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re: is it normal?
Some of the behaviors sound very typical ADHD: being bossy, not always keeping straight who is the kid and who is the adult, low frustration tolerance, and even temper tantrums. However, losing emotional control to the point of needing to go to the ER is a good sign that more is likely going on, as is the need for respite care. I would strongly encourage the family to find a good Child Psychiatrist and keep an appointment for at least a consultation.
There are medications, support, and other treatments that can help your granddaughter and her family find a happier, less chaotic, lifestyle and routine.
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