When my son was not in good control he began showing major signs of precocious puberty. At that time he was 4 years old. As soon as they switched him from the liquid cortef (Upjohn) to the pill, he returned to good control. During that time though, he developed some pubic hair, body odor, mood swings, enlarged penis and a HUGE interest in my "fashion magazines". Now that he is in good control those symptoms have lessened somewhat, but he will never be able to erase the sensations and emotions he experienced during that time. I read an article that said that on average, girls were going into puberty earlier than days gone by. The age they stated was 9 - 10 for girls and 13 - 14 for boys. Is it possible that your daughter had a short time frame where she "escaped" from her good control allowing for the pubic hair to come in and breast buds to develop? I only ask this because about one month ago my son had clinic and two weeks later his OHP levels came back 10 times higher than what Dr. New allows as an acceptable range. She re-tested and the levels came back showing that he was in good control just two weeks later. It could have been a faulty test, but as his Mom, I had noticed a dramatic change in his moods as well as other tell tale signs. Then, without altering his meds, he changed back to his "normal", pleasant self inside of just a few weeks. This is why they believed it was a temporary "escape" rather than an error in testing. I'm certainly glad that they didn't adjust his meds based on the first test. In the article they stated that some of the doctors were choosing to let the child go into puberty early rather than put them on Lupron to stave off puberty as long as they were within a year or two of the latest average and that short stature was not an issue. I hope this helps you with some of your questions. Feel free to email me if you have any further thoughts or concerns. Good luck.