What is the best approach for managing temper tantrums in children?

Managing Temper Tantrums in Children

The best approach for managing temper tantrums in children is to implement a combination of preventive strategies, including identifying triggers, teaching emotional regulation skills, and using consistent behavioral techniques such as ignoring the tantrum while ensuring safety, followed by positive reinforcement when calm behavior returns. 1, 2

Understanding Temper Tantrums

• Temper tantrums are a normal developmental response to anger and frustration, occurring most commonly in children between 1-4 years of age as they attempt to exercise mastery and autonomy 2
• Tantrums occur more frequently in active, determined children with abundant energy 2
• About half of children experience weekly tantrums, with most episodes lasting several minutes 3
• Common tantrum behaviors include screaming, shouting, and in more problematic cases, aggressive physical behaviors 3, 4

Preventive Strategies

• Identify and address common triggers such as hunger, fatigue, boredom, or illness that may reduce a child's tolerance for frustration 2
• Implement positive parenting techniques including helping children identify and name their emotions, which builds regulation skills 1
• Provide dedicated "time-in" or special time with caregivers (10-30 minutes of child-directed play) to strengthen the relationship and reduce attention-seeking tantrums 1
• Set appropriate boundaries and provide guidance through connecting and listening with children 1
• Use positive language instead of "no" commands (e.g., "We color on paper, not on the table" rather than "Stop that") 1

During a Tantrum

• The primary strategy should be ignoring the tantrum behavior while ensuring the child's safety 2, 5
• Encourage the child to use self-directed time-out or separation from the group to regain control 1
• Remain calm to model self-regulation and avoid retraumatizing the child 1
• Avoid power struggles by judiciously ignoring peripheral issues such as inappropriate language 1
• For older children, remind them of previously practiced anger management strategies 1

After a Tantrum

• Offer nurturance to the child after the tantrum has subsided 2
• Help the child review triggers and options for behaviors that would have led to self-control 1
• Teach the child to express negative feelings in more acceptable ways 2
• Celebrate and reward small steps toward desired behaviors 1
• Process with the child about what happened, helping them understand the connection between their feelings and behaviors 1

Parenting Approaches to Avoid

• Research shows that increased maternal power assertion (excessive strictness) and less consistency predict increases in tantrum severity over time 5
• Other problematic parenting practices that may encourage tantrums include inconsistency, unreasonable expectations, overprotectiveness, and overindulgence 2

When to Seek Professional Help

• Tantrums that include aggressive physical behavior, last longer than 15 minutes, or occur more than 3 days per week may be considered problematic and warrant professional attention 4
• If tantrums are accompanied by symptoms of intrusion, avoidance, negative alterations in cognitions and mood, or increased arousal persisting for more than a month, this may indicate post-traumatic stress and require specialized intervention 1
• For children with autism spectrum disorder who have severe temper tantrums, medication such as risperidone may be indicated for treatment of irritability, including symptoms of aggression, deliberate self-injuriousness, and quickly changing moods 6

Impact on Caregivers

• Problematic tantrums significantly impact caregivers' emotional well-being compared to non-problematic tantrums 4
• Parents and caregivers should be equipped with appropriate strategies to effectively manage tantrums 3
• Consistent application of behavioral techniques and parental emotional regulation are key to successful management 1, 5