Firstly, for your daughter's and your own sanity, ignore the funny looks people may give you - if they are not in the same situation they cannot possibly understand the difficulties your daughter is experiencing, or the difficulty you face in choosing the best treatment for her.
If the poor motor skills are contributing to her being unable to correctly hold her pencil, results in early fatigue or hinders her ability to sit upright, then I would suggest beginning OT. However, consider this one carefully as children with ADHD may have the ability to do all these things but don't due to the difficulty with remaining in one position for any length of time, and with concentrating only writing neatly (as an example).
The aggression and defiance may be her way of managing her own frustrations at constantly being told to sit still, don't do that, stop fidgeting etc, when to her mind, she is doing nothing wrong.
When meeting with the neurologist, bring a list of questions and concerns you have regarding medication (a written list so you won't forget anything) and inform the neurologist that you are considering medication as an option; if you inform him/her that you are seriously considering it or anti it, s/he may be selective in the information given. This is never done intentionally, but due to human nature we tend to offer information based on the information we are provided.
There is a mom who regularly contributes on this forum and sings the praises of medication due to the phenomenal results her son has had and how how much better he feels on it. The key to remember is that any medication should always provide more positive than negative side effects; when the balance shifts the other way it is time to reconsider the options.
Depending on the neurologist, s/he may also offer some advice on more natural alternatives such as Omegas etc, depending on the severity of your daughter's ADHD. Some doctors prefer not to prescribe medications before the age of 7 years.
Keep an open mind and do what you feel is best for your daughter in the long term.
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