Nearly all preschoolers have occasional tantrums, but only a small number (8.6 percent) have them daily. Mild displays of temper often reflect frustration in expectable contexts, while problematic temper loss is characteristically unpredictable, prolonged, and/or destructive.
A team of Missouri-based researchers has identified five “red flag” traits that may help parents and caregivers identify children at risk for mood and disruptive disorders. They found that long, frequent, violent, and/or self-destructive tantrums may indicate depression or disruptive disorders such as attention-deficit/hyperactivity disorder (ADHD). If a child is regularly engaging in these types of tantrums, there may be a problem, and parents should discuss their concerns with their child’s doctor.
Five types of “red flag” behaviors were identified:
- Extreme aggression. If most tantrums include aggression towards a caregiver or destruction of an object (e.g., a toy), then the child is more likely to be diagnosed with ADHD, oppositional-defiant disorder, and/or another disruptive disorder.
- Self-injury. If tantrums include the child intentionally injuring himself (e.g., scratching, head banging, biting), the child is more likely to have major depressive disorder.
- Numerous tantrums. More than five tantrums per day for several consecutive days likely signals a problem.
- Long tantrums. While healthy children might have tantrums that last as long as 10 minutes, those who were found to have disruptive disorders averaged more than 25 minutes per tantrum.
- Inability to self-calm. Those who are unable to calm themselves seem to be more likely to have psychiatric problems too.
While parents should not overreact if during one tantrum the child lashes out, they should pay close attention. Often, behavioral difficulties occur as the result of interaction between biological vulnerabilities and environmental stressors. Possible causes (e.g., inadequate sleep, low iron levels, developmental delays, disadvantaged background, family stress and trauma, parenting practices such as harshness or neglect, insecure parent-child attachment, parental mental health problems) should be considered, as should the events surrounding the tantrum.
Assessment may follow an ABC approach:
- Antecedent—What events preceded the behavior?
- Behavior—What was the behavior?
- Consequence—What did the parents do to resolve it?
In general, parents should focus on reinforcing positive behavior, using a consistent approach, and setting limits and clear consequences for misbehavior. Children should be referred for follow-up when safety is at risk, or parents are concerned that the behavior will affect their child's development.
In this, as in so many other aspects of parenting, parents 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 health care provider right away. If self-injury ever occurs, parents should consult their child’s doctor or a mental health professional immediately.