Tips for Assessing and Managing Temper Tantrums

By Sandra K Thomas, M.D.

Tantrums in toddlers are normal.  They are a part of your child’s development.

The most important thing to remember is to ignore them and do not give in. Unfortunately, this does not always work and we have to rethink and not punish. There may be a source for this, an imbalance in their thinking.

Tantrums are actually emotions that go beyond your child’s control. Typically, they start with a trigger, peak within 3 minutes, then rapidly subside, usually ending up with sadness.They are not always meant to be manipulative. They typically occur while a child is making developmental spurts in abilities and in their thinking, and they are usually not well matched with self-control.This is typical because they cannot always do, say or tolerate feelings. Many times an 18 to 24 month old child is frustrated by their inabilities to describe to you what they feel or want. On the other hand, children around age 4 years have tantrums associated with fatigue or stress while their bodies are adjusting to dropping their afternoon nap.

Life is frustrating for young children who are adjusting to new skills such as climbing, scribbling, opening things, and parents – at first delighted by their progress- suddenly want them to stop! Each new word is exciting at first, but then parents start ignoring, or even try to shush him. Here is where the lack of words and surge of emotions may cause a sudden burst of temper in the child. During this time, tantrums are more expected, hence the name “terrible twos.”

Children do not understand “sharing” until age 3 or older. They have a strong sense of “mine,”, “me” and “I want.” And the more intense children are even more difficult to distract and do not give up as easily.

The threshold for frustration has a lot to do with their overall state. Is he tired, stressed, hungry, in pain? Children with chronic conditions, both mental and physical, are more likely to not be able to cope. And some children have mental health issues that make them more sensitive to loud noises, tight waistbands and other sensory integration issues. Often, these children cannot bear sounds,feelings or emotions at any age and need intervention by occupational and physical therapists. Conditions such as ADHD, anxiety and depression predispose these children to irritable responses even with normal stress, and these are often combined with sleeping disorders and lagging in skills.  When tantrums are extreme, consider these conditions.

Some children’s tantrums are beyond the usual range and require more then the usual response. If they occur more than once per day, last more than 5 minutes or persist after 6 years of age, they may be a more severe problem. Paying attention to the trigger may help prevent future tantrums. Look at their overall picture at the moment.  Were they tired, hungry, jealous, unable to express themselves?  Do they have some deficits in development delay frustrating them? Avoid these frustrations and get help for the child.

If distraction works, use it! Dance, tell a joke, sing! These are useful modeling techniques. If talking, cajoling and scolding doesn’t work, let them explode and recover on their own.

The fastest way to curb most tantrums is to ignore them, but a surprising number of children want to be held. This does not reinforce the behavior as long as you do not give in to the demand. It lends “ego support” and reassures the child that life goes on and all is well. They typically go from angry to sad, but the older child is often embarrassed by their loss of control. Comfort is appropriate and kind if it is authentic.

To build self-control in your child, give them special attention, praise and good marks when they show self control. Complement them when they perform correctly such as coming to the dinner table on time, brush their teeth, turn off electronics and go to bed. (Hint: if they have a fit when told to turn off electronics, they get none the next day!). Adult management here is the key.  If you give in to their demands, expect a worse fit the next day. But you cannot say no to all of their demands. Decide in advance what is important.  Giving into a request for a snack may be appropriate if they are hungry. What are the 5 or 6 most important events to say no to. Write them down and all adults in the house need to have the same response.

Do not respond with anger or loss of control. Ignore their tantrums, but not to the point of ignoring the child. They may throw a worse fit just to get your attention. Be alert to the risks of excessive punishments. It is a poor model for the child. And do not get in a battle of wills.  You might lose and in doing so, lose the child’s confidence in adult kindness and self-control.