Dr. MJ Bazos MD, Patient Handout
TemperTantrums:
A Normal Part of Growing Up

Strong emotions are hard for a young child to hold inside. When children feel frustrated, angry, or disappointed, they often express themselves by crying, screaming, or stomping up and down. As a parent, you may feel angry, helpless, or embarrassed. Temper tantrums are a normal part of your child’s development as he learns self-control. In fact, almost all children have tantrums between the ages of 1 and 3. You’ve heard them called ‘the terrible twos.’ The good news is that by age 4, temper tantrums usually stop.

Why do children have tantrums?
Your young child is busy learning many things about her world. She is eager to take control. She wants to be independent and may try to do more than her skills will allow. She wants to make her own choices and often may not cope well with not getting her way. She is even less able to cope when she is tired, hungry, frustrated, or frightened. Controlling her temper may be one of the most difficult lessons to learn. Temper tantrums are a way for your child to let off steam when she is upset.

Following are some of the reasons your child may have a temper tantrum:

• Your child may not fully understand what you are saying or asking, and may get confused.
• Your child may become upset when others cannot understand what she is saying.
• Your child may not have the words to describe her feelings and needs. After 3 years of age, most children can express their feelings, so temper tantrums taper off. Children who are not able to express their feelings very well with words are more likely to continue to have tantrums.
• Your child has not yet learned to solve problems on her own and gets discouraged easily.
• Your child may have an illness or other physical problem that keeps her from expressing how she feels.
• Your child may be hungry, but may not recognize it.
• Your child may be tired or not getting enough sleep.
• Your child may be anxious or uncomfortable.
• Your child may be reacting to stress or changes at home.
• Your child may be jealous of a friend or sibling. Children often want what other children have or the attention they receive.
• Your child may not yet be able to do the things she can imagine, such as walking or running, climbing down stairs or from furniture, drawing things, or making toys work.

How to help prevent temper tantrums
As a parent, you can sometimes tell when tantrums are coming. Your child may seem moody, cranky, or difficult. He may start to whine and whimper. It may seem as if nothing will make him happy. Finally, he may start to cry, kick, scream, fall to the ground, or hold his breath. Other times, a tantrum may come on suddenly for no obvious reason. You should not be surprised if your child has tantrums only in front of you. This is one way of testing your rules and limits. Many children will not act out their feelings around others and are more cautious with strangers. Children feel safer showing their feelings to the people they trust. You will not be able to prevent all tantrums, but the following suggestions may help reduce the chances of a tantrum:

• Encourage your child to use words to tell you how he is feeling, such as ‘I’m really mad.’ Try to understand how he is feeling and suggest words he can use to describe his feelings.
• Set reasonable limits and don’t expect your child to be perfect. Give simple reasons for the rules you set, and don’t change the rules.
• Keep a daily routine as much as possible, so your child knows what to expect.
• Avoid situations that will frustrate your child, such as playing with children or toys that are too advanced for your child’s abilities.
• Avoid long outings or visits where your child has to sit still or cannot play for long periods of time. If you have to take a trip, bring along your child’s favorite book or toy to entertain him.
• Be prepared with healthy snacks when your child gets hungry.
• Make sure your child is well rested, especially before a busy day or stressful activity.
• Distract your child from activities likely to lead to a tantrum. Suggest different activities. If possible, being silly, playful, or making a joke can help ease a tense situation. Sometimes, something as simple as changing locations can prevent a tantrum. For example, if you are indoors, try taking your child outside to distract his attention.
• Be choosy about saying ‘no.’When you say no to every demand or request your child makes, it will frustrate him. Listen carefully to requests. When a request is not too unreasonable or inconvenient, consider saying yes. When your child’s safety is involved, do not change your decision because of a tantrum.
• Let your child choose whenever possible. For example, if your child resists a bath, make it clear that he will be taking a bath, but offer a simple decision he can make on his own. Instead of saying, ‘Do you want to take a bath?’ Try saying, ‘It’s time for your bath. Would you like to walk upstairs or have me carry you?’
• Set a good example. Avoid arguing or yelling in front of your child.

