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Temper
Tantrums
By: Dr. V. K. Pathak
MD (Ayu. Pediatrics)
Introduction
1. Episodes of unpleasant,
undesirable, disruptive behavior.
2. 18 months and 4 years.
3. Atypical tantrums can be a
presenting feature of behavioral
and developmental disorders,
e.g., autism.
Epidemiology
• Occurs maximum in toddlers and
decreases as age increases.
• Only 10% of 4–5 year old have temper
tantrums as compared to 85–90% of
18–36 month old.
• Children with speech delay, behavioral
disorders and developmental disorders
have more frequent and aggressive
tantrums.
Etiology
• Occur as a response to unfulfilled
demands, frustration, anger or
attention seeking behavior.
• Physiological triggers are hunger,
illness, fatigue, fear or overstimulating
environment.
Clinical Features
• Episodes of crying, screaming, going limp,
flailing, hitting, throwing items, pushing,
or biting.
• Sometimes may lead to breath-holding
spells.
• Usually occur once a day, lasting for
approximately 1–3 minutes.
• In atypical/severe cases: It may occur >5
times/ day and/or lasts for >15 minutes.
Examination
• Physical examination is normal in
most of the cases,
• Vision and hearing impairment
should always be ruled out
• Neurodevelopmental disorders, e.g.,
autism should be ruled out
Laboratory tests
• No tests are required in most
cases.
• Iron deficiency anemia and
lead toxicity may aggravate
tantrums and breath holding
spells.
Management
Nonpharmacological
The acronym RIDD can help parents and
caregivers handle a typical tantrum
• Remain calm, state firmly in neutral tone
• Ignore the tantrum
• Distract the child.
• Do not give unnecessary physical
punishments which can increase
undesirable behavior.
Pharmacological
• Iron supplementation may be helpful
in cases of breath holding spells with
anemia
• Low dose antipsychotic agents.
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Temper Tantrums

  • 1. Temper Tantrums By: Dr. V. K. Pathak MD (Ayu. Pediatrics)
  • 2. Introduction 1. Episodes of unpleasant, undesirable, disruptive behavior. 2. 18 months and 4 years. 3. Atypical tantrums can be a presenting feature of behavioral and developmental disorders, e.g., autism.
  • 3. Epidemiology • Occurs maximum in toddlers and decreases as age increases. • Only 10% of 4–5 year old have temper tantrums as compared to 85–90% of 18–36 month old. • Children with speech delay, behavioral disorders and developmental disorders have more frequent and aggressive tantrums.
  • 4. Etiology • Occur as a response to unfulfilled demands, frustration, anger or attention seeking behavior. • Physiological triggers are hunger, illness, fatigue, fear or overstimulating environment.
  • 5. Clinical Features • Episodes of crying, screaming, going limp, flailing, hitting, throwing items, pushing, or biting. • Sometimes may lead to breath-holding spells. • Usually occur once a day, lasting for approximately 1–3 minutes. • In atypical/severe cases: It may occur >5 times/ day and/or lasts for >15 minutes.
  • 6. Examination • Physical examination is normal in most of the cases, • Vision and hearing impairment should always be ruled out • Neurodevelopmental disorders, e.g., autism should be ruled out
  • 7. Laboratory tests • No tests are required in most cases. • Iron deficiency anemia and lead toxicity may aggravate tantrums and breath holding spells.
  • 8. Management Nonpharmacological The acronym RIDD can help parents and caregivers handle a typical tantrum • Remain calm, state firmly in neutral tone • Ignore the tantrum • Distract the child. • Do not give unnecessary physical punishments which can increase undesirable behavior.
  • 9. Pharmacological • Iron supplementation may be helpful in cases of breath holding spells with anemia • Low dose antipsychotic agents.