What we eventually discovered that citric acid in its artificial form (301) was triggering part of the behaviour it's in everything ribena, yoghurt some cheeses, biscuits and juice etc. removing that from her diet made a big difference. Then she needed glasses and again her behavior improved. With the screaming and not talking we walked away if she was safe and asked her to use her words when she was ready to talk. In regards to the toileting we have had to go on osmolax as she was holding on and stretched her bowel it's taken 4 months and there has been a big improvement until we went away last weekend.
She is now a polite and helpful 4.5yo, so different to the screaming yelling child from last year.
I would hold off the assessment for a little while and see if she improves over time.
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