Nolan Alexander (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids. Why does my child throw tantrums? If you're like me, you've asked yourself this question more than once. Today, Dr. Hilary Kimbley explains what's really happening when children have tantrums and how parents can respond in ways that help children build emotional regulation skills over time. Dr. Kimbley, thanks for joining us. How are you today?

Hillary Kimbley, PhD, ABPP: Good. Thank you. Thank you for having me. I often wonder too why kids have tantrums when my own is having it, even though I know about all these things.

Host: Yeah. So, is it normal for children to throw tantrums?

Hillary Kimbley, PhD, ABPP: It actually is normal. Tantrums are a normal part of childhood, especially in young children, typically between the ages of one to four. If you think about how children are developing during that period of their lives, young children are still learning to manage their big emotions, tolerate frustration, and communicate their needs and by having the words to communicate what they need or how they're feeling. And so, we typically tend to see a lot of tantrums, especially in early childhood.

Host: So, is that why my child throws tantrums?

Hillary Kimbley, PhD, ABPP: Yes. Part of the reasons why it's actually a normal part of development, definitely.

Host: I've sat there and I've tried to figure it out, but what do you think are some of the most common triggers for tantrums?

Hillary Kimbley, PhD, ABPP: There are some very common triggers for tantrums. And this is not an exhaustive list, but some of the most common triggers include things like hunger or tiredness. If you're over-tired or hungry, that can lower our emotional control or ability to regulate ourselves. And younger children if they feel frustrated for example, if they have difficulty doing something or they don't get what they want or even sometimes seeking more independence, they might have a tantrum.

As I mentioned, difficulty communicating their needs or just learning those skills during that developmental period, so if they don't have the words or the language yet to express their needs or feelings, they might have a tantrum. That tantrum might be communicating that they have a need or want or a big feeling. And in some kids, if they're overstimulated, they're around too much noise, too much activity if their routines have changed. Or even sometimes transitions, like if you ask them to stop a preferred activity or change environments, those things typically trigger tantrums as well.

Host: Yeah, I mean, that all makes sense to me. So, how should parents like myself respond in the moment when a tantrum happens?

Hillary Kimbley, PhD, ABPP: When parents are thinking about how to respond in the moment, it's important for them, in general, to remain calm, brief, and consistent in their approach. And really thinking about the biology or brain science behind the tantrum. Tantrums are typically happening, because the emotional side of the brain takes over the more logical side of the brain, or like the logical side meaning the ability for a child to listen or understand. I call it the thinking brain kind of goes offline or shuts off. Or maybe an easier way to understand it is, during a tantrum, the body's alarm system gets too loud and the calm system goes quiet. So, it's very important initially for parents to remain very calm, so they can get their child's alarm system to start turning off and their calm system to turn back on.

So, some practical steps to achieve that for parents are to, in general, to keep their tone low and calm and keeping their behavior calm as they approach their child. This is going to set the emotional temperature, to ensure safety during the tantrum. That might include removing objects or moving to a safe space. Using minimal words or lengthy explanations. Again, when that alarm is going off in the brain, it's less likely that a child will be reasonable or logical. Acknowledging how they feel, "I can see you're really frustrated or angry," and then letting them know "I'll be here to help you to calm down."

So, holding the boundary though, especially if they're upset about a limit, like saying no or having a transition, holding that boundary. And then, once they calm down, see if they need space or if they want you to comfort them, and then trying to reconnect and redirect them.

Once you see that they're calming down, their thinking brain is turning back on, briefly try to talk about what's happening what their choices might be in that moment, and then how you guys can redirect them to something else, like giving them a choice or an option or something like that.

Host: Those are really good points to make. And what are some common mistakes parents make during tantrums, things we want to avoid?

Hillary Kimbley, PhD, ABPP: Common mistakes, you know, parents may unintentionally argue, yell, or negotiate. Those are some of the common mistakes we see. Or expect a child, like I mentioned earlier, to be able to reason when they're already overwhelmed because the focus is typically on stopping the behavior rather than focusing on noticing what's going on and, really, that the child is having a hard time regulating their emotions in the moment.

So, they might, like I mentioned, give in to the demand. And if they give in to the demand, like they might teach a child that the tantrum works. If they react with anger, that could escalate the tantrum or make it worse or last longer, become more intense. Sometimes if there's a lot of overexplaining, like I mentioned, a child really can't process all that information coming in if they're in the middle of a tantrum.

And sometimes, unintentionally it could even, I would say punish or maybe diminish emotional expression. It's important to set limits on the behavior, like we don't yell or kick when we're angry, but it's okay to validate a child's emotion and say, you know, "It's okay to be angry and this is how we express it." So, we don't want to unintentionally punish their emotional expression.

Host: How can parents help prevent tantrums even before they start?

Hillary Kimbley, PhD, ABPP: In general, if we kind of think about the triggers starting with meeting the basic needs, so making sure your child did get adequate sleep and they're eating regular meals at regular times throughout the day. And then, trying to teach skills when your child is calm, such as like, "When you feel this way, this means like you're angry or you're sad. And if you're feeling angry or sad, these are ways to calm down." We can do some deep breathing or we can go seek help or support. Trying to stick to predictable routines is helpful. That helps to reduce some anxiety or big feelings and surprises. Making sure there's time for rest throughout the day.

Giving choices when you're able to, because that can help reduce power struggles and build some autonomy. And then, during transitions, giving warnings. For example, "five minutes before we have to stop this activity" helps kids to know what's coming and there's not an abrupt shift like in their task that they have to cope with.

And then, also, keeping expectations age-appropriate. Like I've mentioned, if we know that our child hasn't, didn't get good sleep that night or we know we've been to five stores that day, we could expect that there might be an increase in tantrums or they might be becoming tired and have difficulty regulating themselves.

Host: And when should parents talk to a behavioral health specialist or a healthcare provider about tantrums?

Hillary Kimbley, PhD, ABPP: It's best to consider seeking guidance from a behavioral health specialist when tantrums become very frequent or intense, meaning like there might be multiple tantrums during a day, like four to five a day, and then lasting more than five to 10 minutes. If the tantrum involves a lot of self-harm or aggression and they are seeming unsafe, if the tantrums, the amount or the intensity of the tantrums are interfering with a child's functioning at home or in a school or daycare or preschool setting. And then, if the tantrum is occurring way beyond that developmental period or age range that I mentioned earlier, like if you're seeing tantrums beyond close to five or beyond five, it might be worth seeking support from a behavioral specialist, health specialist, or initiating a conversation with your child's pediatrician.

Host: This has been so insightful today. Dr. Kimberly, anything else you want to add?

Hillary Kimbley, PhD, ABPP: I always like to tell parents, you know, we're going toget it wrong. Let's have realistic expectations for ourselves. Sometimes, especially if we're, like, out in public or we're not feeling too good ourselves, it is okay if you make mistakes and are responding to tantrums in unhelpful ways. Give yourself grace and just pause and reflect about on how you can respond differently next time. Think about what you did wrong. It's even okay to apologize to your child if you did react strongly. And then, tell your child and practice with yourself how you will correct it the next time. It's a good model for your child that it's okay to make mistakes. It's good to model your own feelings and your need to learn a new response to things, and that also helps them just to overall learn and develop good emotional regulation skills.

Host: That is great to know. Dr. Hilary Kimbley, thank you for joining us today.

Hillary Kimbley, PhD, ABPP: No problem. Thank you for having me.

Host: For more tips on managing tantrums and supporting your toddler's development, visit childrens.com/toddlertips. Thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share the episode, and please follow Children's Health on your social channels.