 How have professionals advised parents to manage temper tantrums? What strategies have stood the test of time? The historical medical literature on tantrums – scant though it is – comprises one of the most consistent bodies of writing I’ve encountered thus far in my work for this blog. Parents, pediatricians, and other professionals who work with children have mostly been singing the same tune with regards to what causes tantrums and how parents can respond to them . . . with one major exception: corporal punishment. The overwhelming message is that tantrums are simply an unavoidable parental drudgery, almost a rite of passage to suffer through.
The pool of evidence here is disappointingly small; scientific medicine has barely weighed in on tantrums (although armchair psychiatrists in the first quarter of the twentieth century had some bizarre opinions). Professionals discussed tantrums in advice literature aimed toward parents, yet they rarely conversed about tantrums amongst themselves. I encountered virtually no discourse on tantrums within academic journals prior to the 1970s, and no real body of literature on tantrums existed before the 1990s. One comment in 1991 that there was “surprisingly little in the [medical] literature about temper tantrums” seems like a gross understatement.[1] (And, the handful of recent projects seeking to study tantrums are frustrating to navigate; in a 2003 analysis of 335 young children in Madison, Wisconsin, the authors converted parents’ “tantrum narratives” into impossible-to-comprehend charts they called “tantrugrams,” complete with “tantrum termination hazard plots.”(!)[2]) Pediatrics’ quietude on tantrums is not unexpected. The field is predominantly (at least in theory) devoted to the study and implementation of biomedical, evidence-based child care; it is concerned with parenting, of course, but only in so much as it demonstrably affects children’s lives. Since pediatrics is not about the scientific art of parenting, it would certainly be unfair to hold it accountable as such. “A Fairly Common Affliction”:[3] In Search of Tantrum Epidemiology We don’t need science to tell us that tantrums are ordinary, but it does. Sort of. Every source I found discussed how usual tantrums were; almost none provided numbers, yet common sense and practical observation substantiates the claim (at least in the U.S.). (Also relying heavily on common sense, I’ve opted not to define a tantrum here; we all know one.) Tantrums are virtually a universal parental challenge – a completely “natural” phenomenon.[4] Typically, they begin around 15-18 months of age, and continue until about 3 years. For many families, coping with tantrums is a daily chore. Outbursts typically last only 2 to 5 minutes, but a few minutes can feel like an eternity, and can exert far-reaching disruptive effects. Speaking of the effects of tantrums, one physician wrote in The Medical Journal of Australia in 1972 that “parents may find that they do not like their child, a regrettably frequent phenomenon.”[5] One of my favorite items I encountered in this research was a subheading in a 1957 text for parents entitled “Annoying Characteristics of the Developing Child.” (If this wasn’t amusing enough, the first sentence began: “Any parent could say a great deal about this subject….”)[6] Despite their ubiquity, however, tantrums have always held a certain association with deficient or inappropriate parenting (or parents).[7] This is no bygone idiosyncrasy – it persists in modern literature and cultural norms. Certain parenting styles, behaviors, or responses may “encourage” or “foster” tantrums, a 1991 piece in the American Family Physician explained.[8] Who hasn't felt judged with a bawling tyke? This is not very surprising. Indeed, many if not all the topics covered in this blog abut uncomfortable questions about whether parents play causative roles in conundrums ranging from behavioral developmental delays to nutritional deficiencies to sleep problems. Tantrums are no exception. So why do they happen? In short – for all kinds of reasons. Tantrums are the regrettable outcome of a perfect alignment of circumstances: 1) Kids are at the “right” developmental stage. Toddlers are walking, talking developmental milestones. They are acquiring new motor, communication, and mobility skills daily. They are becoming individuals. They have pursuits. Independent pursuits. Yet their autonomy, not to mention their logical reasoning and language capabilities, is still obviously and grossly limited.[9] A physician interviewed for the 1943 Better Homes & Gardens mothers’ handbook explained it this way: “your child has an indomitable urge to exercise his newly developing function[s].”[10] Tantrums are a titanic clash of a child’s budding independent spirit with its parents bidding. 