Behavior Modification in Children

With Temper Tantrums

by Kay Ireland, Demand Media

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

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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.

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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.
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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
childrens 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
too young to know how to satisfy the want. Tantrums are the result of high
energy and low ability to use words to get needs or wants met.
Tantrums typically peak between ages 2 and 3, and start to decline by 4.
They usually run their course within a year. Twenty-three to 83 percent of all
2- to 4-year-olds have temper tantrums at least occasionally (2, 3, 7, 8, 15).
Most children throw tantrums in a particular place with a particular person.

To behave rightly, we
ourselves should never lay a
hand on our servants [or
children] as long as our anger
lasts .... Things will truly
seem different to us when we
have quieted and cooled
down. Montaigne

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 childs level of energy and the parents 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 childrens 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.
3.

The child responds aggressively.

The childs 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
childrens rights (4, 9).

Guidelines for Parents

From a number of research studies plus Tavris, the following guidelines are suggested for building child selfcontrol 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: Im so angry at you right now for dumping your
cereal all over the clean floor, I feel like hitting you. But I dont hit, so Im going to leave and come back when
Ive calmed down.
2. Distract or redirect the child.
When a child is misbehaving, a calm parent can sometimes re-direct the childs behavior. Example: Heres a
bowl of warm water. Lets 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: Im 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 childs 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 were out of the store and weve both had a
chance to calm down, lets 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 wont
work. It wont 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 childs anger can negatively affect their childs
willingness to relieve distress in others (10). Example: You look and sound angry right now. Id 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 childs 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 5year-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 its OK to feel angry, its 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 friends 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 childs protests about having to take a national test or measles shot. Example:
Sounds like you are angry at the school rule that says you cant wear shorts, sandals and tank tops to school.
10. Teach understanding and empathy by calling your childs attention to the effects of his or her
actions on others.
Invite the child to see the situation from the other persons 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: Lets 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.