Managing temper tantrums: Advice from a Mayo Clinic specialist
<http://www.mayoclinic.com/health/tantrum/HQ01622> 
What should you do when your child's temper is out of control? Here's advice
from a Mayo Clinic specialist.

Managing temper tantrums: Advice from a Mayo Clinic specialist
Jay L. Hoecker, M.D. 
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You're shopping with your toddler in a huge discount store. He or she has spied
a toy that you don't intend to buy. Soon, you find yourself at the center of a
gale-force temper tantrum. Everyone is looking at you, and your face is burning
with embarrassment.

Could you have prevented the tantrum? What's the best response? And why do these
emotional meltdowns happen in the first place? Here are some tips from Jay
Hoecker, M.D., a pediatrician at Mayo Clinic in Rochester, Minn.

Why do tantrums happen?
A tantrum is attention-getting behavior, unwanted and unwelcomed by the parent,
which occurs when the child can find no other way to address the physical or
emotional challenges of the moment. The basis for the behavior may be an
inability to express the emotion, wish or need any other way because of the
child's stage of language development.

What types of challenges are you talking about?
Physical challenges are things like hunger and thirst. Emotional challenges are
more open to speculation. One theory about tantrums in 2-year-olds is that
frustration has a lot to do with it, particularly when it comes to
communication.

Two-year-olds have a vocabulary of about 50 words and can link two words
together for simple sentences. But even their parents understand what they're
saying only 50 percent of the time. Strangers understand even less. You can
think of the young Helen Keller, mute and wanting to communicate. She can't, so
she throws tantrums.

Can anything be done to improve communication skills?
Interestingly enough, some people have taught toddlers sign language - maybe
half a dozen words, such as "I want," "more," "enough," "hurt" and "tired."
These are kids between 18 and 24 months old, and they can communicate better.
They get their needs met, and they have fewer tantrums.

Are there ways to prevent tantrums?
It helps if you can plan ahead. If you're going to the store, try to make sure
the child isn't hungry or tired. Avoid the "temptation islands," full of
eye-level treats, located near the checkout lanes. You might take a snack for
the child to eat, so he or she won't get cranky from hunger. Some parents let
their children become part of the shopping process, by allowing them to pick out
some item in the store that is acceptable. Whatever measures you take to prevent
tantrums, make sure you have figured out in advance what you're going to do if a
tantrum happens.

What's the best way to handle a tantrum?
Children have tantrums because they want your attention. It doesn't matter if
the attention is positive or negative. They just want 100 percent of it. They
want you to stop your life and give them 100 percent of your attention. So if
you lose your cool and yell, or have a tantrum yourself, you've given them what
they want.

If you can, it's best to pretend to ignore a tantrum. At home, you can act as if
it's not interrupting things. After they quiet down, you may be able to
negotiate with them, saying, "I noticed your behavior, but that won't get my
attention. You need to use your words to get my attention. All that behavior
will get you is a timeout."

What's a timeout?
During a timeout, the child has to sit someplace boring for a set length of
time. Usually, the punishment lasts one minute for each year of the child's age.
After a while, kids will even volunteer that they need a timeout and will go sit
in their chair. Never lock a child in a room for a timeout.

If the child is too upset to sit still, you can say, "You're in timeout and, as
far as I'm concerned, you're invisible to me." You pretend that you don't even
see the child, but you can still assure his or her safety. Up until the age of
5, magic is real to children. So if you say they're invisible to you, they'll
believe it.

What about when you're out in public?
If your child is having a temper tantrum in a store, the most important thing
you should remember is that any other adult nearby who has had children will be
sympathizing with you as you stand there, ignoring the tantrum. They won't
sympathize with you if you lose your cool and resort to physical punishment.

Some adults may give you bad looks during tantrums, but they must've never had
children, so they don't count. They'll never understand.

If the child is about to do something harmful, like pull over some shelves, you
should intervene. Sometimes all you can do is pick up the child, leave your cart
full of groceries and go home.

How do you do timeouts away from home?
When your child has a tantrum in a store and you can't do a regular timeout, you
can do a "marked" timeout. You use a felt-tip pen to make a mark on the back of
the child's hand, and tell him or her you will discuss this mark later.

When you get home, you look at the mark and say, "How did this get here? What
were you doing when that happened?" and kind of relive the scene. Then he or she
must sit in timeout for the mark. If there are several marks, you do one timeout
now and then another later, until the tally is zero.

What if 'marked' timeouts don't work?
If a child continually gets multiple marked timeouts, the parent may have to
just avoid these situations for a while. Sometimes, it's better to not take the
child to the store. But most single parents don't have many other options.

Do preschoolers have tantrums on purpose?
Parents who think their preschoolers are planning things out are really giving
the children too much credit. It's not that these children have evil plans to
embarrass you in public. They're not capable of such plotting and planning.
Their world is right there in sight, right at the ends of their noses. The child
does not enjoy a tantrum anymore than the parents do.

When should children outgrow tantrums?
Getting along with people is one of the main things we learn in kindergarten.
And fortunately, the majority of us pass kindergarten. So you wouldn't expect
tantrums in a first grader. If a 6-year-old or 7-year-old is still having
tantrums, and timeouts aren't working, something else may be going on. It's time
to see a doctor.



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By Mayo Clinic Staff 
Jun 15, 2006 
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Education and Research. 
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