Do Tantrums Mean Trouble?
January 2, 2008 by Heidi Green | 3 questions or comments
About the study
Researchers recruited 3-, 4-, and 5-year-olds from doctors’ offices and preschools/day cares throughout the greater
Researchers used the Preschool Feelings Checklist, DSM-IV criteria, and the Preschool Age Psychiatric Assessment (PAPA). Trained interviewers determined the number of tantrums by the child in the past 3 months, as well as the intensity, duration, frequency, context, behavior, and recovery after the tantrum(s).
This study included 279 preschoolers. The children were divided into four groups: healthy children (150); children with major depressive disorder (MDD) but no attention deficit hyperactivity disorder (ADHD), conduct disorder, and/or oppositional defiant disorder (21); children with ADHD, conduct disorder, and/or oppositional defiant disorder but no MDD (54); or children with MDD and a disruptive disorder (54).
Tantrums were classified as being normative (rarely escalating to excessive crying or shouting, and without destruction or violence), excessive without aggression (having crying, shouting, and/or directed flailing, but without aggression or violence), or excessive with aggression (having crying and screaming, as well as episodes of aggression and/or violence towards objects and/or people).
Study results
In short, researchers found that long, frequent, violent, and/or self-destructive tantrums may indicate depression or disruptive disorders such as ADHD. If a child is regularly engaging in these types of tantrums, there may be a problem.
Five types of “red flag” behaviors were identified:
- Extreme aggression. If most tantrums include aggression towards a caregiver or destruction of an object (e.g., toy), then the child is more likely to be diagnosed with ADHD, oppositional-defiant disorder, and/or another disruptive disorder.
- Self-injury. If tantrums include the child intentionally injuring himself (e.g., scratching, head banging, biting), the child is more likely to have major depressive disorder.
- Many tantrums. More than five tantrums per day for several consecutive days signaled a problem.
- Long tantrums. While healthy children might have tantrums that last as long as 10 or 11 minutes, those who were found to have disruptive disorders averaged more than 25 minutes per tantrum.
- Inability to self-calm. Those who are unable to calm themselves seem to be more likely to have psychiatric problems, too.
What it all means
First, this study shows that it’s normal for children to display excessive behavior sometimes. Even healthy children might have “red flag” behavior occasionally, especially if they are tired, hungry, or sick. Therefore, parents should not overreact if during one tantrum the child lashes out. However, it also means that they should pay attention.
Second, it means that parents of children of all ages should be concerned about signs of self-injury. The researchers advise parents to consult their child’s doctor or a mental health professional at the first sign of this behavior.
It’s important to note that this study relied solely on information provided by the preschoolers’ parents. The data were not verified by other means (e.g., information from other care providers, video of tantrums).
The bottom line
In this, as in so many other aspects of parenting, mothers and fathers should trust their instincts. If your child’s tantrums cause you concern, this article from babycenter might help, or you can talk to your child’s doctor. Some tantrums are a normal part of childhood, but if you see these “red flags” regularly, a talk with your child’s doctor is probably a good idea.
On first glance that sounds like good advice to tell concerned parents to “talk to their doctors.” But what does that really mean? Will the doctor say, “Let’s see if we can do some detective work and find out what is causing the behavior.” Will the doctor say “Perhaps your child isn’t getting enough of the important omega-3 fatty acids,” or “There are some vitamins that might be helpful in improving your child’s frustration tolerance,” or “Try removing the worst of the synthetic food additives that have been shown to cause such behaviors”? Unfortunately, most doctors are taught that when there’s a problem you look for a pill, and those who go beyond this quick fix are often in the minority. I’ve been helping parents of hard-to-raise children for over 30 years, and have found that those doctors who are best informed about how to best help these children recognize that what a child eats has a direct effect on how he behaves. I encourage parents who would like more information to visit www.feingold.org.
The concern that Jane raises is the subject of a “Frontline” report scheduled to air Tuesday, January 8, 2008 at 10:00 p.m. on Georgia Public Broadcasting. The report examines why approximately 6 million U.S. children are taking powerful psychiatric drugs. “It’s really to some extent an experiment, trying medications in these children of this age,” says one doctor.
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