When is a Temper Tantrum Just a Temper Tantrum? Or is it Time to Get Help?

by Terry Matlen Patient Expert

We've all seen it in others' kids or experienced it with our own: the childhood meltdowns that bring both child and parent to their knees. The screaming fits at the supermarket that are so embarrassing and frustrating, parents want to take the first plane out of the country. The nagging worry that they will be seen as awful, unfit parents, with social services lurking around the corner; all scrutinizing and judging the lack of parenting skills. Been there? Done that? I sure have and it's not something I'd want to re-visit ever again.

But at what point are your child's temper tantrums something to be concerned about?

I remember years ago, when my kids were tots, I had a friend whose young
son would have explosive "over the top" temper outbursts. Some were predictable, like with all our kids- if he couldn't have ice-cream NOW, he would attack the floor with legs and arms flailing. Other times, the outbursts seemed unprovoked. His parents tried everything they could to help, but not a single therapist could understand the reason for his problems. Medications, behavioral interventions...nothing worked. He carried his tantrums up until middle school, at which time I'd lost touch with that family. I've often wondered how the young man is faring.

A new study came out on temper tantrums and while reading it, the feelings, the worries, all came flooding back to me. How DO we know when a tantrum is just a tantrum? When is it time to seek the opinion of a professional?

The study, by Dr. Andy Belden of Washington University School of Medicine in St. Louis, was published in the Journal of Pediatrics. His team analyzed parent reports of tantrum behaviors in 279 children, aged 3-6, comparing healthy children to those with histories of ADHD, oppositional defiance disorder, depression, and other disruptive disorders.

His conclusion was that children who have long, frequent or aggressive temper tantrums might be at risk of depression or disruptive disorders.

Though most all children have tantrums when hungry, tired, over-stimulated or frustrated, the key in this study was to
analyze the styles and duration of the tantrums.

Belden's team devised five high-risk tantrum styles:

  • Tantrums that caused self injury; tantrums involving violence

  • Tantrums in which children cannot calm themselves without help

  • Tantrums lasting more than 25 minutes

  • Tantrums occurring more than 5 times a day, or between 10 and 20 times a month

Of those, Belden said tantrums in which children harm themselves were most often associated with depression and should be considered very serious.

He said any of those high-risk behaviors would warrant a call to the doctor: "If it gets to the point where the parent is uncomfortable leaving the house because they are so fearful their child will have a tantrum, that should be a sign to the parent to seek help."

Thinking about my friend's son, knowing what I now know about temper tantrums, I pray that he is doing ok and that he got the help he needed.

If you're concerned about your child's temper tantrums, perhaps the best place to start is to discuss it with his pediatrician. If you're still unsure, consult with a pediatric psychologist, psychiatrist or neurologist.

Terry Matlen
Meet Our Writer
Terry Matlen

Terry wrote for HealthCentral as a patient expert for ADHD.