Waking up screaming and other problems

My 3yr old daughter is showing the following problems on almost a daily basis:
1) she will not speak after waking up in the morning for at least
30 minutes during which she just points if she wants something.

2) she hates going to nusery school, cries at the mention of it and will hardly talk to anyone there: although she seems to be quite happy with school when we call to pick her up from it.

3) she wakes up in the night crying sometimes to the point of making herself sick

4) very bad tempered during the day sometimes leading to vomiting after crying if she doesn't like something like not getting her juice in the right cup

does this all sound like she may need serious help medically or is there something we as parents can do?

[Kevin Kennedy, Ph.D.]

Dear K,

It's hard to tell if there's any unusual concern. Much of what you describe is not unlike the mercurial, temperamental dispositions of many three-year-olds. The fact that some of the reactive behavior occurs in response to denial of her wishes indicates it is within the normal spectrum.

Relative to the behavior in the morning, it may take a while for your daughter to ease into the day. I wouldn't make much of her refusal to speak, but I'd also not cater to her pointing as a way of communicating. Simply let her know that, if she'd like something, let you know via her words.

Also relative to the morning, do you think she's getting a sufficient amount of sleep? She should be getting in the vicinity of eleven hours. She may be overly tired/sleep deprived.

Relative to the pre-school experience, some children take to this more readily than others. If she's basically happy during the day, in spite of her reluctance early on, there's really nothing to worry about. But, if the pre-school staff perceives that she's unhappy, it would be worth considering keeping her at home a bit longer (if, of course, you have such an option).