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Handling disruptive behavior

February 1, 2012
By Dr. Joseph Castel

Misbehaving children have plagued parents for all time.

Most behaviors that children exhibit are normal. It is a result of learned behavior, attention seeking behavior or mimicking other children. Parents often question whether these behaviors are normal or problematic and need intervention.

Temper tantrums are a normal part of emotional development. They usually start around 2 years of age and begin decreasing after 4 years of age.

Children, just like adults, become frustrated with environmental stresses including fatigue, hunger, overstimulation and inability to communicate emotions. The child's frustration turns to anger, and a meltdown ensues. These emotional outbursts are uncontrolled, but they may develop into a life of their own depending on how the parent responds to the episode.

Steps to avoid temper tantrums include: establishing good routines; setting bedtime, morning routines and meal times; and maintaining limits on play and TV viewing.

Make an effort to find, reward and encourage appropriate behavior.

Limit your children's choices to avoid overwhelming them. For example, allow them to choose between two outfits to wear. Do not ask them, "What do you want to wear today?"

Identify problem areas, such as the toy section in the grocery store, and avoid that area. Never reward the inappropriate behavior by giving in to the child's demands.

Allowing a temper tantrum to obtain a desired item or activity is teaching the child to perform that behavior when they want something. The behavior should never be addressed with aggressive responses either - no scolding, yelling or spanking. These responses escalate the turmoil and decrease the parent's authority role. The parent must remain the adult and stay calm.

A parent needs to seek help for temper tantrums that do not respond to standard behavior management such as time out or redirection, or if the child is hurting himself or others, shows low self-esteem, has excessive separation anxiety or if the parent has questions about the behavior.

If, despite the use of interventions, the tantrums are increasing in frequency, intensity or duration, or develop shortly after 12 months of age or last past 4 years of age, the family should contact a professional to evaluate the child's emotional status. Also evaluate a child if speech is delayed, or if the child is exhibiting signs of hearing loss or abnormal social activities with other children.

"Abnormal" behavior in children can be normal. Determining when to seek help for a child's behavior can be a difficult decision. All children need boundaries and schedules. Parents need to seek help when the defiance produces significant family or social discord.

Your pediatrician will be able to help with an evaluation or provide referral information or resources that can be beneficial.

Dr. Joseph Castel is the director of Nason

Pediatrics and started here in 1997. He is board certified with the American Academy of Pediatrics. He lives in Hollidaysburg.



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