My daughter is 5 but started displaying difficult behavior at 22 months. Toilet training took over 1 year (completed by 3 1/2 years). She would hold her urine, sometimes for hours, rather than release on the adult or kiddy potty (seemed to be a control issue). Her defiant behavior is escalating with constant arguing after a request is made of her, giving ugly looks, growling at times, yelling, refusal to comply, "giving attitude", sassy talk, throwing things, etc. This behavior occurs with parents and to a slightly lesser degree, maternal grandparents, whom she sees a few times a week. At school, however, she is generally compliant per teacher and even wants to please the teacher. She sometimes wants to mind other kids' business. She likes playing with a couple of active boys best and is very nurturing towards younger children. She loves to hug and cuddle but will also be unrelentless about having things her way. She has started tantrums after being given a choice and then being unhappy with her own choice! She has been getting occupational therapy for sensory integration since birth. She seems to enjoy the drama and may be drawn to the intensity of the tantrum and works herself up further. We adopted her at birth. She was exposed to crystal methamphetamine in utero but there is little good research on it's effects on the older child. I am sure that plays a role but the fact that she controls the misbehavior at school leads me to believe that she chooses where to misbehave. I love her dearly but am exhausted! I have used positive reinforcement, active ignoring (behavior doesn't taper off), natural consequences, loss of privileges, time-out, and am now starting a behavior report card...your ideas are welcome. I will get The Explosive Child.