Is My Child's Anger Normal?

Most children have occasional tantrums or meltdowns. They may sometimes lash out if they’re frustrated or be defiant if asked to do something they don’t want to do. But when kids do these things repeatedly, or can’t control their tempers a lot of the time, it may be more than typical behavior.

Here are some signs that emotional outbursts should concern you:

• If your child’s tantrums and outbursts are occurring past the age in which they’re developmentally expected (up to about 7 or 8 years old)

• If their behavior is dangerous to themselves or others

• If their behavior is causing them serious trouble at school, with teachers reporting that they are out of control

• If their behavior is interfering with their ability to get along with other kids, so they’re excluded from play dates and birthday parties

• If their tantrums and defiance are causing a lot of conflict at home and disrupting family life

• If they’re upset because they feel they can’t control their anger, and that makes them feels bad about themselves

When children continue to have regular emotional outbursts, it’s usually a symptom of distress. The first step is understanding what’s triggering your child’s behavior. There are many possible underlying causes, including:

• ADHD: Many children with ADHD, especially those who experience impulsivity and hyperactivity, have trouble controlling their behavior. They may find it very hard to comply with instructions or switch from one activity to another, and that makes them appear defiant and angry. “More than 50 percent of kids with ADHD also exhibit defiance and emotional outbursts,” says Vasco Lopes, PsyD, a clinical psychologist. Their inability to focus and complete tasks can also lead to tantrums, arguing, and power struggles. That doesn’t necessarily mean they’ve been diagnosed with ADHD — in fact, ADHD is sometimes overlooked in kids who have a history of severe aggression because there are so many bigger issues.

• Anxiety: Children who seem angry and defiant often have severe, and unrecognized, anxiety. If your child has anxiety, especially if they’re hiding it, they may have a hard time coping with situations that cause them distress, and they may lash out when the demands at school, for instance, put pressure on them that they can’t handle. In an anxiety-inducing situation, your child’s “fight or flight” instinct may take hold — they may have a tantrum or refuse to do something to avoid the source of acute fear.

• Trauma or neglect: A lot of acting out in school is the result of trauma, neglect, or chaos at home. “Kids who are struggling, not feeling safe at home can act like terrorists at school, with fairly intimidating kinds of behavior,” says Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in a school setting. Most at risk, she says, are kids with ADHD who’ve also experienced trauma.

• Learning problems: When your child acts out repeatedly in school or during homework time, it’s possible that they have an undiagnosed learning disorder. Say they have a lot of trouble with math, and math problems make them very frustrated and irritable. Rather than ask for help, they may rip up an assignment or start something with another child to create a diversion from their real issues.

• Sensory processing issues: Some children have trouble processing the sensory information they are getting from the world around them. If your child is oversensitive, or undersensitive, to stimulation, things like “scratchy” clothes and too much light or noise can make them uncomfortable, anxious, distracted, or overwhelmed. That can lead to meltdowns for no reason that’s apparent to you or other caregivers.

• Autism: Children on the autism spectrum are also often prone to dramatic meltdowns. If your child is on the spectrum, they may tend to be rigid — needing consistent routine to feel safe — and any unexpected change can set them off. They may have sensory issues that cause them to be overwhelmed by stimulation, and short-circuit into a meltdown that continues until they get exhausted. And they may lack the language and communication skills to express what they want or need.

Medication won’t necessarily fix defiant behavior or aggression; it can reduce the symptoms of ADHD, anxiety, and other disorders and improve the conditions for working on those behaviors. Behavioral approaches that have parents and children working together to rein in problem behavior are key to helping the situation.

Find the triggers
The first step in managing anger is understanding what triggers set off a child’s outbursts. So, for instance, if getting out the door for school is a chronic issue for your child, solutions might include time warnings, laying out clothes and showering the night before, and waking up earlier. Some kids respond well to breaking tasks down into steps, and posting them on the wall.

Consistent parenting
When a child’s defiance and emotional outbursts occur, the parent or caregiver’s response affects the likelihood of the behavior happening again.

If a child’s behavior is out of control or causing major problems, it’s a good idea to try step-by-step parent training programs. These programs (like Parent-Child Interaction Therapy, or PCIT, and Parent Management Training) train you to positively reinforce behavior you want to encourage in your child, and give consistent consequences for behaviors you want to discourage. Most children respond well to a more structured relationship, with calm, consistent responses from parents that they can count on.

Here are some of the key elements taught in parent training:

• Don’t give in. Resist the temptation to end your child’s tantrum by giving them what they want when they explode. To give in only teaches them that tantrums work.

• Remain calm and consistent. You’re in a better place to teach and follow through with better, more consistent consequences when you’re in control of your own emotions. Harsh or angry responses tend to escalate a child’s aggression, be it verbal or physical. By staying calm, you’re also modeling — and teaching — your child the type of behavior you want to see in them.

• Ignore negative behavior and praise positive behavior. Ignore minor misbehavior, since even negative attention like reprimanding or telling the child to stop can reinforce their actions. Instead, lavish labeled praise on behaviors you want to encourage. (Don’t just say “good job,” say “good job calming down.”)

• Use consistent consequences. Your child needs to know what the consequences are for negative behaviors, such as time outs, as well as rewards for positive behaviors, like time on the iPad. And you need to show them that you follow through with these consequences every time.

• Wait to talk until the meltdown is over. One thing you don’t want to do is try to reason with a child who is upset. As Steven Dickstein, MD, a pediatrician and child and adolescent psychiatrist, puts it, “Don’t talk to the kid when they’re not available.” You want to encourage a child to practice at negotiation when they’re not blowing up, and you’re not either.

• Build a toolkit for calming down. Both you and your child need to build what Dr. Dickstein calls a toolkit for self-soothing, things you can do to calm down, like slow breathing, to relax, because you can’t be calm and angry at the same time. There are lots of techniques, he adds, but “The nice thing about breathing is it’s always available to you.”