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Temper Tantrums

by Danielle Lehoux, MD

Temper-TantrumAs pediatricians, we take care not only of children’s physical health but also emotional growth. We often get asked advice about behavioral concerns. Today, I will talk about temper tantrums.

Just a few weeks ago, I was the witness of a tornado forced temper tantrum from a 3 year old boy. Everything was peaceful while I was evaluating his older brother and him playing on his mother’s cell phone. When it came time to evaluate him, disaster struck. He became immediately enraged when the cell phone was taken from him; he threw himself on the floor and started kicking, screaming, crying, and pulling his hair. He took off his shoes and threw it at his mother. His face was beet red with tears streaming down, his veins popping out if his little neck, ear piercing screams coming out of his tiny body. Initially, I stood there in shock at how quickly this sweet appearing child had turned into a real live Tasmanian devil.

His mother was trying to pick him up from the floor, begging him to calm down, his older brother was also telling him to stop but it only seemed to make him angrier. I snapped out of my shock when he started pulling his mother’s hair. I helped mom pry her hair out of his grip and pulled her aside, calmly told her to ignore him while we spoke about his older brother. When the little boy noticed he no longer had an audience, the screaming stopped. By this time, his mother was in tears as well, frustrated and defeated. I sympathized with mom at and told her I had been in her shoes as well. I vividly remember avoiding eating out at restaurants afraid that my toddler would embarrass me with an angry outburst. I would not even go near a department store with toys.

The following are common questions I receive from my patients’ parents and advise in how to handle a tantrum.

What are temper tantrums?

Temper tantrums are common, normal, age-related behaviors in young children. In a way, defiance and oppositional behaviors are part of the normal progression towards self-reliance and independence. Children do not understand the reasoning behind rules and limitations, they only see that their desires have been rejected, bringing out intense emotions that they cannot control. It’s an expression of anger and frustration.

Some children use temper tantrums as a way to get attention, others as a way to achieve something or avoid doing something.

At what age are temper tantrums common?

Temper tantrums are noted in children who are 2 to 3 years of age, but they may occur any time between the ages of 12 months and 5 years. Temper tantrums tend to improve once children have more verbal capacity and are able to verbalize their feelings.

Do boys have more temper tantrums than girls?

No, Boys and girls are affected equally.

Why do children have temper tantrums?

Temper tantrums are a normal, age appropriate behavior to show anger, frustration, protest. Children are more likely to have a tantrum when they are hungry, tired, or sick.

Can temper tantrums be a sign of an underlying condition?

Sometimes temper tantrums are indicative of more significant problem such as speech or language delay. It can also be a sign of a mood disorder or learning disorder. Be sure to tell your pediatrician about your concerns.

What are some Do’s and Don’ts regarding temper tantrums?

  • DO be consistent. Children need consistency in things like bedtime, mealtime.
  • DO praise your child for good behavior
  • DO give your child choices. Remember, this is a stage where children are learning autonomy, this gives them a positive way to show independence
  • DO tell your pediatrician about your concerns. They can distinguish between normal tantrums and problematic tantrums that may require further evaluation.
  • DO use time outs. One minute for every year of the child’s age is usually the norm.
  • DO remain calm when your child throws a tantrum.
  • DO ignore the tantrum as much as possible, letting your child know tantrums do not get your attention.
  • DO NOT physically punish your child. Shouting and spanking indicate that a parent has lost control of the situation
  • DO NOT give in to your child’s wishes in an attempt to stop temper tantrums. It might stop the current tantrum, but it will only perpetuate the behavior.
  • DO NOT go shopping when your child is tired or hungry. Children are more likely to act out when they are tired or hungry.

Reference:

Grover, Geeta. Temper Tantrums. Berkowit’z Pediatrics: A Primary Care Approach, 3rd edition

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