety and has also been seeing a counselor (though it doesnt seem very helpful). Her school psychologist also got involved and for the past three months she has been undergoing various testing and we find out on the 14th their results and eligibility for an IEP/assistance. Basically I don't know what to do. I feel like we're going through all the right steps but nothing is changing - her behavior is only getting worse. Her behavior is very hard for me to accept because I was a straight A, goody-two-shoes kid who would have been crushed to disappoint a teacher. I've never been wrote up in my entire like whereas my step-daughter has been wrote up twice in the past two weeks! I know she can't control some of her behaviors but I feel like the drugs are only a tool, she has to try and help control herself some as well. I don't really know how to punish her because nothing seems to effect her. Her dad works nights so I am the one responsible for managing her the majority of the time. She's very close to being expelled, will more than likely have to repeat sixth grade, has no friends, is nightmare at home and now Im beginning to worry about her sister's (half-sister who is a toddler) safety because of her violence. No one around seems to understand and judges us as parents but I'd love for them to tell me what to do because I've tried it all and nothing has worked. My husband is a foster child and my parents are out of the picture so we're doing this alone and have no support outside of each other. I'm sorry for the length but I just don't know what else to do. I feel like Im beginning to breakdown and am having issues controlling my own anger at the situation (and Im normally a very calm person). It's just so frustrating and helpless feeling.