Sorry this will be long.
I'm about to make it longer with abuse of the quote function.
BACKGROUND: LO was born withdrawing from several illegal substances and was our foster child until DH and I adopted her at 13 months. She was always a very busy baby. As a young toddler she was VERY busy, and she started biting. Her teacher felt the biting was out of the norm and suggested sensory issues as a cause. I had noticed some sensory differences as an infant, such as crying when she touched grass, but hadn't worried too much. I pulled out my old copy of the Out of Sync Child and reviewed the checklists, which made me concerned.
I contacted an OT for an eval and got my pediatrician to put in a referral to a developmental pediatrician. My pedi wasn't worried though. The OT had us do a questionnaire/checklist and did an observation in a small room as well as the sensory gym. Her conclusion was that she saw "definite sensory issues" in most areas and "significant sensory differences" in other areas. The only thing she wasn't different in was taste/smell. However, she meets/exceeds milestones in all areas so they felt the differences weren't interfering with her ability to function and they said she wouldn't quality for a dx of SPD or anything else. (Autism is not a concern as she has no social differences). The developmental pediatrician agreed with the assessment a few months later. We did 6 weeks of OT and she was released, and e have kept up a sensory diet since, especially lots of climbing/crawling/jumping/vestibular and proprioceptive activities, and heavy work.
I have some second hand experience with children who were drug exposed. My younger niece is a substance abuser; I have a greatniece G who is 7 1/2 and a greatnephew A who is 5 1/2. One of my older niece's friends was a heavy user working the streets when she became preganant at 28. This girl had been led to believe she'd never be able to become pg because of chronic health issues. My greatnieceG was a foster to adopt situation and g'nephew A was adopted by his grandfather and his soon to be former 3rd wife. Friend's baby, 2 year old S lives with his mom who has turned her life around and has an entourage of assorted grandparents, aunts, uncles and family friends who worship her as the gift she is.
Niece was on methadone during both pregnancies with some non-compliant self medication. G was treated with morphine for withdrawl which took a few months; A was treated with phenobarb because the plan was for him to go home with mom and phenobarb is less risky with a user. He was on phenobarb until he was at least 12 months old because he was behind on his vax schedule and they don't like to risk fevers newly off phenobarb. S didn't require meds though she definately was drug exposed until about 6 months into the pregnancy when her mother finally figured out she was pregnant.
I was a very hands on adult in niece's life during both her pregnancies- I was the one driving her to the various appointments- sometimes 3 and 4 a week in the last trimesters. She allowed me to sit in on them because she didn't understand most of what was being done and why, so my information is first hand. S's mom shared some of her story with me; she's pretty honest about what she was up to.
In addition to the drug exposure, I think you can get a lot of information from birth family pedigrees. Many people who use drugs are self medicating for behavioral health concerns. If you have access to such information, it would give you some general areas to in context with Charlotte's unique blend of strengths and weaknesses.
For my "unholy trinity", what the birth parent brought to the table (or bedroom) is reflected in the child. (you should see it when these three get together for a playdate- OMG!)
My niece has some significant mental illness. She was always an impulsive and "spirited". My husband would say "feral". She was a wild child. Like your Charlotte, she was very bright. Her IQ at assessment was just over 130. Niece's mom died when she was 9 which was about the age some of her bahvioral stuff started. Most professionals insisted on writing it off to losing her mom, but one of them saw through that and suggested bipolar with ADHD. He wanted to medicate; but my idiot BIL took custody of her to access her social security checks- he refused meds (he's a recovering addict) and stopped taking her to the psychologist who wasn't taken in by her drama. Fast forward 10 years- niece is full on mentally ill and has a criminal record of theft, drug dealing and bad choices. A few months ago she was in an accident in a stolen car and gave the police her sister's indentification- still working to clean that mess up.
As for the men who fathered her kids, we don't know much. G's dad was German and a drug user; I met him once and he seemed pretty dull but he was probably using, so? A's dad was from the DR, he seemed a little more on the ball but again, sort of thuggy. S's dad was a low level mobster who comes from a lovely middle class family.
She's not an "easy" kid. Not that any are but she definitely qualifies as "spirited". She doesn't do well in daycare settings because she gets bored. We moved her into Montessori last winter and she did/does great there in general. Since the time change she's gotten less exercise and her behavior has been tanking. As a coincidence, it was time for the school to bring in speech/occupational therapists to do mini evaluations. We had them evaluate Charlotte at a cost of just $10.
