On Call for All Kids - Temper Tantrums

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Temper tantrums in toddlers and children are developmentally normal. These screaming, kicking, crying fits are a part of typical development and allow our children to communicate their unhappiness and/or frustration about an event or response, typically when they do not get their way or something that they want.

Most toddler temper tantrums last for a few to 15 minutes, and for most children, they will recover and move on with their day. On this week’s On Call for All Kids, Jennifer Katzenstein, Ph.D., director of psychology and neuropsychology at Johns Hopkins All Children’s Hospital, helps parents understand temper tantrums and when to worry.

What do I do when my child is having a temper tantrum?

The best thing to do when dealing with a toddler temper tantrum is to stay calm and actively ignore the behavior. This means turning your eye gaze away from the child, you yourself engaging in a different behavior, and not speaking or interacting with the child. This can be incredibly difficult, but our attention to our children is the strongest tool we have for behavior management. We want to use our attention to reinforce positive behaviors and remove our attention from negative behaviors, such as temper tantrums.

As soon as the child stops tantruming, we want to give a specific praise for stopping the behavior, by saying something like, “Thank you so much for sitting quietly.” And then, a parent can either redirect the situation, or if the child is developmentally able, discuss what the antecedent was that initiated the event. Labeling an emotion afterward and expressing understanding of the child’s anger or frustration can also be helpful, such as saying, “I can tell you are frustrated and angry right now.” We can also move to other ways to manage the frustration, as a child gets older.

If temper tantrums start to get aggressive, either to the child, someone else or property, then we have to intervene. This may mean moving to a timeout, or discussing with your doctor or psychologist other behavior management options.

Giving in to their tantrum by talking to them or giving attention to the tantrum before it ends can make things worse. If you give them attention mid-tantrum, we have only taught them that this is how loud they have to scream and/or how much they have to kick and flail to get your attention, which means future tantrums are likely to go this far, or even further! If you start actively ignoring, you have to ignore all the way to the end of the behavior.

What do I do when dealing with a temper tantrum in public?

Staying calm yourself is very important during this time, as this can be embarrassing. I know – it just happened to me at the airport! Get your child to a safe place, where they can’t hurt themselves and you can keep an eye on them. If you can, let them have the tantrum, keep an eye on them, and actively ignore the best you can. Try to manage the glances and stares from others the best you can, reminding yourself that you are doing the right thing until the behavior has ended. Then, you have to muster all of your energy and give specific praise!

What can I do to prevent temper tantrums?

The temper tantrum is a response to something that happened in the environment. If there is a consistent trigger that upsets a child, then this “antecedent” is something to take note of and address as you are able. If temper tantrums occur with a change in routine, or when a child is finishing play, it is important to give a five-minute transitional warning. This may help prepare them for the change and avoid a tantrum.

As part of active ignoring, it is also very important to provide regular, specific, and labeled praise to a child. Make sure they are getting two to three labeled praises for every one corrective or negative statement that is made. Providing options whenever possible, between two shirts or two food options, etc., can also be helpful.

When should I worry about temper tantrums and get additional help?

If temper tantrums are more severe, lasting longer periods of time, and occurring multiple times per day and/or occurring in a child older than 5 on a regular basis, then it may be time to talk to your pediatrician or get a psychologist involved to help support the family.

In addition, if your child is injuring himself or others, destroying property, holding his/her breath, or having headaches, stomachaches or anxiety, definitely reach out to your pediatrician. Parenting is no easy task, and if you are becoming concerned about your own stress level, feeling frustrated, or uncertain on how to handle the tantrums, it is time to reach out.

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts.