Which is the best advice the nurse can give to parents asking for help in handling their toddlers temper tantrums?

What are tantrums?

Tantrums come in all shapes and sizes.

They can involve spectacular explosions of anger, frustration and disorganised behaviour – when your child ‘loses it’.

You might see screaming, stiffening limbs, an arched back, kicking, falling down, flailing about or running away. In some cases, children hold their breath, vomit, break things or hurt themselves or other people as part of a tantrum.

Tantrums are common in children aged 1-3 years.

This is because young children are still at an early stage of social, emotional and language development. They can’t always communicate their needs and feelings, including the desire to do things for themselves, so they might get frustrated. And they’re learning that how they behave influences others. So tantrums are one of the ways that young children express and manage feelings, and try to understand or change what’s going on around them.

Older children can have tantrums too. This can be because they haven’t yet learned safe ways to express or manage feelings.

For both toddlers and older children, there are things that can make tantrums more likely to happen:

• Temperament – this influences how quickly and strongly children react to things like frustrating events or changes in their environment. Children who are more sensitive might be more easily upset by these things.
• Stress, hunger, tiredness and overstimulation – these can make it harder for children to express and manage feelings and stay calm.
• Situations that children just can’t cope with – for example, a toddler might have trouble coping if an older child takes a toy away.
• Strong emotions – worry, fear, shame and anger can be overwhelming for children.

Self-regulation is the ability to understand and manage feelings and reactions. Children start developing it from around 12 months. As your child gets older, they’ll be more able to regulate reactions and calm down when something upsetting happens. You’ll see fewer tantrums as a result.

How to make tantrums less likely

These are a few things you can do to make tantrums less likely to happen:

• Help your child understand their emotions. You can do this from birth by using words to label feelings like ‘happy’, ‘sad’, ‘cross’, ‘tired’, ‘hungry’ and ‘comfy’.
• Identify tantrum triggers like tiredness, hunger, worries, fears or overstimulation. You might be able to plan for these situations and avoid the triggers – for example, by going shopping after your child has had a nap or something to eat.
• When your child handles a difficult situation without a tantrum, encourage them to tune in to how this feels. For example, ‘I just saw you build that tower again without getting upset when it fell. How did that feel? Did you feel strong and calm?’
• Talk about emotions after a tantrum when your child is calm. For example, ‘Did you throw that toy because you were cross that it wasn’t working? What else could you have done?’
• Model positive reactions to stress. For example, ‘I’m worried this traffic is making us late. If I take some deep breaths, it will help me stay calm’.

Some young children who are still learning to speak have tantrums because they’re frustrated. Teaching your child some key word signs for words like ‘angry’ or ‘hungry’ can help until they learn the words to say instead.

How to handle tantrums when they happen

Sometimes tantrums happen, no matter what you do to avoid them. When a tantrum happens, the way to respond depends on your child’s age:

• For toddlers, time-in works well – stay close, offer comfort, and reassure children that you understand their feelings.
• For older children, you can use 5 calming down steps – identify the emotion, name it, pause, support your child while they calm down, and address the issue that sparked the tantrum.

And these tips might help tantrums pass with less distress for everyone:

• Make sure that your child and others nearby are safe. This might mean carrying your child somewhere else if you need to.
• Once your child is in a safe place, calmly acknowledge the emotion they’re expressing – speak slowly and in a low voice.
• Stay quietly with your child until they calm down. Touch or hold them if they want you to, or give them more physical space if they need it. Don’t try to reason with your child.
• Be consistent about not giving in to demands. This will help your child learn that tantrums don’t help them get what they want.
• Try a ‘paradoxical instruction’. This means giving your child permission to scream and shout until they’re ready to stop. For example, ‘You can yell louder if you want to. It’s a big park and we’re not bothering anyone’.
• Comfort your child when they’ve calmed down. A tantrum is distressing for everyone.

Tantrums in preschoolers and early school-age children

At this age, children are also better able to understand that their actions have effects. For example, after your child has calmed down from their tantrum, you could explain that a natural consequence of having a tantrum is that other children might not want to play with them.

If your child has additional needs like autism, they might have frequent or severe tantrums. See our article on challenging behaviour in autistic children or ask for advice from the professionals who work with your child.

Coping with tantrums: managing your own feelings

If you can stay calm when your child is having a tantrum, it gives your child a model of calm behaviour. Here are ideas for staying calm and keeping things in perspective during tantrums:

• Have a clear plan for how you’ll handle a tantrum in whatever situation you’re in. Concentrate on putting your plan into action when the tantrum happens.
• Accept that you can’t control your child’s emotions or behaviour directly. You can only keep your child safe and guide their behaviour so tantrums are less likely to happen in the future.
• Accept that it takes time for change to happen. Your child has a lot of growing up to do before tantrums are gone forever. Developing and practising self-regulation skills is a life-long task.
• Beware of thinking that your child is doing it on purpose or trying to upset you. Children don’t have tantrums deliberately. They’re stuck in a bad habit or don’t have the skills right now to cope with the situation.
• Keep your sense of humour. But don’t laugh at the tantrum – if you do, it might reward your child with attention. It might also upset your child even more if they think you’re laughing at them.
• If other people give you dirty looks, ignore them. They’ve either never had children or it’s been so long that they’ve forgotten what it’s like.

Be kind to yourself when things don’t go to plan and a tantrum happens. Raising children is a big and important job, which all parents learn as they go. You’re doing your best, and you can’t control everything.

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