Behavior Modification in Children With Temper Tantrums

by Kay Ireland, Demand Media

Avoid reacting to your child's tantrum, which could reinforce the behavior. Related Articles

 How to Curb a Three-Year-Old's Temper Tantrum  Behavior Modification for ADHD Children  How to Stop Toddler Tantrums & Misbehaving  How to De-Escalate a Tantrum  Parenting: Behavior Modification for a 5 Year Old  Signs of Abnormal Child Behavior

It can happen anytime, anywhere -- your child erupts into a fit of screaming and crying. Your first instinct might be to give her whatever she wants to make the behavior stop, but doing so will just reinforce the behavior. Instead, take steps to stop the behavior quickly and then teach your child that throwing fits is completely ineffective in helping her get what she wants in the future. Sponsored Link

5 Foods you must not eat Cut down a bit of stomach fat every day by never eating these 5 foods. trimdownclub.com

Redirect Attention

When you're in the throes of dealing with a tantrum -- especially in a public place -- you need the behavior to stop as soon as possible. The practice of redirection and distraction often works as a quick fix to calm down your little one until you can address the behavior. The Colorado State University Extension website suggests redirecting your child's attention to something that makes her forget her tantrum altogether, like a toy or activity. While it might not always work, it could stop a minor tantrum from becoming a full-on meltdown.

Avoid a Reaction

Your child throws a tantrum because she wants to elicit a reaction from you. If you give her attention -- even negative attention -- you could be reinforcing the behavior, causing it to happen again and again. Never give into your fretting child's demands, warns the American Academy of Pediatrics' HealthyChildren.org. Instead, remain calm. If the tantrum is minor, try ignoring the behavior altogether. If it's severe, say, "I'm sorry, I can't talk to you when you're crying like that. Let me know when you've calmed down and we can talk." That way, your little one learns that tantrums won't help her get what she wants.

Offer Choices

Tantrums often occur when your child feels out of control and helpless -- they're her way of tipping the scales in her favor. You can head off and stop tantrums by offering choices whenever possible, suggests the University of Michigan Health System website. You don't have to give your child free reign over your home, but offering a couple of choices could be enough to keep your child calm. Try "Do you want cereal or toast for breakfast?" or "The red shirt or the blue one?" to give your child a little control and stop meltdowns. Reward Good Behavior

While you might be focused on stopping negative behavior, it may be just as important to praise and reward positive behavior as well. This teaches your little one that using manners and polite words gives her a better reaction than throwing a tantrum. When your child says please or gets through the grocery store without crying, be specific with your praise -- "I loved the way you asked me so nicely! It makes me happy when you use happy words."

In the middle of the store, your daughter throws herself to the floor and begins to whine and beg for a toy. This experience is a common one for parents of toddlers and children. Temper tantrums can cause embarrassment and discomfort for parents. Understanding the root cause of your child's tantrums may help you ward off tantrums in the future.

Sponsored Link

Google Chromecast for £30 Stream the web to your TV wirelessly. Find out more. google.com / chromecast Causes of Tantrums Underlying emotions and states may make temper tantrums more likely, such as when your child is sick, hungry or tired, according to Dr. William Sears. Children may use temper tantrums to get their way if it has been effective in the past, according to the Kids Health website. During the early years, children are becoming independent and want control over themselves and their environments. When they cannot have it, temper tantrums often come into play. Parents may find that in some cases it is better to avoid triggers, like going to a store, if a child needs rest or dinner first, according to Dr. Sears. Distraction Modifications Keeping distractions with you, like puzzles for children or books for toddlers, may prove effective when it comes to preventing or ending temper tantrums, according to the American Academy of Pediatrics. If your child is begging for a toy or beginning to whine, offer a distraction. In other cases, you may need to change environments or go to a private place where your child can calm down. In a public place, that may mean finding a bathroom or going to the car to cool down. Attention and Control Modification Children may also use temper tantrums as a means to get attention, according to the Kids Health site. Try to spend more time with your child and reward positive behavior, like complimenting a toddler who is sitting quietly at a restaurant. Your child may also be seeking control, so providing options may be effective. When going out to eat, you may want to give your child the choice of multiple meals or drinks. Showing that your child has some control over her environment may make her less prone to having temper tantrums. Other Behavior Modifications In some cases, you may find that you are not bothered that your child wants a toy or candy. Knowing when to give in and when to hold your ground is an important part of parenting, and it can ward off some temper tantrums, according to the Kids Health website. Parents may also find that ignoring the tantrum until a child calms down or providing love and affection during a tantrum may cause a child to cool off, according to the American Academy of Pediatrics. No matter the course of action you choose, hitting or scolding your child may make a tantrum worse.

