Acting-out behaviors

Alternative names 
Temper tantrums

Definition
Disruptive or undesirable behavior in response to unmet needs or desires. Emotional outbursts when not allowed to do or have something that a child wants. Inability to control emotions due to frustration and difficulty expressing the particular need or desire.

Information

Temper tantrums or “acting-out” behaviors are natural during early childhood development. As children learn to separate from their parents (that is, as they learn that they are separate beings), they have a normal and natural tendency to assert their independence. This desire for control often manifests as saying “no” often and having tantrums, which are compounded by the fact that the child may not have the vocabulary to adequately express his or her feelings.

Tantrums generally begin between the ages of 12 to 18 months, peak between 2 and 3 years, then decrease rapidly until age 4 after which they should be seldom seen. Being tired, hungry, or sick can make tantrums worse or more frequent. Make sure that your child eats and sleeps at his or her usual times. If your child no longer takes a nap, it is still important to have some quiet time. Lying down for fifteen to twenty minutes or resting with you while you read stories together at regular times of day can help prevent tantrums.

When your child has a temper tantrum, it is important that you remain calm. It helps to remember that tantrums are normal - they are NOT your fault, you are NOT a bad parent, and your son or daughter is NOT a bad child. Shouting at or hitting your child will only make the situation worse. A quiet, peaceful response and atmosphere, without “giving in” or breaking the rule that you just set, will reduce stress and make both of you feel better. Remember that children imitate behavior. You can also try gentle distraction to activities that they enjoy or try making a funny face. If you are not at home during a tantrum, try to carry your child to a quiet place like the car or a rest room, keeping him or her safe until the tantrum has ended.

Other methods to try to prevent tantrums include:

     
  • Use an upbeat tone when asking your child to do something. Make it sound like an invitation, NOT an order. For example, “if you put your mittens and hat on, we’ll be able to go out to your play group.”  
  • Make rules count. In other words, don’t battle over unimportant things like which shoes your child wears or whether he or she sits in the high-chair or booster seat. Safety is what really matters, like not touching a hot stove, keeping the car seat buckled, not playing in the street, etc. As the American Academy of Pediatrics experts put it “while [your toddler or preschooler] will be saying ‘no’ to everything…, you should be saying ‘no’ only the few times a day when it is absolutely necessary.”  
  • Offer choices whenever possible. For example, let your child pick what clothes he or she wants to where, stories he or she wants to read, etc. If a child feels independent in many areas, he or she is more likely to follow rules when it is a must. DO NOT offer a choice if one doesn’t truly exist.

The American Academy of Pediatrics recommends that you call your pediatrician if:

     
  • Tantrums get worse instead of better after age four.  
  • Your child injures him or herself or others or destroys property during tantrums.  
  • Youd child holds his or her breath during tantrums, especially if he or she faints.  
  • Your child also has nightmares, reversal of toilet training, headaches, stomachaches, refuses to eat or go to bed, anxiety, or excessive clinginess to parents.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.