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Temper Tantrums

By Stephen Brian Sulkes, MD, Professor of Pediatrics, Division of Neurodevelopmental and Behavioral Pediatrics, Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry

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A temper tantrum is a violent emotional outburst, usually in response to frustration.

Temper tantrums usually appear toward the end of the first year, are most common at age 2 (terrible twos) to 4, and are infrequent after age 5. If tantrums are frequent after age 5, they may persist throughout childhood.

Causes of temper tantrums include frustration, tiredness, and hunger. Children also may have temper tantrums to seek attention, obtain something, or avoid doing something. Parents often blame themselves (because of imagined poor parenting) when the actual cause is often a combination of the child’s personality, immediate circumstances, and developmentally normal behavior. An underlying mental, physical, or social problem rarely may be the cause but is likely only if tantrums last > 15 min or occur multiple times each day.

Temper tantrums may involve

  • Shouting

  • Screaming

  • Crying

  • Thrashing about

  • Rolling on the floor

  • Stomping

  • Throwing things

The child may become red in the face and hit or kick. Some children may voluntarily hold their breath for a few seconds and then resume normal breathing (unlike breath-holding spells, which also can follow crying bouts caused by frustration).

Although providing a safe setting for children to compose themselves (eg, a time-out) is often effective, many children have difficulty stopping tantrums on their own. In most cases, addressing the source of the tantrum only prolongs it. It is therefore preferable to redirect the child by providing an alternative activity on which to focus. The child may benefit from being removed physically from the situation.