Ask An Expert / Behavior Problems

My son is 2 years old and has such severe outbursts and tantrums that it scares us. What do we do?

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The key to helping is figuring out the cause of the tantrums. Luckily, the earlier the intervention the better.

Natalie Weder, MD
Natalie Weder, MD

Child and Adolescent Psychiatrist

Child Mind Institute

My son is 2 years old, and my husband and I are in desperate need of help and direction for him. He has such severe outbursts and tantrums that it scares us and we are afraid he is going to cause himself harm as well as us. It started off when he was frustrated he would head bang. We thought when he could communicate it would decrease. He can speak above avg for his age. I also practice daily emotions via iPad app. Now, however, we are not sure when it will occur. He can be having a great time, then a switch goes off and he has bashed both of us with his head, hands, feet, etc. or he will hit his head hard! We have tried distracting, reinforcing positive behavior, ignoring negative behavior but it still doesn't help. What do we do? Where should we go? I know that this is more then just terrible twos.

Although tantrums can be quite common among 2-year-olds, they usually aren’t that severe. If you are noticing that your son’s tantrums are happening very frequently and also that they are severe and impairing — and it sounds like they are — then they warrant an intervention. Getting your son a thorough evaluation that determines what is causing his tantrums is the best place to start. You need to do this because tantrums can be caused by a range of things, including ADHD, anxiety, and developmental delays, and figuring out what is at the root of his behavior is necessary to understanding how to treat it. Try to find a professional who has experience evaluating children, ideally a child psychologist or child psychiatrist. Pediatricians can also be a good place to start because they can rule out any medical causes and then refer you to a specialist. Fortunately, there are some very good treatments to help children with behavior issues. Parent-child interaction therapy (PCIT) has been shown to be very beneficial for children between the ages of two and seven. PCIT helps to restructure how parents and children interact with each other, reducing problematic behaviors like tantrums and improving the overall parent-child relationship. Finally, I just want to say that it is good that you are starting to look for help now. Treating behavior issues is easier with younger children, and often results in better outcomes.