Seablue, with that family history, your description of her behavior, and the toe-walking, I'd have her evaluated for autism spectrum disorders ASAP. Autism definitely runs in families. Girls do present unusually and are very, very often overlooked.
I would initiate the evaluation both with a private expert (developmental pediatrician or neuropsych) and with the school district. If she is on the spectrum, the district is required to offer her services from age 3; you could miss out on a lot of help by waiting.
IMHO this is way out of the league of an OT. Nearly all OTs will tell you this stuff is sensory in origin; if you only have a hammer, everything looks like a nail. I would instead seek an expert who has seen lots and lots of bright autistic children, including many girls.
Best wishes,
DeeDee
