My daughter is 11 and has been diagnosed with an unspecified mood disorder and ODD. Some background: Development was normal. She walked at 10 months, talked on time, interacted well as an infant. Evidence of sensory issues from an early age. She never liked being in a car seat and riding in the car has been a source of stress for 11 years, has to sit in a certain seat adjusted a specific way, the seat belt does not feel right and she often tries to ride with it so loose that it would not protect her in a crash. Clothes are also an issue (she currently does not wear underwear because there is no pair that is comfortable to her). When she was 3 or 4 we noticed that she a tendency to have very strong tantrums but assumed she would outgrow them. She had them at home but never at preschool. Tantrums started at school the first week of Kindergarten. She continued to have tantrums at home and at school thru K and first grade. She no longer tantrums at school but does at home. At home tantrums could be over riding in the car, or doing a family activity that she did not want to do, dinner time, food choices etc. When she tantrums she will cry loudly and stand right next to me and sometimes push me with her body. She tantrums for up to 1 hour and it is very difficult to escape her during this time. She will not go to her room. We have tried physically putting her there and holding the door closed but this has gotten dangerous as she gets older and stronger. I have sometimes locked my self in my car as it is the only way that I can escape from her standing right next to me yelling/crying during a tantrum. She has started to pull my hair and has slapped me a couple of times. During the school year we have 1-2 mornings a week where she refuses to get on the bus to school, she has a major meltdown/tantrum and we wind up driving her late with her crying. It mostly comes out as defiance but there are times when it comes out as I just cant do this. She seems to be OK once we actually get her into the school. I have checked with the principal on several of these days and am consistently told she is doing fine. She also refuses to go to doctors for physical ailments. We need to bribe/force her to go if she needs medical care. It is very difficult to get her to take medication even if she has something like strep throat and is pain. The summer before 2nd grade we contacted her pediatrician who recommended that since she had tantrums at school we initiate testing thru the school and he wrote to the school requesting testing and that she be evaluated for an IEP. The following tests were performed via the school: WISC-IV, Behavior Assessment System for Children-2, WIAT-II, and an evaluation by the school Occupational Therapist (OT). The school findings from the tests indicated that she has some sensory issues, and significant variability on the subtests of the WISC-IV (range of 67th to 96th percentile) and the WIAT-II (range of 59th to 96th percentile); there were behavioral issues that were identified as at risk or clinically significant. The schools conclusion was that she was performing at or above grade level, had stopped having tantrums at school, and did not need an IEP. We then went thru a succession of tdocs outside the school system. One would not work with difficult child but told husband and I to read two books with totally opposite approaches and pick the one that we thought would work the best. We started with another therapist. difficult child did not want to go and we initially took her there by force and the first couple of sessions were spent with her tantruming for the hour. I was able to get her to agree to come for a 10 minute session and we were able to work that up to 1 hour (if I sat with her) but she would shut down whenever the therapist tried to get her to discuss her emotions or behavior. Six months after we started that therapist closed his practice. I requested a clinical summary and it stated the diagnosis was an unspecified mood disorder. Our current therapist saw difficult child once (we dragged difficult child to an initial meeting) and diagnosed her with ODD. Working with husband and me, therapist has been teaching us PCIT (parent child interactive therapy) and has established a behavorial modification system. There have been some improvements but I feel something more needs to be done but I am not sure how to get there and what my next steps should be. I know from reading this board that the ODD is describing the symptoms and is not a diagnosis of her underlying problems. I feel that she struggles with sensory issues and with anxiety (but know that I am not capable of diagnosing). She recently had some physical medical issues and dealing with that put her in tail spin. We had about 2 months of daily tantrums and she is finally coming out of that and the tantrums are lessening to a couple per week. difficult child is adamant that she likes her behavior and she does not want to change. She says she will not see a therapist. We have never mentioned psychiatrist to her and have actually scheduled and then canceled appts because we could not figure out how to get her to go or how we would ever get her to take medications if prescribed. I dont even know how a Neuropysch would be able to evaluate her when mention of a doctor visit can trigger a tantrum. Some specific questions: 1)Do you think it is worth finding a neuropsychologist to review the testing that we have from 2nd grade and see if they can determine what are specific issues for her without actually seeing difficult child? 2)Do you think I should bring her to a neuropsychologist and that a good one will find a way to test her even if she is refusing and tantruming? 3)Although I am willing for some short term worsening of her behavior for long term gain I worry that forcing her to go to appointments is doing more harm than good. She tells us that we dont love her and want to change her and her tantruming increases for days around an appointment. Are therapist and psychiatrist appts something that we impose our will on her about? Thank you all in advance.