Temper Tantrums

Temper tantrum refers to an emotional outburst that is characterized by stubbornness, crying, screaming, yelling, defiance, or angry rants.

• Temper tantrums can be triggered by feeling tired, hungry, frustrated, or unable to verbally express feelings or desires.
• They can be learned behaviors and can also be an attempt to get one's own way or get attention.
• Temper tantrums are not meant to convey disrespect to the parent and they are not simply "misbehavior." They are a developmentally normal way for children to seek independence, gain ownership over their own choices, and learn emotional and behavioral self-regulation skills.
• They are common in younger children, but tend to decrease in frequency and intensity as children get older.
• Temper tantrums are equally common in boys and girls.
• A child can often stop a temper tantrum if he gets what he wants.

A meltdown happens when someone becomes overwhelmed by a situation and loses control over their own emotional response to something. Meltdowns are often experienced by individuals with an Autism Spectrum Disorder diagnosis (which includes a range of challeenges, each with varying levels of severity, and encompasses what was formerly known as Aspergers Disorder).

• Meltdowns often include intense emotional outbursts and may also include a physical response that is difficult to manage.
• Meltdowns may not have a specific or identifiable cause, though they often occur in response to being overstimulated by environmental factors or experiencing an unexpected or unwanted change in routine.
• Unlike a tantrum, a meltdown will not necessarily stop if the person gets what she originally wanted.

Parents are their children's first teachers, and communication between caregivers is important.

• Help parents and caregivers to see that it is their role to teach children by using positive discipline and by encouraging healthy communication between children's parents and caregivers. See: Parenting.

Reassure parents that temper tantrums are a normal part of child development. They can improve their responses to tantrums by slowing down their reactions and being aware of their own emotional responses when their child has tantrums. Encourage parents to:

• Pause and take a few deep breaths before reacting to a tantrum.
• Take time to understand why the child is upset.
• Try to understand what it is that the child wants.
• Help the child to verbalize the feelings appropriately.

Sometimes, children have temper tantrums because their parents have been overindulgent (e.g., the child is used to being given a lot of attention or gifts and becomes upset when those things are withheld).

• Remind the parents that it is important to implement limits and consequences in a consistent and predictable manner. Consistent, predictable, healthy parenting skills foster strong relationship attachments and support healthy cognitive and moral development. For more about parenting approaches, see: Parenting.

Help parents learn how to verbalize the child's experiences and feelings in order to model this for the child. Teach parents to:

• Be directive. For example, say “It is time for bedtime now,” not “Would you like to go to bed now?”
• Give choices. For example, say “It is time for bed; would you like to brush your teeth first or go to the bathroom first?"
• Reframe the tantrum behavior into a desired behavior. For example, say “In our home, we use walking feet. We can run and jump when we are outside."

Encourage parents to take steps to reduce the frequency of tantrums. For example, they can:

• Keep unsafe or valuable items out of reach of small children to avoid power struggles, tantrums, or property damage.
• Establish healthy routines and traditions to give the child structure.
• Proactively learn skills to use when their child is having a tantrum.
• Learn what triggers anger in themselves and their child and how to effectively self-regulate their own moods and reactions.

The child and family may need additional support if the temper tantrums get worse, increase in frequency, or cause damage to property or injury to other people.When helping parents change or modify behaviors in the home to reduce tantrums, explain that the child will probably react initially by increasing the frequency and severity of the tantrum behavior before starting to comply with new expectations.

It is important for parents to “catch” their child doing something positive and acknowledging positive behavior. For example, “I like how you took your shoes off at the door.” This can create positive behavioral momentum and encourage further good decisions.

Parental moods and reactions impact children, and it is important for parents to use healthy self-regulating skills when teaching children how to self-regulate.

Keeping a journal about the tantrums (including the date, time and circumstance) may be helpful for identifying patterns and triggers.

Referral information, including reports from medical providers, school staff, clinicians, or other sources regarding the client's wellbeing.

Releases of Information ( ROIs ) that are current or updated before getting information about the client from other sources.

Client history, related to sensory functioning, development, and psychological history.

Treatment Plan, including a history of presenting problem and recommended course of treatment.

General concerns

• Experiences developmental delays (see Chapter C-1: Development Across the Lifespan for typical development)
• Limited language skills for age
• Has a developmental disorder
• Has a learning disorder
• Poor nutrition
• History of child abuse or neglect
• Feels lonely or craves attention from caregivers
• Has experienced a traumatic brain injury
• Low tolerance for change
• Often overstimulated by environment
• Exposure to domestic violence (past or present, against self or others)

Tantrum behaviors

• Extreme fits
• Especially stubborn
• Excessive crying for age and situation
• Screaming more than normal
• Yelling more than normal when upset
• Especially defiant
• Angry rants
• Hurts self or others when she does not get what she wants
• Resists being soothed during a tantrum
• Uses emotional outbursts to get her way
• Has emotional outbursts when sad, has low energy, or is not receiving attention from others
• Manipulative

Family/home environment

• Parents lack critical understanding of:
  • Parenting skills
  • Child development issues
  • Healthy boundaries
• Caregivers are often too busy to spend time with child
• Limited supervision, structure, routines, consistency, and predictability
• Spends time with different caregivers who have different rules or expectations of the child’s behavior
• A lot of change in family dynamics or environment
• Rigid or controlling home environment

Questions to the caregiver

• Describe your child’s daily routine.
  • What activities do you do with your child?
  • Have there been any recent changes to his routine?
  • How does your child respond to changes in his environment?
  • How do you prepare your child for changes in his daily routine?
• How would you describe your child?
  • Does she get easily frustrated?
  • Is she very independent?
• Describe your child’s tantrums.
  • How do you respond to the tantrums?
  • How do you correct your child’s behavior?
  • What has worked to calm the child down during his tantrums?
• Have you noticed any patterns related to your child’s tantrum?
  • What types of triggers have you noticed?
• How many people are living in the home?
  • How much time do they spend with the child?
• Has your child been diagnosed with a developmental disorder, learning disorder, or FASD ?

Routinely review Chapter C-4: BHA/P Services and Common Interventions for how to prepare for and conduct interventions during appointments and for information on the levels of service available throughout Alaska.

Specifically, you mayconsider:

• Educational counseling related to child development and parenting skills.
• Social support services, including Infant Learning Programs or an Individualized Education Plan.
• Individual counseling or family counseling focused on child development and healthy discipline practices.
• Referrals to a clinician or child therapist who is especially skilled in working with children.

Be sure you are familiar with the information in Chapter B-5: Mandatory Reporting and Duty to Warn and Chapter B-8: Documentation and Billing. Report instances of the following, consistent with your organization's policies and procedures:

• Child abuse or neglect.
• Suicidal thoughts or plans.
• Intentions to cause harm or injury to the self or others.