TEMPER TANTRUMS
 
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TEMPER TANTRUMS

 

DEFINITION:

An uncontrollable outburst of negative emotion characterized by episodes of crying, screaming, and/or physically violent behaviour triggered by anger, frustration, or disappointment.

EPIDEMIOLOGY:

  • incidence: common
  • age of onset:
    • 18 months to 3 years
  • risk factors:
    • ?

PATHOPHYSIOLOGY:

1. Background

  • a behaviour expressed in toddlers and young children in response to a stressful situation
  • temper tantrums more likely to persist in children with:
    • delayed language skills who are less able to express their feelings verbally
    • difficult or high-strung temperment
    • positive reinforcement, i.e. achieve goal through temper tantrums

CLINICAL FEATURES:

1. Behavioural Manifestations

  • crying and/or screaming
  • physically violent behaviour
    • kicking, hitting, throwing objects

INVESTIGATIONS:

  • not needed

MANAGEMENT:

  • 1. Stay calm and do not hit or yell at child
  • 2. Identify cause of tantrum, i.e., tantrum triggers
  • 3. Options:
    • distract or hold (toddlers)
    • ignore until calms down (in older children)
    • remove and place child in a quiet place (time out)
  • 4. When child calm, explain that tantrums are unacceptable behaviour (and that the child is still loved)
  • 5. Behavioural Modification
  • 1. Positive Reinforcement
    • reward acceptable behaviour, i.e., star and sticker chart
  • 2. Negative Reinforcement
    • do not respond by giving the child what they want
  • 6. Prevention
    • identify triggers and avoid
    • if triggering situation is unavoidable, give warnings, i.e., the activity which triggers a tantrum will end in a few minutes
  • 7. Teach child to express negative emotions (anger, frustration, disappointment) in another way (use of story books)
  • 8. Act as a role model and remain calm in stressful situations and do not express overt negative emotions

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