2) There is often some background disturbance. Background contributors are endless: hunger, tiredness, overstimulation, exhaustion, being too cold or too hot, thirst, etc. 3) A child encounters an inciting trigger. Triggers can be literally anything. (If you’re in need of a good laugh, try this: google “kids crying for ridiculous reasons.” Some of these are truly hilarious. Here are some of my favorites.) To anyone who has spent even a brief amount of time with a young child, the notion that his “being thwarted” is a major trigger for tantrums and outbursts is as obvious as the sky is blue. This truism has been in place throughout the 20th century, and I think the language is just perfect: thwarted. Here is a representative description from the 1950s: “when a child is frustrated, prevented from doing what he wants to do, or made to do what he does not want to do, he goes into an unthinking rage.”[11] How to Manage a Tantrum? Trick Question. Don’t. As I mentioned, up through the mid-1900s, American society was accepting of various forms of physical punishment. Cultivating deep faith in measured discipline, psychological experts touted the significance of maternal distance, authority, and scheduling in child-rearing. Corporal punishment and spanking were commonplace, but some writers espoused alternative methods. In her 1925 advice book, Training the Toddler, Elizabeth Cleveland explained that for seemingly endless violent tantrums, parents might find the use of cold water effective – administered through a bath or shower or by “a dash of cold water in the face.” “This should be done in a common sense way,” Cleveland advised, “with no effect of violence, as a curative treatment rather than punishment.”[12] In the 1950s, the arrival of Dr. Spock symbolized a turning of the tides. He famously told parents to “trust themselves.” Some professionals started to admonish physical discipline as “harmful.”[13] Punishment came under fire, but continued to appear in the literature as a possible last resort for parents. One 1957 book advised that “smacking should usually be avoided” – (usually!) – admitting that “sometimes smacking may help in the early stage of a tantrum.”[14] A 1962 text similarly explained that “a sharp decisive spank to indicate that the parent means business can be very effective.”[15] Spock’s own evolution mirrored the decades-long shift. In 1945, he wrote that he was not “particularly advocating spanking,” but saw it as “less poisonous than lengthy disapproval….” By 1985, he “deplored” it.[16] Sadly, corporal punishment still exists – I have neither the inclination nor the space to discuss this much here, but its prevalence has continued to motivate pediatric literature to denounce it.[17] Best Practices If we turn a blind eye to the topic of corporal punishment, the rest of professionals’ suggestions on handling tantrums are very stable over time. I’ve distilled things into an overarching credo and several bullet points for tantrum management. They will likely be familiar. The Credo: “Stay Calm and Carry On” This speaks for itself, and parents everywhere are likely trying to stay calm. I am, at least. Like it or not, professionals have been advising parents in the storm’s eye of a tantrum to practice calmness and patience for over a hundred years. In the 1950s and today, “the more casual the parent the easier it is to manage the tantrum.”[18] Strategies 1 – 3: “the essence of treatment lies in prevention”[19] Pediatricians point to prevention as a parent’s best defense against a tantrum. This too seems obvious, but it is such a striking a point of agreement across professions and over time that it’s worth conveying. In 1925, Elizabeth Cleveland summarized that “if thwarting a child’s purposes stirs him to anger, the thing to attack is not the anger, but the purposes.”[20] A 1980 advice book explained: “there is a vast difference between keeping a child from an object and seizing the object from him once he has it.”[21] So true. Some authors offer various tricks to help prevent meltdowns: childproof thoroughly, remove tempting or dangerous items from children’s purview, employ diversion and distraction to change a child’s course (“children are tremendously suggestible,” Better Homes & Gardens noted in 1943);[22] and minimize background causation to the extent you are able.[23] One writer in 1980 recommended that parents try being “clever and resourceful” to get their child to do what he needed to. If such attempts failed, he wrote, the parent should “be more skillful next time.”[24] Strategies 4 – 6: “the parent has to be victorious”[25] Again, advisors across disciplines and decades warn parents not, under any circumstances, to succumb to children’s desires. If the child “wins,” this is likely to set a pattern, and, as one physician quipped in 1943, the child will be “as unhappy as the folks around him, for no child of 18 to 27 months possesses the judgment to run his own life.”[26] Ten years later, one parents’ guide explained that a child “must know that he does not get his way with tantrums. That is the absolute rule the parent must follow.”[27] Strategy 7: “Isolate and Ignore”[28] If strategies 1-3 (prevent!) failed, then the best way to succeed in strategies 4-6 (don’t give in!) is to not react at all to a child’s outburst. “The best way to treat a tantrum is to ignore it,” wrote an insistent author in 1957. “A display of indifference is a much more severe and effective punishment than any disciplinary method.”[29] For greatest efficacy, non-reaction should be complete, and isolating a child can help: “tantrums require an audience,” wrote Elizabeth Cleveland in 1925, “and few children will indulge in one there is no one to see.”