Although there have been many similar instances throughout difficult child's life with different issues, it is truly unbelievable how much she just seems to just NOT CARE about rules or consequences. We are in the process of getting her further evaluated - the psychiatrist we've been working with has referred us to a pediatric neurology clinic in a teaching hospital a few hours away. She has added ODD to the ADHD diagnosis, with the notation that her constellation of symptoms are not adding up to something that is clearly diagnosed, that she presents with many symptoms that are like a certain type of disorder that usually occurs as a result of injury or illness without having had any injury or illness. difficult child is home for Thanksgiving, and one thing that has come to a head is that she was, once again, caught misusing electronics and breaking the rules we have for their use (I wasn't the one who let her use these things because I KNOW exactly what will happen). This even AFTER both her father and grandmother both had separate talks with her about how, if she would just follow the rules for ANY decent amount of time, that these were privileges that we would actually let her have, but she is just CONSTANTLY finding ways to break them and be sneaky/deceptive about it. This goes beyond impulse control, which she has none of. Her actions require forethought, planning, and deliberate (attempts to) cover up. It's like she truly does not care. The not caring is pervasive, applying to many different areas of her life. And that scares the mess out of me. Like I told her grandma, until difficult child finds some inner wellspring of actually giving a damn, there's not much we can do. What do you do when they truly don't care?