Hi Nik,
Is your DD depressed? If so, the methylphenidate won't really treat that. Changes in sleep are a warning sign for depression, and should definitely be followed up.
Who is your prescribing doc? With your complicated set of diagnoses, you should really try to find a psychiatrist or developmental pediatrician who's seen and prescribed for lots of other kids like yours (including ADHD and the autism spectrum). You will want someone who's intimately aware of all the effects of all the possible meds, and experienced in both diagnosing kids and choosing dosages. We have been very happy with our dev. ped. in this regard.
I wouldn't rely on your DD's opinion to adjust her dosing; kids can be very peculiar in their judgments about their medications. Too much of an ADHD med is usually just as bad as not enough.
While you're working on getting the appointment with a suitable doc, take some data: note how she looks to you, how she says she's feeling, how much she's sleeping, etc. That way you can bring hard evidence to the doc that will help them make a solid assessment and hopefully figure out what needs to be adjusted.
HTH,
DeeDee
