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What can we do about a 6-year-old who throws serious, increasingly violent tantrums—but not when other adults are around?
Clinical Expert: Samantha P. Miller, PhD
en EspañolQ I have a girl who will be 6 next month. She is very smart, funny, likes to talk a lot, seems well-adjusted at school and in other social situations, but at home, with my husband and I and with her grandparents, she throws tantrums that last for as long as 6 hours. It can be because she doesn't want to go to bed, because her sister is playing with a toy that she feels is hers. Sometimes she cannot or will not even tell us what has upset her. In the past year her tantrums have become more violent with her hitting people, throwing things and hitting the walls. We took her to a psychologist and of course she was on her best behavior; he felt it was a stage she would outgrow, and we're being over-sensitive. What can we do?
It sounds like your daughter’s tantrums, even if they don’t interfere with her performance at school, are clearly interfering with your family life, and you have good reason to want to do something about them.
Disruptive behavior is often linked to patterns of interaction between parents and children. For example, a mom might try to set a limit with a child, and then, if her child refuses to accept the limit, she might raise her voice or strain to repeat herself. At this point the child might go from refusing to comply with the request to crying or throwing a tantrum. This might continue until the child’s outburst is either so loud or has gone on for so long that the mom gives up and withdraws the limit.
When a child has that experience—that limits are withdrawn when she defies, protests, or throws a tantrum—she learns that having an outburst gets adults to back off. Or, on the other hand, the mom might get so frustrated that she just yells until her child obeys the rules. That’s also a problem because it reinforces that a child needn’t pay attention until an adult is yelling, or being very harsh.
This kind of frustrating and emotional interaction isn’t good for either kids or parents. The good news is there is excellent behavioral therapy that has been very successful in reducing disruptive behavior by reshaping the way the parents and child interact.
Parent-Child Interaction Therapy (PCIT) is an innovative treatment for children whose problematic behaviors—defiance, inability to follow directions, aggression—fall outside the range of what’s typical for their age. These kids may be very high functioning in other ways, but their behavior is out of control.
In PCIT, parents and the child meet in a structured setting, supervised by a trained psychologist who directs their interaction. Parents learn specific skills to respond more positively to behavior they want to encourage, and specific disciplinary techniques to respond to undesired behaviors. A consistent set of instructions and responses, over a number of sessions, gives both parents and child a clear sense of what to expect, and has been shown to dramatically reduce problematic behavior.
