Are My Child’s Tantrums Normal? - Learn from a Hopebridge BCBA

Discussion on the Signs of Atypical Tantrums as they Relate to Autism

We’ve all been there. Trying to cook dinner next to an overtired child flailing on the floor after she skipped a nap. Attempting to console a crying toddler because his “Paw Patrol” figurine does not fit perfectly inside his toy truck. Piecing a sandwich back together because your child wants this exact slice of bread, but it better not be cut in half. 

One of the toughest parts of parenting is navigating tantrums. Sometimes the reasons would be comical if they were not so mentally and emotionally draining, but it’s important to remember that they are just as frustrating and upsetting for our kids. In many cases, it is all part of typical toddler behavior … but how do you know if the tantrums are a sign of autism or other disorder?

To guide us through the subject, we turned to our Hopebridge Board Certified Behavior Analysts (BCBA). Working with children with autism spectrum disorder (ASD) in our Hopebridge therapy centers, our BCBAs can provide more context around tantrums and recommendations for families to help children cope with their frustrations.

Find Answers: ‘Are my kid’s tantrums typical for someone their age?’

In general, temper tantrums are not a cause for concern. Every child tantrums. Severe tantrums can cause caregivers to question their parenting techniques, but should not, as they may be a sign of behavioral challenges or disorders, such as autism. 

The answers are not clear-cut, but caregivers can monitor duration, frequency, triggers and the level of aggression to learn more. Here are a few guidelines parents can use to distinguish between regular outbursts and those that may warrant more serious interventions.

Signs of Typical Tantrums:

• Experienced by children 1 year to 4 years of age; may be more intense around age 2.
• Usually last around 15 minutes.
• Recovery is quick and the child will continue to go about his or her day.
• Occur approximately two to five times per day.
• Reasons tend to center around the child not getting what he or she wants (such as an item, activity, etc.) or experiencing pain.
• The child is able to communicate what they want in a developmentally age-appropriate manner.
• Can include screaming, crying, dropping, kicking and maybe one maladaptive behavior (such as hitting), but not all.

Signs of Atypical Tantrums:

• No age limit and tantrums may continue after the child is 4 years old.
• Duration is longer. There is seemingly no time limit and meltdowns may occur for anywhere from 15 minutes to two hours; they can sometimes last all day.
• Self-calming does not usually work for recovery. 
• Occur 10 or more times a day, more than once within a 30-day period.
• May seem random and can stem from overstimulation; may happen when no other person is around (automatically maintained), or the child seems to ignore surroundings and safety.
• Can include severe maladaptive behaviors, including: self-injurious behavior such as head-banging, hair-pulling, self-biting or hand-to-head movements; aggression such as hitting, kicking or throwing objects; and elopement behaviors such as running away and running into the street. Watch for broken skin and bruises during aggression, either on themselves or others.

While they may seem counterproductive, tantrums are a form of communication. Children use them as a way to say, “I want,” “I don’t want to,” and “I’m in pain,” especially when they have a difficult time understanding or verbalizing their feelings. This is why we tend to witness more of these meltdowns from children with autism who have a more difficult time expressing what they are trying to communicate like their neurotypical peers.

5 Recommendations to Help Parents Prevent and Reduce Tantrums

Evidence-based interventions like applied behavior analysis (ABA therapy) can be beneficial in reducing the severity or number of tantrums and other “problem behaviors” for children on the spectrum. While this type of therapy is limited to those diagnosed with autism, ABA strategies can also be effective for neurotypical children (and even adults). Here are five tips based on ABA principles that caregivers can use to help their kids cope and lessen the number of tantrums.

1. Determine tantrum triggers.
   Like all behaviors, tantrums serve four key functions for children. These functions include escape, access to tangibles, access to attention and sensory stimulation. Identifying the reason behind the behavior – in this case, the tantrum – can help alleviate the current challenge, as well as proactively reduce the behavior in the future. Common triggers include transitions, food selectivity, interruption of a preferred activity, demands from others, and difficult or disliked situations, such as toilet-training.
   
2. Use preventative strategies.
   Antecedent strategies can be implemented to reduce the occurrence of maladaptive behaviors. First-then boards (example: first brush teeth, then play with dinosaurs), visual schedules and timers are beneficial support tools. These resources can provide structure and help children manage expectations and transitions, which can ease frustrations that might lead to a meltdown. In ABA, therapists sometimes use the “forced-choice” method with children who have a tough time hearing they can’t have what they want. Instead of an outright, “no,” it provides redirection and gives the child more independence by allowing them to select from two acceptable choices.
3. Minimize the situation.
   One of the most challenging parts of controlling tantrums is learning how to respond to them without rewarding negative behavior. For example, if the child is seeking attention by screaming and the parent quickly runs to put a stop to it, the child gets the desired attention, even if not an entirely positive experience. The best way to respond is often dependent upon the trigger, which is why determining the motive is the first step. Though it is easier said than done, caregivers also should do their best not to “give in” to the child’s wants during a tantrum, which can reinforce the behavior. Instead, empathize with their feelings and support your child, while also helping them become more comfortable with boundaries. Once you decide on a plan, it is important to follow through to ensure consistency rather than conflicting messages.
4. Keep your child safe during meltdowns.
   Tantrums can be scary, especially if the child is prone to hurt oneself or others. Caregivers need to do what they can to keep the child and others safe. Manipulate the environment to minimize danger, even before there is an occurrence. This includes installing a safe lock for doors to the outside, moving dangerous objects and locking up objects that may pose a larger threat. In the moment, caregivers can use a pillow or another soft item to block a child from head-banging and or other self-injurious behaviors, if need be. If possible, parents should move the child to a safer space; for instance, away from other children and away from hazardous items like a fireplace, stove or pool.
5. Know when to seek professional help.
   As a reminder, tantrums are “normal,” but excessive outbursts can be a sign or symptom of autism or another behavioral disorder. Some of the red flags parents should note include: tantrums that last longer than 25 minutes at a time; tantrums that occur more than 10 times a day, more than once a month; lack of self-calming techniques to end the tantrum; engagement in unsafe behaviors; and a child unaware of their surroundings. If two or more of these instances sound familiar, we recommend seeking professional help.

Learn More About How Hopebridge Can Help With Challenging Behaviors

Where is a family to start when seeking more information or interventions? We recommend speaking with a pediatrician about concerns. In cases like these, the physician can offer a referral for autism testing or assessments for other disorders.

If the diagnosis is autism, ABA therapy is an excellent tool to not only reduce tantrums, but to replace them with more effective behaviors and communication skills.

Hopebridge can help with all of these steps. If you can’t wait to learn more about your child’s behaviors and whether they may be signs of autism, please fill out our easy online form to schedule a diagnostic or ABA evaluation.

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