Definition

• Tantrums are normal in toddlers.
• Tantrums may include whining, crying, screaming or yelling. It may also include pounding the floor, slamming a door, or breath-holding.
• Also called meltdowns or emotional outbursts.

Health Information

Causes

• A tantrum is an immature way of expressing emotions, especially when feeling frustrated and angry. Toddlers don’t have the verbal skills to put their feelings into words. They don’t have much impulse control. They don’t have the ability to pause and self-calm. No matter how calm and gentle a parent you are, your child will probably throw some tantrums. The triggers for tantrums are many.
• All tantrums become more likely if your child is hungry, tired or sick. If you suspect hunger, give your child a snack. If your child is exhausted, put him down for a nap.

What to Expect

• The peak age for normal tantrums is between 2 and 3 years.
• By school age, temper tantrums should be uncommon.
• By adolescence, they should be rare. Your teenager can be reminded that blowing up creates a bad impression. Teach coping skills such as deep slow breathing or counting to 10 to regain control.

Care Advice

1. Help Your Child Put Feelings into Words:
   • Before a tantrum, try to put what your child is feeling into words. Let him know that you understand why he is angry. For example, "You feel angry because…" We need to teach children that anger is normal. But it needs to be managed appropriately.
   • Praise your child when he controls his temper and verbally expresses his anger.
2. Teach Your Child That Temper Tantrums Don’t Work:
   • Teach that you don’t change your mind or give in because of them.
   • Stay calm and speak in a soft voice. Be a good role model.
   • Avoid screaming at your child or having an adult tantrum.
   • Figure out what has triggered your child’s outburst. Usually that is easy.
   • There are 6 different types of temper tantrums. One may match the tantrum your child is having. Each type is followed by a response that should help you deal with tantrum.
3. Frustration-Related Tantrums - Support Your Child:
   • Children often have temper tantrums when they are frustrated with their limitations. They may be frustrated because they can’t put something together. Young children may be frustrated because their parents don’t understand their speech. Older children may be frustrated with their inability to do their homework.
   • At these times, your child needs encouragement and a parent who listens. Put an arm around him and say something that shows understanding such as, "I know it’s hard, but you’ll get better at it. Is there anything I can do to help youƒ" Also, give praise for not giving up.
   • Prevention: Some of these tantrums can be prevented by steering your child away from tasks that he can’t do well.
4. Demanding-Type Tantrums - Ignore Them:
   • Young children often throw temper tantrums to get their way. They may want to go with you rather than be left with the sitter. They want a cookie, to empty a desk drawer, or to go outside in bad weather. As long as your child stays in one place and is not too disruptive, you can leave him alone.
   • Tell your child you understand how he feels. "You’re mad because you want a cookie. But it’s almost dinner time". And don’t give in to your child’s demands.
   • During the temper tantrum, if his behavior is harmless, ignore it completely. Once a tantrum has started, it rarely can be stopped. Move away, even to a different room. Then your child no longer has an audience.
   • Don’t try to reason with your child during a tantrum. That will only make it last longer. Simply state, "I can see you’re very angry. I’ll leave you alone until you calm down. Let me know if you want to talk."
   • Don't scold your child during a tantrum. That will make it get worse.
   • Your child has to calm down and regain control on his own.
   • After the tantrum, be friendly and try to return things to normal.
   • Prevention: If you recognize that a certain event is going to push your child over the edge, try to shift his attention to something else. You can prevent some of these tantrums by saying "No" less often.
5. Refusal-Type Tantrums - Gently Move Your Child:
   • If your child refuses something unimportant (such as cleaning up his toys), let it go before a tantrum begins. However, if your child must do something important, such as go to bed or to child care, he should not be able to avoid it by having a tantrum.
   • Once a tantrum has begun, let your child have the tantrum for 2 or 3 minutes. Try to put his unhappiness into words: "You want to play some more, but it’s bedtime."
   • Then take him to the intended destination (for example, the bed). Help him as much as is needed (including carrying).
   • Prevention: Some of these tantrums can be prevented by giving your child a 5-minute warning instead of telling him suddenly to stop what he is doing.
6. Screaming-Type Tantrums - Give a Time-out:
   • Screaming is a super-duper tantrum performed by a child with exceptional vocal cords and lungs.
   • Clarify the Rule: "No screaming in our house". Some tantrums are too disruptive for parents to ignore. On such occasions, send or take your child to his bedroom for 2 to 5 minutes.
   • Examples of disruptive behavior include:
   • Screaming or yelling that won’t stop with ignoring it.
   • Clinging to you or following you when you try to go to another room.
   • Having a tantrum in a public place such as a restaurant or church. Move your child to another place for his time-out. That could be outside or even in your car with supervision. The rights of other people need to be honored.
7. Aggressive-Type Tantrums - Give a Time-out:
   • Harmful behavior should never be ignored. On such occasions send or take your child to his room for 2 to 5 minutes. Examples of aggressive behavior include:
   • Hitting, kicking or biting you.
   • Throwing objects or damaging property during a temper tantrum.
   • Doing something dangerous to himself such as running away.
8. Rage-Type Tantrums - Hold Your Child:
   • If your child is totally out of control and screaming wildly, consider holding him. His loss of control probably scares him. Also, hold your child when he is having tantrums that carry a danger of self-injury (such as if he is violently throwing himself backward).
   • Take your child in your arms, tell him you know he is upset, and give him your calmness. Hold him until you feel his body start to relax. This usually takes 1 to 3 minutes. Then let him go. This comforting response is rarely needed after 3 years of age.
   • Some children won’t want you to comfort them. Hold your child only if it helps. If your child says "Go away," do so.
   • After the tantrum subsides, your child will often want to be held briefly. This is a good way to get him back into normal family activities.

Call Your Doctor If

• Your child has hurt himself or others during tantrums
• Tantrums occur 3 or more times per day
• Tantrums also occur at school
• Your child has many other behavior problems
• One of the parents has tantrums or screaming bouts and can’t give them up
• Tantrums are not better after using this plan for 4 weeks
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.