What to do when tantrums occur
When your child has a temper tantrum, follow the suggestions listed below:

1. Distract your child by calling his attention to something else, such as a new activity, book, or toy. Sometimes just touching or stroking a child will calm him. You may need to gently restrain or hold your child. Interrupt his behavior with a light comment like, ‘Did you see what the kitty is doing?’ or ‘I think I heard the doorbell.’ Humor or something as simple as a funny face can also help.
2. Try to remain calm. If you shout or become angry, it is likely to make things worse. Remember, the more attention you give this behavior, the more likely it is to happen again.
3. Minor displays of anger such as crying, screaming, or kicking can usually be ignored. Stand nearby or hold your child without talking until he calms down. This shows your support. If you cannot stay calm, leave the room.
4. Some temper tantrums cannot be ignored. The following behaviors should not be ignored and are not acceptable:

• Hitting or kicking parents or others
• Throwing things in a dangerous way
• Prolonged screaming or yelling

Use a cooling-off period or a ‘time-out’ to remove your child from the source of his anger. Take your child away from the situation and hold him or give him some time alone to calm down and regain control. For children old enough to understand, a good rule of thumb for a time-out is 1 minute of time for every year of your child’s age. (For example, a 4 year old would get a 4-minute time-out.) But even 15 seconds will work. If you cannot stay calm, leave the room. Wait a minute or two, or until his crying stops, before returning. Then help him get interested in something else. If your child is old enough, talk about what happened and discuss other ways to deal with it next time.

You should never punish your child for temper tantrums. He may start to keep his anger or frustration inside, which can be unhealthy. Your response to tantrums should be calm and understanding. As your child grows, he will learn to deal with his strong emotions. Remember, it is normal for children to test their parents’ rules and limits.

A word about...safety
Many times, you will have to tell your child ‘no’ to protect her from harm or injury. For example, the kitchen and bathroom can be hazardous places for your child. Your child will have trouble understanding why you will not let her play there. This is a common cause of a tantrum. ‘Childproof’ your home and make dangerous areas or objects off-limits. Keep an eye on your child at all times. After telling your child ‘no,’ never leave her alone in a situation that could be hazardous. Take away dangerous objects from your child immediately and replace them with something safe. It is up to you to keep your child safe and teach her how to protect herself from getting hurt. Be consistent and clear about safety.

Do not give in by offering rewards
Do not reward your child for stopping a tantrum. Rewards may teach your child that a temper tantrum will help her get her way. When tantrums do not accomplish anything for your child, they are less likely to continue. You may also feel guilty about saying ‘no’ to your child at times. Be consistent and avoid sending mixed signals. When parents don’t clearly enforce certain rules, it is harder for children to understand which rules are firm and which ones are not. Be sure you are having some fun each day with your child. Think carefully about the rules you set and don’t set too many. Discuss with those who care for your child which rules are really needed and be firm about them. Respond the same way every time your child breaks the rules.

When temper tantrums are serious
Your child should have fewer temper tantrums by the middle of his fourth year. Between tantrums, his behavior should seem normal and healthy. Like every child, yours will grow and learn at his own pace. It may take time for him to learn how to control his temper. When the outbursts are severe or happen too often, they may be an early sign of emotional problems. Talk to your pediatrician if your child causes harm to himself or others during tantrums, holds his breath and faints, or if the tantrums get worse after age 4. Your pediatrician will make sure there are no serious physical or psychological problems causing the tantrums. He or she can also give you advice to help you deal with these outbursts. It is important to realize that temper tantrums are a normal part of growing up. Tantrums are not easy to deal with, and they can be a little scary for you and your child. Using a loving and understanding approach will help your child through this part of his development.