Ask An Expert / Behavior Problems

My 7-year-old granddaughter’s aggression is getting worse. What does it mean? And what can we do?

There are many causes, but aggressive kids respond well to behavioral therapy.

Harold S. Koplewicz, MD
Harold S. Koplewicz, MD

President

Child Mind Institute

My 7-year-old granddaughter's aggression is getting worse. Yesterday she bit my grandson. I have seen her attack her parents and hit both of them when she is upset. They are trying all kinds of coping skills with her. They do not believe in physical punishment, so she has never been hit. She is at the top of her class in school and is a great child, but when things aren't going her way, whammo, she explodes. We have noticed sugar and sleep play a little part in all this. Any other suggestions for us?

Aggression in young children can be triggered by so many different things it can be hard to figure out what’s driving it. But that’s the first step in coming up with a strategy to manage it.

Sometimes it’s an expression of a mood problem — depression (rare) and mania (very rare) can both appear as extreme irritability in children. Anxiety can also cause kids to lash out when they can’t verbalize effectively the powerful fears they’re experiencing.

Impulsivity can look like aggression, when it’s actually just kids not considering the consequences of their actions, their impact on other people. Sensory processing issues can cause a child to have violent tantrums, as a panic reaction to a severe overload of stimuli.

So you might want to get professional help to see if there is an underlying cause triggering this behavior. But it’s also quite possible that these aggressive outbursts are a result, at least in part, of a dynamic in the family.

Tantrums and disruptive acting out can often be addressed very effectively by the behavioral therapy called Parent-Child Interaction Therapy or PCIT. The goal of PCIT is to reset the relationship so that parents express a consistent pattern of positive reinforcement for desirable behavior and predictable consequences for undesired behaviors. In PCIT parents and children play together and then perform tasks while parents receive real-time direction via an earpiece—when to praise, actively ignore, or intervene in response to specific behaviors.

PCIT can dramatically reduce tantrums and disruptive behavior by boosting the child’s ability to rein in his behavior, and give parents much more effective tools for managing children who tend to be aggressive.