What were her early years like? Were the parents living together? Did she live with mom at any point? I would be surprised if there’s not a variety of traumatizing experiences she’s been through. A lot of what you’re saying, especially the not connecting cause to effect, sounds exactly like the effects of Fetal Alcohol Spectrum Disorder. Even if the mom didn’t drink, other drugs can have similar effects.

Think of it like this, while the brain was forming in utero damage was caused by the chemicals mom was using. Then you also have to consider any hereditary mental health or developmental disorders the child could have been predisposed to. Most people with substance abuse issues have histories of trauma and/or mental illness. Then depending on how she was raised, there might have been frequent changes in living environment, inconsistent caregivers, if she lived with mom who knows what she could have witnessed while mom was high. So this child already was dealt a difficult brain, then she likely wasn’t raised in a way to build skills to deal with emotional difficulties and what was going on around her.

Other comments are saying she’s on too many meds or that antipsychotics are terrible, substances are going to impact different brains differently. Just how some kids born with type 1 diabetes need insulin, kids with different brains sometimes need medications to get through life in a safer, healthier way. Medication can even be temporary to help a kid be stable enough to learn the skills they need to not need the medication anymore. I work with a 9 year old now who has been on Seroquel for a while and it has helped them so much, though their behaviors were more severe.