Preschoolers' Severe Tantrums May Signal a Problem

All kids have meltdowns at one time or another, especially when they're sleepy, hungry, bored, sick, or just plain frustrated. As aggravating — and sometimes mortifying — as these can be, occasional tantrums are simply par for the parenting course during those first couple of years, when kids crave more control and independence but can't always clearly express their wants and needs.

As toddlers start becoming preschoolers — and begin learning how to communicate and deal with their frustrations better — those fits of frustration should begin to let up. If they don't and the outbursts become constant, drawn-out, or downright aggressive, an underlying emotional, behavioral, or psychological problem might be to blame, says a new study.

Using parents' reports, researchers studied the tantrums of 279 3- to 6-year-olds, comparing the flaring tempers of healthy kids with those of children with depression and disruptive disorders like attention deficit hyperactive disorder (ADHD) and oppositional defiant disorder (ODD).

What they discovered: Preschoolers with depression or disruptive disorders were more likely to exhibit these five tantrum "styles":

1. Excessive aggression or destructiveness during tantrums — regularly lashing out by hitting, kicking, biting, or spitting at parents or caregivers; or throwing or trying to break objects
2. Consistent tantrums — 10 to 20 episodes at home on separate days within a month or more than five a day for multiple days at school or away from home
3. Tantrums lasting a long time — 25 minutes or more, versus the average tantrum time of about 10 minutes
4. Trouble calming themselves down after tantrums
5. Hurting themselves on purpose — holding their breath or biting, scratching, head-banging, or hitting themselves

Of course, the researchers point out that it's perfectly normal for little kids to exhibit some of these extremes in behavior every once in a while. It's only when these kinds of meltdowns become a pattern that there might be cause for concern. (However, it's important to note that kids who were depressed were found to be at significantly greater risk of injuring themselves intentionally.)

What This Means to You

It's tempting to run and hide when your tot has a tantrum — especially if bystanders are watching your mini-melodrama — but here are some better suggestions for managing the situation when young tempers flare.

First, try to understand what's going on before you react. Tantrums should be handled differently depending on the cause. You might need to offer comfort rather than consequences when kids have just had a great disappointment. When kids melt down because they just aren't getting their way, try ignoring them (while still keeping them in your sight).

But if you're in public or your kids pose a threat to themselves or others, use a time-out to 1) show that there are consequences for "making bad choices" and 2) teach kids that taking time to regroup in the face of frustration is a far better choice than throwing a tantrum. You can give toddlers and preschoolers 1 minute for every year of age. For school-aged kids, end time-outs once they've calmed down.

Call your the doctor if your child has tantrums more often, more intensely, or for longer periods of time (usually more than 10 minutes) or is regularly:

• losing control
• argumentative
• antisocial
• aggressive, violent, or destructive
• negative
• exhibiting signs of low self-esteem
• self-injuring or hurting others

Most tantrums are a normal part of growing up and learning how to cope with life's little aggravations. Luckily, more often than not this frustrating phase, too, shall pass.

Source: "Temper Tantrums in Healthy Versus Depressed and Disruptive Preschoolers: Defining Tantrum Behaviors Associated With Clinical Problems," The Journal of Pediatrics, January 2008.