©iStockphoto.com/laartist
©iStockphoto.com/laartist
by Heidi Green
January 02, 2008
Nearly all parents of preschoolers will tell you: Tantrums happen. They’re a normal occurrence of early childhood, and they’re frustrating for everyone while they last. But should they be a cause for concern? Maybe. A team of Missouri-based researchers believe they have identified five “red flag” traits of the tantrums of children at risk for mood and disruptive disorders.
Research
Researchers recruited 3-, 4-, and 5-year-olds from doctors’ offices, preschools, and day cares throughout the greater St. Louis area. Healthy children, as well as those with symptoms of depression, disruptive disorders, or both, were included in this study. Those with chronic illnesses, neurological problems, pervasive developmental disorders, and language and/or cognitive delays were excluded.
Researchers used the Preschool Feelings Checklist, DSM-IV criteria, and the Preschool Age Psychiatric Assessment (PAPA). Trained interviewers determined the number of tantrums by the child in the past three months, as well as the intensity, duration, frequency, context, behavior, and recovery after the tantrum(s).
This study included 279 preschoolers. The children were divided into four groups: healthy children (150); children with major depressive disorder (MDD) but no attention deficit hyperactivity disorder (ADHD), conduct disorder, and/or oppositional defiant disorder (21); children with ADHD, conduct disorder, and/or oppositional defiant disorder but no MDD (54); or children with MDD and a disruptive disorder (54).
Tantrums were classified as being normative (rarely escalating to excessive crying or shouting, and without destruction or violence); excessive without aggression (having crying, shouting, and/or directed flailing, but without aggression or violence); or excessive with aggression (having crying and screaming, as well as episodes of aggression and/or violence towards objects and/or people).
Results
In short, researchers found that long, frequent, violent, and/or self-destructive tantrums may indicate depression or disruptive disorders such as ADHD. If a child is regularly engaging in these types of tantrums, there may be a problem.
Five types of “red flag” behaviors were identified:
Recommendations
First, this study shows that it’s normal for children to display excessive behavior sometimes. Even healthy children might have “red flag” behavior occasionally, especially if they are tired, hungry, or sick. Therefore, parents should not overreact if during one tantrum the child lashes out. However, it also means that they should pay attention.
Second, it means that parents of children of all ages should be concerned about signs of self-injury. The researchers advise parents to consult their child’s doctor or a mental health professional at the first sign of this behavior.
It’s important to note that this study relied solely on information provided by the preschoolers’ parents. The data were not verified by other means (e.g., information from other care providers, video of tantrums).
In this, as in so many other aspects of parenting, mothers and fathers should trust their instincts. Though some tantrums are a normal part of childhood, if your child’s tantrums cause you concern, talk to your child’s doctor right away.