[30] Modern physicians uphold these directives. In 1991, a piece in the journal American Family Physician read: “temper tantrums are best handled by ignoring the outburst.”[31] In 2009, the American Academy of Pediatrics suggested that parents “let the tantrum end itself.”[32] Most of their advice is grounded in experiential knowledge, but the very few studies that have sought to measure and assess tantrums in any way indicate that ignoring tantrums probably is the best way to go, showing that intervening upon a tantrum has a small correlation with its length.[33] As one piece described, “the more consternation the outburst provokes on the part of the parents, the longer it tends to continue.” (Those reports also indicate that children who tend to get their way from tantrums throw about twice as many tantrums.)[34] And there you have it. Be calm, prevent, don’t give in, and then wait it out. Toddlers have successfully stumped generations of parents and physicians. I keep thinking of one of my family’s favorite children’s books right now, about a family who encounters myriad obstacles in search of a bear. As the family meets each stumbling block, they all sing out: we can’t go over it, we can’t go under it, we’ve got to go through it! And so it is with tantrums. *Addendum: Tips and Tricks for Surviving Tantrums
_______________________________________________________________________________________ [1] A. K. Leung and J. E. Fagan, “Temper Tantrums,” American Family Physician 44, no. 2 (August 1991): 559. [2] Michael Potegal, Michael R. Kosorok, and Richard J. Davidson, “Temper Tantrums in Young Children: 2. Tantrum Duration and Temporal Organization,” Journal of Developmental and Behavioral Pediatrics: JDBP 24, no. 3 (June 2003): 148, 149. [3] Elizabeth Cleveland, Training the Toddler (Philadelphia: J.B. Lippincott Company, 1925), 87. [4] Joseph D. Teicher, Your Child and His Problems: A Basic Guide for Parents (Boston: Little, Brown and Company, 1953), 133. [5] D. L. Gurry, “Temper Tantrums,” The Medical Journal of Australia 2, no. 17 (October 21, 1972): 949. [6] Ronald S. Illingworth, The Normal Child: Some Problems of the First Five Years and Their Treatment (Boston: Little, Brown and Company, 1957), 233. [7] See, for example: Teicher, Your Child and His Problems: A Basic Guide for Parents, 144. [8] Leung and Fagan, “Temper Tantrums,” 560. [9] Ibid., 559. [10] The Better Homes & Gardens Child Care and Training Department, Better Homes & Gardens: A Handbook for Mothers, from Prenatal Care to the Child’s Sixth Year (Des Moines, Iowa: Meredith Publishing Company, 1943), 139. [11] Teicher, Your Child and His Problems: A Basic Guide for Parents, 133. [12] Cleveland, Training the Toddler, 90. [13] Teicher, Your Child and His Problems: A Basic Guide for Parents, 143–44. [14] Illingworth, The Normal Child: Some Problems of the First Five Years and Their Treatment, 297. [15] Gordon D. Jensen, The Well Child’s Problems: Management in the First Six Years (Chicago: Year Book Medical Publishers, 1962), 62. [16] “PARENTS AND EXPERTS SPLIT ON SPANKING,” The New York Times, June 19, 1985, sec. Home & Garden, http://www.nytimes.com/1985/06/19/garden/parents-and-experts-split-on-spanking.html. [17] L. S. Wissow and D. Roter, “Toward Effective Discussion of Discipline and Corporal Punishment during Primary Care Visits: Findings from Studies of Doctor-Patient Interaction,” Pediatrics 94, no. 4 Pt 2 (October 1994): 587. [18] Teicher, Your Child and His Problems: A Basic Guide for Parents, 144. [19] Illingworth, The Normal Child: Some Problems of the First Five Years and Their Treatment, 296–97. [20] Cleveland, Training the Toddler, 91. [21] Garry Cleveland Myers, The Modern Parent: A Practical Guide to Everyday Problems (New York: Greenberg Publisher, 1980), 174. [22] The Better Homes & Gardens Child Care and Training Department, Better Homes & Gardens: A Handbook for Mothers, from Prenatal Care to the Child’s Sixth Year, 140. [23] William E. Blatz and Helen Bott, The Management of Young Children (New York: William Morrow & Company, 1930), 72; Teicher, Your Child and His Problems: A Basic Guide for Parents, quote from 144. [24] Myers, The Modern Parent: A Practical Guide to Everyday Problems, 178–79. [25] Blatz and Bott, The Management of Young Children, 48. [26] The Better Homes & Gardens Child Care and Training Department, Better Homes & Gardens: A Handbook for Mothers, from Prenatal Care to the Child’s Sixth Year, 140. [27] Teicher, Your Child and His Problems: A Basic Guide for Parents, 143–44. [28] Leung and Fagan, “Temper Tantrums,” 561. [29] Illingworth, The Normal Child: Some Problems of the First Five Years and Their Treatment, 297. [30] Cleveland, Training the Toddler, 90. [31] Leung and Fagan, “Temper Tantrums,” 559. [32] American Academy of Pediatrics, “Temper Tantrums: A Normal Part of Growing Up,” 2009. [33] Michael Potegal and Richard J. Davidson, “Temper Tantrums in Young Children: 1. Behavioral Composition,” Journal of Developmental and Behavioral Pediatrics: JDBP 24, no. 3 (June 2003): 145. [34] Leung and Fagan, “Temper Tantrums,” 561, 560. [35] Illingworth, The Normal Child: Some Problems of the First Five Years and Their Treatment, 298.
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