3 1/2 year-old daughter with incredibly "difficult" behaviour.

Dr. Kennedy,
Thank you in advance for your advice.
I have a daughter who will be turning 3 1/2 this upcoming Friday. She is healthy, smart, attentive and loves to laugh and play. At birth, we found that her left ear was slightly deformed with a closed ear canal (hemifacial microsomia, Goldenhar syndrome). Despite the fact that, aesthetically, her ear sets her aside from other kids, she has passed all hearing tests up to date and seems to be able to react and respond just fine. She has been in and out of hospitals since she was born due to her syndrome, early problems with her hips, her jaw-line structure being off, hearing tests, and scans on her brain. My daughter has also had 2 febrile seizures in the past 3 1/2 years. She is very afraid of Doctors and hospitals, and cringes whenever she must go. She cries and yells to the point where I cannot get a word in with the hospital staff. I think that she might have transferred this angry and afraid behaviour to the outside world, but I might be wrong.
I cannot take her out with me shopping, because whenever I talk to a person that isn't family, she screams, pulls up her shirt, cries, hits me, refuses to leave the store and go home unless I buy her something/tell her we'll be back later. When we get home from experiences like these (happens every time), I try and speak with her to find out what's bothering her or what she's afraid of, and why she was crying and yelling and hitting me, but she will only say things like "No!" and "I don't know!" and pout and stare up at the ceiling. She seems like a very angry child. She is afraid of other kids, and will cry when they get close to her even if she's seen them many times before and been to their houses. She is afraid of children's mothers, but not their fathers as much. She will not speak to other people at all. I have tried play groups, going out to friend's houses, speaking with others about it, making rules, time-outs, and I just don't know what I could do anymore.

[Kevin Kennedy, Ph.D.]

Arrange an evaluatiion with a child psychiatrist. The extremity of this behavior is indicative of acute anxiety and it may need to be treated, even though she is so young. You won't get much mileage from talking with her about the situation, since she really doesn't have the cognitive skills to be able to offer any insight.