All children (and many adults) have temper tantrums on occasion. These outbursts are particularly frequent during the toddler and preschool years and usually begin to decline in frequency and intensity by age 5. However, for some children, these tantrums persist, causing continued difficulties throughout childhood. Below are answers to some of the most commonly asked questions from parents of these children.

"When should I be concerned about my child's tantrums?" Temper tantrums are considered to be part of normal development for young children, particularly those under the age of 5. However, some children continue to exhibit severe tantrums past this age. These tantrums may be:  Explosive  Difficult to control or soothe  Prolonged, lasting more than 15-20 minutes  Frequent, occurring several times per week When tantrum behaviors interfere with your child's typical functioning and/or the functioning of the family, there may be cause for concern. For example, children who exhibit severe temper outbursts often have difficulty making and keeping friends, succeeding in school, and getting along with family members. Frequent, out-of-control tantrums can cause a significant amount of family distress, and can result in the family changing their lifestyle in an effort to prevent or reduce the tantrums. Such modifications may include:

 Changing daily home routines, such as mealtimes, transitions, waking up, getting ready for school, or bedtime  Avoiding public venues, such as restaurants or supermarkets  Declining to participate in social activities, such as birthday parties or play dates "Why does my child have severe tantrums?" We don't really know why. We do know that children with severe temper outbursts often have difficulty with attention, impulsivity, anxiety, and mood regulation. At the NYU Child Study Center, we are conducting research to examine possible neurological bases for severe tantrums. "How can I better manage my child's tantrums?" Fortunately, there are things that you as a parent or caregiver can do to help reduce your child's tantrums in the family environment. What parents can do 1. Don't "give in" to your child's tantrums Many, though not all children exhibit tantrums when they don't get their way or when they are required to do something they don't enjoy. When children have tantrums, the intensity of their emotions and behaviors makes it difficult for parents to handle, and it's tempting to give in to the child's demands in order to stop the tantrum. When this happens, the child is reinforced for her tantrum — it was effective at getting the desired result. Thus, "giving in" to your child's tantrum behaviors can make the outbursts likely to continue; the child quickly learns that a tantrum can help her get what she wants. When you "give in" to a tantrum, you may have stopped your child's behavior in that moment (which may be a temporary relief). But you have set the stage for your child to continue having tantrum behaviors in the future. With this in mind, we suggest the following:

 Do not let your child get what he wants out of the tantrum. Although this may be a difficult feat to carry out, consistently saying "No" despite the tantrum will likely cause the outbursts to get better over time.  You must follow through on saying "No" consistently. If your child even occasionally gets his way as a result of a tantrum, he is likely to keep having them.  Planned ignoring: Leaving the room where the tantrum is occurring can help stop the behavior.  Do not try to convince or negotiate with your child during a tantrum. This will likely prolong the tantrum.  Make sure your child understands that you will not listen to his demands when he tantrums. This is best discussed at a time when the child is not upset. 2. Offer extra incentives Often children will tantrum in an effort to get out of doing something they don't like. In these cases, offering extra incentives to complete the avoided behavior can be helpful. For example, if your child throws a tantrum whenever it's time for her to complete her homework, consistently offering incentives (i.e., watching her favorite TV show, playing a game) after she's completed her assignments may motivate her to finish the job.

It is important to note that rewards must:

 be motivating to the child  be carried through every time the child completes the desired behavior  be consistently denied when the child does not complete the behavior  not be replaced with comparable rewards if the behavior is not completed (i.e. "You cannot watch TV but you can still play video games"). 3. Catch your child being good (Positive Parenting) Parents of children with severe tantrums may feel like they are always giving their child negative feedback, or giving attention mostly when their child is acting inappropriately. And unfortunately, this is likely the case. This cycle can cause your child to continue acting out in order to get attention, and create strain and hostility in the parent-child relationship.

As parents, you can help counteract this by looking out for, and specifically praising, your child's efforts at positive behavior.

