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David Baxter PhD

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Managing temper tantrums: Advice from a Mayo Clinic specialist
Jay L. Hoecker, M.D.

What should you do when your child's temper is out of control? Here's advice from a Mayo Clinic specialist.

You're shopping with your toddler in a huge discount store. He or she has spied a toy that you don't intend to buy. Soon, you find yourself at the center of a gale-force temper tantrum. Everyone is looking at you, and your face is burning with embarrassment.

Could you have prevented the tantrum? What's the best response? And why do these emotional meltdowns happen in the first place? Here are some tips from Jay Hoecker, M.D., a pediatrician at Mayo Clinic in Rochester, Minn.

Why do tantrums happen?
A tantrum is attention-getting behavior, unwanted and unwelcomed by the parent, which occurs when the child can find no other way to address the physical or emotional challenges of the moment. The basis for the behavior may be an inability to express the emotion, wish or need any other way because of the child's stage of language development.

What types of challenges are you talking about?
Physical challenges are things like hunger and thirst. Emotional challenges are more open to speculation. One theory about tantrums in 2-year-olds is that frustration has a lot to do with it, particularly when it comes to communication.

Two-year-olds have a vocabulary of about 50 words and can link two words together for simple sentences. But even their parents understand what they're saying only 50 percent of the time. Strangers understand even less. You can think of the young Helen Keller, mute and wanting to communicate. She can't, so she throws tantrums.

Can anything be done to improve communication skills?
Interestingly enough, some people have taught toddlers sign language ? maybe half a dozen words, such as "I want," "more," "enough," "hurt" and "tired." These are kids between 18 and 24 months old, and they can communicate better. They get their needs met, and they have fewer tantrums.

Are there ways to prevent tantrums?
It helps if you can plan ahead. If you're going to the store, try to make sure the child isn't hungry or tired. Avoid the "temptation islands," full of eye-level treats, located near the checkout lanes. You might take a snack for the child to eat, so he or she won't get cranky from hunger. Some parents let their children become part of the shopping process, by allowing them to pick out some item in the store that is acceptable. Whatever measures you take to prevent tantrums, make sure you have figured out in advance what you're going to do if a tantrum happens.

What's the best way to handle a tantrum?
Children have tantrums because they want your attention. It doesn't matter if the attention is positive or negative. They just want 100 percent of it. They want you to stop your life and give them 100 percent of your attention. So if you lose your cool and yell, or have a tantrum yourself, you've given them what they want.

If you can, it's best to pretend to ignore a tantrum. At home, you can act as if it's not interrupting things. After they quiet down, you may be able to negotiate with them, saying, "I noticed your behavior, but that won't get my attention. You need to use your words to get my attention. All that behavior will get you is a timeout."

What's a timeout?
During a timeout, the child has to sit someplace boring for a set length of time. Usually, the punishment lasts one minute for each year of the child's age. After a while, kids will even volunteer that they need a timeout and will go sit in their chair. Never lock a child in a room for a timeout.

If the child is too upset to sit still, you can say, "You're in timeout and, as far as I'm concerned, you're invisible to me." You pretend that you don't even see the child, but you can still assure his or her safety. Up until the age of 5, magic is real to children. So if you say they're invisible to you, they'll believe it.

What about when you're out in public?
If your child is having a temper tantrum in a store, the most important thing you should remember is that any other adult nearby who has had children will be sympathizing with you as you stand there, ignoring the tantrum. They won't sympathize with you if you lose your cool and resort to physical punishment.

Some adults may give you bad looks during tantrums, but they must've never had children, so they don't count. They'll never understand.

If the child is about to do something harmful, like pull over some shelves, you should intervene. Sometimes all you can do is pick up the child, leave your cart full of groceries and go home.

How do you do timeouts away from home?
When your child has a tantrum in a store and you can't do a regular timeout, you can do a "marked" timeout. You use a felt-tip pen to make a mark on the back of the child's hand, and tell him or her you will discuss this mark later.

When you get home, you look at the mark and say, "How did this get here? What were you doing when that happened?" and kind of relive the scene. Then he or she must sit in timeout for the mark. If there are several marks, you do one timeout now and then another later, until the tally is zero.

What if 'marked' timeouts don't work?
If a child continually gets multiple marked timeouts, the parent may have to just avoid these situations for a while. Sometimes, it's better to not take the child to the store. But most single parents don't have many other options.

Do preschoolers have tantrums on purpose?
Parents who think their preschoolers are planning things out are really giving the children too much credit. It's not that these children have evil plans to embarrass you in public. They're not capable of such plotting and planning. Their world is right there in sight, right at the ends of their noses. The child does not enjoy a tantrum anymore than the parents do.

When should children outgrow tantrums?
Getting along with people is one of the main things we learn in kindergarten. And fortunately, the majority of us pass kindergarten. So you wouldn't expect tantrums in a first grader. If a 6-year-old or 7-year-old is still having tantrums, and timeouts aren't working, something else may be going on. It's time to see a doctor.
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