I've read your posts in the past. Your Charlotte (my favorite girl's name by the way- one of my favorite aunties is a Charlotte) sounds a bit like my niece or her son at that age. It's not that they're "bad" or even "willful"; it's like they just can't settle. And you're right, they're more work than a typical kid but worth it because of their sweetness and potential.
Call me cynical, but the school allowing an outside professional to offer mini-evaluations in house bothers me. Maybe I've been living in Spedworld too long, but what's in it for them? The school gets to look proactive to the parents and the service providers gets access to the sort of parents who are prescreened for really caring about their kids, having a fair amount of disposable income and likely excellent insurance. I am always leery of a situation where a professional is both evaluator and service provider. It's a situation I have chosen to avoid where possible. I have seen so many parents waste time and money on marginally effective therapies in similar situations.
If Charlotte's issues are of a concern enough to suggest a mini-consult with a clinician you didn't choose, then they're significant enough to request a full multifactored evaluation from your school district in all areas of suspected disability.
I want to note that Charlotte's teachers are concerned that her short attention span and unwillingness to follow directions are starting to get in her way academically. Which sounds dumb just writing it out because she's 3. But skills build on each other and she is mentally able to do advanced work but not... neurologically?... able to. They have had to purposefully hold off on some lessons she should be ready for.
Kids develop physically, socially, emotionally and academically at different rates. For a really bright kid, intellectual, cognitive or academic maturity may be precocious making things like emotional domain skills like self regulation look more delayed than they actually are. She's 3 1/2, no?
Your descriptions of her sound like every little kid I know who went on to get an ADHD dx later. Given he family hx, ADHDers are notorious self medicators, this is fairly likely. Assuming for a moment that's what you're seeing, ADHD can be thought of as a delay in emotional maturity which would make the disconnect between a LO ready to read and not ready to sit still. If this is the case, you may find her behavior more like a younger kid
The bolded would bother me. They're ascribing motive without really examining whether she has the emotion bandwidth to go along with the cognitive piece. She needs to have both. It's great that she's bright and has the potential to be a high acheiving student, but she's isn't there yet.
This sort of reminds me of one of my old car pool kids. James was attending DS's reading lab school because he was a really bright kid who had wicked sensory issues and dysgraphia as well as what his mom called "ring-of-fire" ADHD. This was pre-Conserta days and he had a hard time with old school Ritalin which exacerbated stuff. Frankly, he wasn't a very likeable kid at times. I'm pretty chill, but I was tempted to throw him off the Scudders Falls Bridge more than once.
James was in 4th grade and reading at college level and doing middle school level math. He was in the school because his particular issues frustrated the crap out of his public school teachers who ascribed his inability to write to a willfull choice. When they started down the path of "presents consistently with symptoms of ODD" mom pulled him, went to due process and got a $80K settlement for 2 years of theraputic school and legals fees.
At any rate, since James was an advanced reader in a school where most were struggling, he took RELA with the high school kids and was given Tom Sawyer to read. Now James could read, as in decode, the text but he lacked the social and emotional maturity to really get the conext and content. To him it was just a book with the n word in it. When he read it again as part of a literature based history class in high school, he got it. He always had the potential to make sense of the material, but he needed to grow into it emotionally. I think that might be a little of what you are living.
The OT who did the school eval wrote essentially the same sort of eval as the first OT. Her observation at school was that she was observed moving around the classroom without prompting and shared a work station with another child without incident. However, "her teacher shared Charlotte's difficulty participating in a group instructional activity: she can't stay in one spot, can't keep her hands to herself and talks out of turn." She also graded the checklist/questionnaire: Typical performance in the areas of Taste/Smell sensitivity; Probable Difference in the area of Auditory Filtering; Definite Difference in the areas of Tactile Sensitivity, Underresponsive/Seeks Sensation, and Visual/Auditory Sensitivity. She recommends a full OT eval and OT.
Which basically puts us right back where we already knew we were. Parent/teacher reporting equals a difference but observation not so much so, or at least less obviously so. I'm beginning to think I'm crazy (though DH filled out the form this time and the teachers added input without me...). On the other hand if it's starting to interfere with her ability to learn/advance, maybe it's worth pursuing. Or maybe it's something I should leave be until she's closer to school age.
I think you'll have more information as she gets older. For an "older" kid, a decent school district evaluation would include a school psychologist observing several times in different settings- maybe circle time, recess and math or music- to get an idea of how she does in different levels of overt structure. You might want to pull the trigger on this before she transitions to kindie if she'll be attending a traditional school. If she'll be staying with a Montessori program, closer to 1st might make more sense. Even if you stay with a private school, you are entitled to the eval.