Example: Putting your hand on your child's shoulder, and saying "I really like the way you shared your toys with your brother," when you notice that he is giving his brother a turn with his toys. Be sure to praise specific behaviors or efforts, not your child's general behavior or temperament.

Example: "David, thank you for putting all your toys back in the container when I asked you to." Not: "Thanks for being good." This type of praise:

 Shows your child what behaviors you want to see from her.  Gives her attention for positive behaviors. What can I do if these tips aren't working? If you are using these strategies consistently and your child's tantrums are not getting better, you may want to consider getting help from a mental health professional. Psychological Treatments Parent Management Training (PMT): PMT teaches parents how to approach their child's tantrums and disruptive behavior as well as modify her environment to reduce the frequency and severity of these behaviors. PMT focuses on teaching parents behavioral management skills, and less emphasis is placed on working one-on-one with the child in therapy. Techniques typically included in the training include effective ways to use positive reinforcement; how to establish consistent rewards and consequences; planned ignoring of misbehavior; and proper use of time-outs. Parent-Child Interaction Therapy (PCIT): Designed primarily for parents of children between 3 and 6 years old, PCIT teaches parents specific skills to interact positively with their child, including how to ignore minor misbehavior, and how to offer appropriate directives and consequences for misbehavior. PCIT sessions usually involve the parent and child interacting together in a room, while the therapist is watching from another room and giving parents specific tips (through a headset). Parents typically benefit from the opportunity to learn and practice these concrete strategies during the sessions. Cognitive-Behavioral Therapy (CBT): CBT for children with temper tantrums and other disruptive behaviors, when combined with parent training, can produce long-term improvement. In CBT, greater emphasis is placed on teaching children skills to help them cope with their emotions. Treatment is best served when parents are included, in order to reinforce CBT skills at home. Skills typically taught in CBT include learning to be aware of when you feel angry, understanding others' perspectives, decision-making, and social problem-solving skills. Medication Treatments Stimulant & non-stimulant medications: These medications, which are often used to treat ADHD, can help improve tantrum behaviors in children with this disorder. As impulsive behaviors decrease, the child may no longer try to avoid situations that his ADHD previously made very difficult. Common stimulants include: Ritalin, Concerta, Adderall, Metadate, Focalin, Vyvanse, Dexedrine, and Dextrostat. Currently, Strattera is the only non-stimulant drug used to treat ADHD and impulsivity. Medications for reducing severe aggression: Recently, other medications have been used to treat aggressive behaviors and temper tantrums in children. These include mood stabilizers (Lithium, Depakote), SSRI-anti-depressants (Prozac, Zoloft), and atypical anti-psychotics (Risperidone). These medications, especially Lithium and anti-psychotics, generally have greater side effects, and are usually only indicated when children show severe bouts of chronic aggression.

Children's Anger and Tantrums

by R.J. Fetsch and B. Jacobson* (12/13)

Quick Facts...  Tantrums typically appear at age 2 or 3 and start to decline by 4.  Twenty-three to 83 percent of all 2- to 4-year-olds have occasional temper tantrums.  How parents respond is critical in tantrum management.  Parents can learn to calm themselves, state clear rules, notice and compliment appropriate behavior, and teach understanding and empathy.  Ten practical guidelines are offered for parents who want to learn healthy ways of dealing with children’s anger and temper tantrums.

All of us who are parents or who are involved with children and youth can play a vital role in their lives by learning to be the best parents we can be. How? By practicing effective parenting strategies from very early on. One of the best opportunities for parents and their children to learn effective parenting and anger management strategies is when children get angry or have temper tantrums. If parents can manage their reactions to temper tantrums well, they can manage many other parenting situations.

What Are Temper Tantrums?

Temper tantrums are a common behavior problem in preschool children who may express their anger by lying on the floor, kicking, screaming, and occasionally holding their breath (5). Tantrums are natural, especially in children who are not yet able to use words to express their frustrations.

Tantrums typically occur at age 2 to 3 when children are forming a sense of self. The toddler is old enough to have a sense of “me” and “my wants” but is “To behave rightly, we too young to know how to satisfy the want. Tantrums are the result of high ourselves should never lay a energy and low ability to use words to get needs or wants met. hand on our servants [or children] as long as our anger Tantrums typically peak between ages 2 and 3, and start to decline by 4. lasts .... Things will truly They usually run their course within a year. Twenty-three to 83 percent of all seem different to us when we 2- to 4-year-olds have temper tantrums at least occasionally (2, 3, 7, 8, 15). have quieted and cooled down.” – Montaigne Most children throw tantrums in a particular place with a particular person. They usually are a public display after the child has been told “no” to something he or she wants to do. The tantrum usually stops when the child gets his or her wish. What happens with the temper tantrum depends on the child’s level of energy and the parent’s level of patience and parenting skill (16).

