When to Worry About Temper Tantrums

How do we know when to worry about temper tantrums in our children? According to recent research, about 83% of preschoolers have regular temper tantrums.¹ If you're reading this, I'm guessing you are the parent of at least one of the 83 percent. I was one such parent, too, and my son's tantrums turned out to be the sign of childhood mental illness. How do you know when to worry about temper tantrums because it might be the same for you?

Signs that Point to When to Worry About Temper Tantrums

Preschool was a precarious time for my son. As a toddler, he had dramatic tantrums. He'd fall to his knees, wailing and throwing his arms in the air as if pleading with the heavens. He'd fall over and bang his fists on the floor. His tantrums were so theatrical that they were kind of cute (How Kids Grow: Defining Normal Behavior).

By age four, though, they weren't so cute. He'd break things, kick teachers, and throw chairs across the room. I never babysat a child in my life, and my son was my firstborn, so I couldn't tell if this behavior was typical. Teachers seemed frustrated, but they never said it wasn't "normal," per se. Behavior plans went into place, and he barely graduated preschool before getting kicked out.

His tantrums got progressively worse. By age eight, he was enough of a danger to himself that he was hospitalized and diagnosed with disruptive mood dysregulation disorder (DMDD). After all those years of thinking I was just a terrible parent who couldn't manage temper tantrums, I had confirmation that his tantrums were not "normal." Right now, DMDD cannot be diagnosed before age six. New research suggests, however, that signs of the disorder (as well as others) might be present in preschool. Sometimes you do need to worry about temper tantrums.

When to Worry About Temper Tantrums: Frequency and Intensity Might Predict Later Issues

In their study, Wiggins et al. (2018) assessed disruptive behaviors in preschoolers and then followed up with those preschoolers as they aged. As expected, not every disruptive behavior was associated with later psychiatric disorders. However, two particular behaviors did serve as possible predictors: easy frustration and "breaking things."

Frustration is a typical response to having your goals thwarted, and anger is a typical response to frustration. In preschoolers, anger often triggers tantrums. It's expected. However, if your preschooler is easily frustrated, resulting in near-daily tantrums, you have more reason to worry. It's not the frustration itself, but the frequency of it, that matters

Frustration and tantrums alone, though, aren't predictive of later mental health issues. In preschoolers, the Wiggins et al. study suggests it's the intensity of a tantrum that should cause concern, too--specifically whether a child breaks things. They don't have to always break things during tantrums, but if it does happen on occasion, that's when it's time to worry about temper tantrums. My son, for instance, was frustrated by everything from doing math to having to deal with a kid who looked at him funny. He broke things when he was upset. He had the combined predictors of his DMDD as early as age three.

When You're Worrying About Temper Tantrums, Seek Help

In general, if you have concerns about your child's behavior, talk to your pediatrician. Frequent temper tantrums could mean everything or nothing, but if you're worried about temper tantrums, don't be afraid to ask about it.

I, personally, wish we'd been aware earlier that my son's behaviors weren't typical. Even if there was nothing we could have done for him, knowing his behaviors weren't typical would have made me feel less worthless as a parent. We might have gotten professional help earlier, too.

So don't grit your teeth and bear it alone. You will be happy you reached out early for support.

____________________________________________

1. Wiggins, J.L., Briggs-Gowan, M.J., Estabrook, R., Brotman, M.A., Pine, D.S., Leibenluft, E., & Wakschlag, L.S. (2018). Identifying clinically significant irritability in early childhood. Journal of the American Academy of Child and Adolescent Psychiatry, v57(3), 191-199.