Q&A: How to Handle Violent & Severe Temper Tantrums

EarlyInterventionSupport Behavior Concerns, Therapist Q&A

blockquote_bgI have a 4 yr old little girl and she throws violent uncontrollable temper tantrums. I’ve taken her to her PCP and she says every kid does it. It will start over anything even the smallest thing. She lost her red color, she doesn’t want to wear that, she wants to eat something else, her TV show ended. Anyway, these tantrums last at least 2 hours and usually only end by her passing out. When they start the screams, whines, she won’t talk at all, she bites, she kicks, she scratches, she throws things.
Basically she will do anything possible to hurt you , herself, and everything and everyone around her. Nothing I say or do can ever calm her down and I’m scared for her to hurt herself or anyone else so I basically have to hold her down to protect everyone. I don’t know what to do anymore. Where do I go and what do I do? I love my daughter and apparently she needs some kind of help.

Your daughter’s frequency and severity of tantrums at age 4 are very concerning. Is your PCP a pediatrician or a developmental pediatrician? If not, I would definitely seek a second opinion with a doctor who is more familiar with preschool aged children and their behavior. While it is true that most children do have tantrums and children as old as 4 & 5 will still have them, the fact that your daughter is engaging in self injurious behavior, as well as trying to hurt others, coupled with the fact that she cannot calm herself and passes out often after 2 hours of screaming makes her case atypical. If you can’t get a second opinion from a developmental pediatrician in your area, then I would find a local child psychologist/psychiatrist who would evaluate your daughter. You can also seek an Early Intervention Evaluation (3-5 preschool services) for behavior through your local school district.

To help you in getting help for your daughter I would suggest starting to keep a log of her tantrums that includes when they occur (date & time of day), what triggered the tantrum, what she does during the tantrum (scream, hit, bite, etc), how long they last, and what happens directly afterwards. Also, do these tantrums occur only at home or do they also occur in other environments and with other caregivers besides yourself? Keeping strict documentation of your child’s behaviors will often make a doctor take a closer look. Also, has she been having these tantrums since she was a toddler or did they start or increase in intensity just recently? Pay attention to any changes in your or her life that can increase tantrums (i.e., did you recently move, did she recently start school, did you recently get a divorce or new partner, did you recently have a baby).

Typical tantrums in children ages 18 months to age 5 last around 3 minutes, and tantrums lasting longer than 5 minutes, while they may occur sometimes, would not typically occur on a regular basis. Younger children tend to lash out more physically because they don’t have the words to express anger or frustration yet, however, by age 4, most children can express anger with words and can also self-calm when upset, something that it sounds like your daughter is having difficulty doing.

I don’t want to alarm you, nor can I make a diagnosis, but violent tantrums in ages 3-5 can be associated with mood disorders such as depression or other disruptive disorders of early childhood. I would definitely seek a second opinion and/or schedule an evaluation with a child psychologist as soon as possible to get you and your daughter the help you need.

EarlyInterventionSupportQ&A: How to Handle Violent & Severe Temper Tantrums