Causes of Temper Tantrums There can be many causes of temper tantrums. Some of the causes are indicators of family problems: inconsistent discipline, criticizing too much, parents being too protective or neglectful, children not having enough love and attention from their mother and father, problems with the marriage, interference with play, emotional problems for either parent, meeting a stranger, rivalry with brothers or sisters, having problems with speech, and illness (2). Other common causes of temper tantrums include being hungry or tired.

Children who have temper tantrums often have other problems like thumb sucking, head banging, bed wetting and problem sleeping. If these behaviors happen, or if your child has temper tantrums that last more than 15 minutes or occur three or more times a day at younger than 1 or older than 4, seek help from a family physician, psychologist, or marriage and family therapist. Be advised to seek more than an exclusively behavior therapy approach, for results have been reported to be about equally effective and ineffective (11, 14, 17). An approach is recommended that combines the best of behavior modification, family systems thinking (1), and other approaches like paradoxical intervention (6).

Sometimes temper tantrums in preschool children are the beginning of patterns that lead to children becoming increasingly disobedient, rebellious and aggressive as they grow older. At the Oregon Social Learning Center, aggressive boys in angry families were studied (12, 13). A complex pattern was observed that included:

 Parents have trouble with some stressor events like divorce, prolonged unemployment, illness, alcohol or other drug problems, other chronic problems, or dealing with a difficult child.  Parents have difficulty controlling children’s teasing, yelling, disobedience, whining.  Parents allow the child to get away with angry displays.  As children learn what they can get away with if they are encouraged to display temper tantrums, angry outbursts, etc., they become increasingly disobedient, rebellious and aggressive.  More and more peers reject the child and parents tend to reject or avoid the child, too.

Carol Tavris (16), in her book, Anger: The Misunderstood Emotion, writes about the pattern becoming circular and occurring hundreds of times each day. She sees the pattern as a three-step process:

1. The child is attacked, criticized, or yelled at by an exasperated parent, brother or sister; 2. The child responds aggressively. 3. The child’s aggression is rewarded when the attacker withdraws and the child learns to use tactics such as whining, yelling and temper tantrums.

When other family members also use these methods, the problems increase. At the Oregon Social Learning Center, Patterson (12, 13) found that when angry exchanges lasted longer than 18 seconds, the family had an increased chance of becoming violent. When talking or even yelling went on and on, it often led to hitting. The problem is often, though not always, inept, inconsistent parenting. One solution lies in stopping the shouting, scolding, or spanking; in getting oneself calm; stating clear rules and requiring compliance; noticing and complimenting appropriate behavior; and following through with logical consequences.

Parents can learn how to nurture and discipline effectively. Overly authoritarian parents who exercise too much power and use discipline punitively can learn more effective “authoritative” parenting. Overly permissive parents who exercise too little power and use too little discipline can also learn to be authoritative parents. As is often the case, balance is important. Authoritative parents learn daily when and how to discipline their children effectively by setting standards, enforcing rules, exercising authority when necessary, and yet recognizing children’s rights (4, 9).

Guidelines for Parents

From a number of research studies plus Tavris, the following guidelines are suggested for building child self- control and self-esteem.

1. Learn to deal with your own and others’ anger.

When parents discipline out of anger or with expectations that are inappropriate for the age of their child, they often make mistakes in the way they react. The place to begin is with ourselves. When we feel calm, we can model effective anger and conflict management. Example: “I’m so angry at you right now for dumping your cereal all over the clean floor, I feel like hitting you. But I don’t hit, so I’m going to leave and come back when I’ve calmed down.”

2. Distract or redirect the child.

When a child is misbehaving, a calm parent can sometimes re-direct the child’s behavior. Example: “Here’s a bowl of warm water. Let’s put it outside where you can splash all you want.”

