L.T.
My daughter knotted and sometimes pulled out her hair around 3 years of age. I had planned to speak to her ped about it, but she stopped before I did. The prevailing opinion among the people I did talk to (friends, family) was that the twirling could be a way to soothe herself and the pulling could either be a way of dealing with frustration or could be exploration/experimentation. BTW, she also had short, fine hair. Anyway, when I asked my daughter how the knots got in her hair or why some of her hair was pulled out she told me "Cinderella did it." (Yikes! Knotting her hair AND an imaginary friend!) Rather than counter her on the Cinderella issue, I told her to tell Cinderella that I loved her hair and I wanted it to stay in her head and I didn't want to have to cut out knots. And if Cinderlla wasn't going to follow my rules she wouldn't be allowed to come to our house anymore. Much to my surprise it worked. The only other thing I can think to recommend (besides talkint to your ped) is if you catch her in the act, don't make a big deal about it, but remove her hand, smooth her hair, and redirect her. Good luck to you!