My 11 year old kid is barking like a dog.... HELP!

Jane has been exhibiting some strange behavior lately. I wrote last week about her "emotional ups and downs", but now it is more than just emotions. She is acting out. Her dad and I have both separately and together sat her down in the past and talked about ADHD, what it does to her brain, how to recognize behaviors resulting from it, learning to control herself, etc. This week however, she is just outright out of control, and I can't get through to her. She has outbursts of all these strange noises, will talk in different indiscernible voices, squeal, suddenly scream for no reason, bark like a dog, and she doesn't even know she is consciously doing these things. I don't know if she is just feigning innocence, in denial, or honestly doesn't know, but she looked at me this morning and said "What outbursts? I haven't made any sounds." It is very disheartening to sit by and watch her act like this, because I thought she had made so much progress and was well beyond this point. I started thinking it could be a self-defense mechanism, a sign of something else going on, but I don't know anything going on that could be bothering her. Maybe there is some kind of trouble at her mother's house.

What do I do? Should she get "in trouble" for having a condition she didn't choose? Should she be scolded because she is old enough to control herself better? Do we just let her be, and see if she stops behaving this way soon? Poor Kate had to calmly ask her 4 times on the way to school to "Please keep your hands to yourself, Jane" because she keep randomly reaching over and grabbing her. Three teachers on her last report card wrote comments about her being impulsive, talking disruptively, and not participating well in class. She is on the highest dose of medication allowed for her size, and it has always worked well until the last few weeks. I'm at my wit's end, but here is what I constantly remind myself:

1. LOVE her, not her behavior, and SHOW her you love her.

2. Don't make her feel bad about herself. When correcting, tell her she is choosing to let the ADHD control her, instead of her controlling it.

3. Be positive. You CAN do this. Show her how happy everyone is around her when she is behaving with self-control.

4. Make yourself available and open if she finally decides to share something personal, or let her defenses down and become vulnerable. Watch for signs of the root problems that is causing this sudden change in behavior.