3. Be prompt and brief with discipline.

One technique you can use is to pick up and remove your small child from the room immediately and isolate him or her for two to five minutes. This also gives you time to get in control of your emotions. Two to five minutes are enough; lecturing is unnecessary. In rare circumstances, it may be helpful to physically hold the child. Be consistent in enforcing rules, especially with older, school-age children. Example: “I’m putting you in your room for ‘time out’ until you calm down and are ready to talk again.” “I want you to go to your room now and stay there until you are ready to come out and use words to ask for what you want rather than spitting on people.”

4. Try to discover the reason for your child’s anger or temper tantrum. What does he or she want and is not getting? The reasons children have temper tantrums vary: to get attention, get someone to listen, protest not getting their way, get out of doing something they do not want to do, punish a parent for going away, for power, for revenge, from fear of abandonment, etc. Let the child know the behavior is unacceptable. Talk calmly. Example: “Now that we’re out of the store and we’ve both had a chance to calm down, let’s talk. I think you were mad at me that I said no to buying the candy you wanted. Is that right?” ... “It is OK for you to be angry at me, but kicking, screaming and yelling that you want candy won’t work. It won’t get me to buy you the candy.”

5. Avoid shaming your child about being angry.

Children in healthy families are allowed to express all their feelings, whether they are pleasant or unpleasant. They are not criticized or punished for having and expressing feelings appropriately, including anger. Some research studies have found that parents’ shaming their child’s anger can negatively affect their child’s willingness to relieve distress in others (10). Example: “You look and sound angry right now. I’d feel angry too if someone messed up my coloring like she messed up yours.”

6. Teach children about intensity levels of anger.

By using different words to describe the intensity of angry feelings (e.g., annoyed, aggravated, irritated, frustrated, angry, furious, enraged), children as young as 2 1/2 can learn to understand that anger is a complex emotion with different levels of energy (10). Example: “I was annoyed when I had a hot meal ready and all of you were late for dinner.” “That man was so angry – I think he was enraged after someone spray painted his business with graffiti.”

7. Set clear limits and high expectations for anger management, appropriate for your child’s age, abilities, and temperament.

As parents, we will be angry all the time if we expect our 1-year-old to be toilet trained, our 2-year-old to use 5- year-old words rather than have a temper tantrum, our shy 8-year-old to be a life-of-the-party magician, and our low self-esteem 15-year-old to snap out of her depressed “funk” and run for Student Council President. Example: “While I want you to know it’s OK to feel angry, it’s not OK to hit others!” “I expect you to help with chores, control your anger without hitting, biting or spitting. I expect you to be honest and thoughtful of others, do your best in school, ask for what you want, and treat others as you would like to be treated.”

8. Notice, compliment and reward appropriate behavior.

Teaching your child to do the right things is better (and easier) than constantly punishing bad behavior. Children who get a steady diet of attention only for bad behavior tend to repeat those behaviors because they learn that is the best way to get our attention, especially if we tend to be overly authoritarian. Example: “I really liked the way you asked Uncle Charlie to play ball with you.” “Thanks, Ebony, for calling me beforehand and asking if you could change your plans and go over to your friend’s house after school.” 9. Maintain open communication with your child.

Consistently and firmly enforce rules and explain the reasons for the rules in words your child can understand. Still, you can listen well to your child’s protests about having to take a national test or measles shot. Example: “Sounds like you are angry at the school rule that says you can’t wear shorts, sandals and tank tops to school.”

10. Teach understanding and empathy by calling your child’s attention to the effects of his or her actions on others.

Invite the child to see the situation from the other person’s point of view. Healthy children feel remorse when they do something that hurts another. Authoritative discipline helps them develop an internal sense of right and wrong. Remember, a little guilt goes a long way, especially with a child. Example: “Let’s see if we can figure out what happened. First she did her ‘nah, nah, nah routine.’ Next, I saw you take her doll. Then she came and hit you, and you hit her back.”

Beyond the Tantrum Stage

Most tantrums and angry outbursts come and go as children and youth grow in their ability to use language and learn to solve problems using words. But occasionally, fits of temper and violence persist into elementary school and may signal serious problems. Sometimes there are biological sources of anger that require diagnosis by a physician or psychologist.

If someone is getting hurt or if you use the suggestions listed in this fact sheet and nothing seems to work, it is time to get professional help. Ask your physician, school guidance counselor or psychologist for names of those skilled in working with children on anger issues. Or, check the yellow pages under counselors, for psychologists and marriage and family therapists who specialize in child behavioral problems.