What are chi l dhood t ant rums?

Temper tantrums are a type of behavioural

disorder in children especially in tod-
dlers whose reaction to frustration is a
dramatic display of temper. The tantrum can
vary in time from 20-30 seconds to several
hours.
The behaviour can include:
Kicking or stamping the feet.
Shouting and screaming.
Throwing things.
Rolling around on the floor.
Banging the head.
Crying (without being hurt).
Holding the breath (which can be frighten-
ing).
Who has t ant rums and why?
Any child can throw a tantrum. Tantrums
are a feature of the so-called terrible twos.
They usually start at 15-16 months of age
(can be as early as 12 months) and may per-
sist until 3-4 years.
Tantrums are more likely to occur if the
child is tired or bored and feels angry or
frustrated.
Reasons for this frustration may include:
Being told no.
Things not going their way.
Difficulty managing a task.
Difficulty expressing what they want to
say.
Their mother leaving them, even for a
brief period.
Sometimes there is no obvious reason.
Tantrums may continue to occur if the child
gets what they want, often when parents or
other carers reward them to seek peace and
avoid conflict.
An example of this is when your child picks
out a toy from the shelf of a shop and
demands I want it. You say no and
return it. The child gets upset, grabs the toy
and shouts mine, mine.
If you give in to avoid a scene and say you
can have it just this time the child gets
the message that no can mean yes if
they protest strongly enough. So if the
tantrum works they are likely to recur.
What are t he pri nci pl es of
management ?
If necessary, parents should seek expert
advice. It is important to keep a record of
the reason for the tantrums. Parents can be
reassured that tantrums are relatively com-
mon and not harmful.
Remember the saying, temper tantrums
need an audience. When ignored, the prob-
lem will probably get worse for a few days
before it starts to improve. Plan ahead to
prevent tantrums.
Drugs have no place in the management of
temper tantrums.
What are hel pful rul es t o
fol l ow?
Stay calm and say nothing.
Look away.
Move away.
Ignore what can be ignored: parents
should pretend to ignore the behaviour and
leave the child alone without comment.
This can include moving on to a different
room and busy yourself with something
else.
Be flexible: decide if the demands are rea-
sonable before saying yes or no and
stick to your decision.
Avoid what is avoidable: try to avoid the
cause or causes of tantrums where possi-
ble.
Distract what is distractable: redirect the
childs interest to some other object or
activity that would interest them.
Use time out: consider firm action by
taking the child to a safe room or space
and insist they be quiet (usually for two
minutes) before they come out of time
out.
Make some realistic and firm rules to fol-
low.
Keep the child busy with activities in cir-
cumstances conducive to boredom and
disruption.
Praise appropriate behaviour as soon as it
occurs.
What i s a breat h-hol di ng
at t ack?
Breath-holding attacks occur in response to
the child becoming upset, such as during a
tantrum. They will let out a brief cry and
then hold their breath.
The attacks are quite frightening as the child
will become pale and then blue and may
lose consciousness, when they should be
placed in the coma position.
The whole episode usually lasts 10-60 sec-
onds and is self-limiting and not harmful.
The child will start breathing again.
These attacks occur in the age group six
months to six years but are most common
from 2-3 years.
PATIENT INFORMATION
Tantrums
AUTHOR: PROFESSOR JOHN MURTAGH
Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.