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Temper tantrums

Acting-out behaviors

Temper tantrums are unpleasant and disruptive behaviors or emotional outbursts. They often occur in response to unmet needs or desires. Tantrums are more likely to occur in younger children or others who cannot express their needs or control their emotions when they are frustrated.

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Temper tantrums (acting-out behaviors) are natural during early childhood. It is normal for children to want to be independent as they learn they are separate people from their parents.

This desire for control often shows up as saying "no" often and having tantrums. Tantrums are worsened by the fact that the child may not have the vocabulary to express their feelings.

Tantrums usually begin in children 12 to 18 months old. They get worse between age 2 to 3, then decrease until age 4. After age 4, they rarely occur. Being tired, hungry, or sick, can make tantrums worse or more frequent.

WHEN YOUR CHILD HAS A TANTRUM

When your child has a temper tantrum, it is important that you stay calm. It helps to remember that tantrums are normal. They are not your fault. You are not a bad parent, and your son or daughter is not a bad child. Shouting at or hitting your child will only make the situation worse. A quiet, peaceful response and atmosphere, without "giving in" or breaking the rules that you set, reduces stress and make both of you feel better.

You can also try gentle distraction, switching to activities your child enjoys or making a funny face. If your child has a tantrum away from home, lead your child to a quiet place, such as the car or a rest room. Keep your child safe until the tantrum has ended.

Temper tantrums are an attention-seeking behavior. One strategy to minimize the length and severity of the tantrum is to ignore the behavior. If your child is safe and not being destructive, going to another room in the house may shorten the episode because now the drama has no audience. Your child may follow and continue the tantrum. If so, do not talk or react until the behavior stops. Then, calmly discuss the issue and offer alternatives without giving in to your child's demand.

PREVENTING TEMPER TANTRUMS

Make sure that your child eats and sleeps at their usual times. If your child no longer takes a nap, ensure that they still have some quiet time. Lying down for 15 to 20 minutes or resting while you read stories together at regular times of the day can help prevent tantrums.

Other methods to prevent tantrums include:

• Use an upbeat tone when asking your child to do something. Make it sound like an invitation, not an order. For example, "If you put your mittens and hat on, we will be able to go to your play group."
• Do not battle over unimportant things like which shoes your child wears or whether they sit in the high-chair or booster seat. Safety is what matters, such as not touching a hot stove, keeping the car seat buckled, and not playing in the street.
• Offer choices when possible. For example, let your child pick what clothes to wear and what stories to read. A child who feels independent in many areas will be more likely to follow rules when it is a must. Do not offer a choice if one does not truly exist.

WHEN TO SEEK HELP

If temper tantrums are getting worse and you do not think you can manage them, seek the advice of your health care provider. Also get help if you are not able to control your anger and shouting, or if you are worried that you may react to your child's behavior with physical punishment.

The American Academy of Pediatrics recommends that you call your child's provider if:

• Tantrums get worse after age 4
• Your child injures themselves or others or destroys property during tantrums
• Your child holds their breath during tantrums, especially if they faint
• Your child also has nightmares, reversal of toilet training, headaches, stomachaches, anxiety, refuses to eat or go to bed, or clings to you

References

American Academy of Pediatrics website. Top tips for surviving tantrums. www.healthychildren.org/English/family-life/family-dynamics/communication-discipline/Pages/Temper-Tantrums.aspx. Updated April 21, 2021. Accessed May 24, 2023.

Walter HJ, DeMaso DR. Disruptive, impulse-control, and conduct disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 42.

Review Date: 4/28/2023  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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