Temper Tantrums in Children: Clinical Overview and Management

Definition and Age of Occurrence

Tantrums typically begin in the toddler years and gradually diminish as language and emotional regulation skills develop, with children with diabetes requiring blood glucose measurement before dismissing a tantrum, as hypoglycemia can mimic normal developmental opposition, according to the American Diabetes Association 1

The American Academy of Pediatrics recommends that parents reduce power assertion and increase consistency, as these are the two parenting factors most strongly associated with decreased tantrum severity over time, and state consequences when necessary, such as time-out or removal of privileges for undesired behaviors 2
The American Academy of Pediatrics also suggests that parents avoid corporal punishment, as harsh disciplinary strategies promote aggressive behaviors and damage the parent-child relationship 2

Pediatricians should anticipate normal developmental stages and provide guidance about managing potentially difficult situations, including discussing positive reinforcement strategies, such as praise, to increase desired behaviors, and explaining the purposeful use of ignoring, redirection, and time-out for undesired behaviors, according to the American Academy of Pediatrics 2
The American Academy of Pediatrics recommends that pediatricians address cultural differences in disciplinary approaches and provide guidance on teaching emotional regulation skills, such as providing nurturance after the episode ends and teaching alternative communication strategies as language develops 2
Normal developmental phases that trigger tantrums include normal negativism, normal exploratory behavior, and normal poor appetite, according to the American Academy of Pediatrics 3, 4

Children with problematic tantrums, such as aggressive, prolonged, or frequent tantrums, and their families should receive assistance, given the significant emotional burden on caregivers, and may require specialized behavioral management, according to the American Academy of Child and Adolescent Psychiatry 5
Temper tantrums can be difficult to distinguish from hypoglycemia in children with diabetes, requiring blood glucose measurement before dismissing the behavior, according to the American Diabetes Association 1
In children with Prader-Willi syndrome, prolonged oppositional behaviors and temper tantrums beyond the typical toddler years are characteristic features requiring specialized behavioral management, according to the American Academy of Pediatrics 6, 7