Tantrums and challenging behaviour in children
Tantrums are a normal part of development, usually starting around 18 months and becoming far less common by age 4, because young children feel strong emotions before they have the words or self-control to manage them. In the moment, stay calm, keep the child safe and do not give in to the demand. Prevent them with routines, enough food and sleep, warnings before changes and plenty of praise for good behaviour. Physical punishment makes behaviour worse over time. Get help if tantrums are very frequent, long, violent or self-injuring, continue well past age 5, or come with speech, hearing or developmental concerns.
Health writers · Aslam Clinic
Tantrums are normal. Most children have them from about 18 months, they peak in the toddler years, and by the age of 4 they are far less common. They happen because a young child feels big emotions — frustration, anger, disappointment, tiredness — long before they have the words to explain them or the self-control to calm down. A tantrum is not a sign of a bad child or a bad parent.
What you do in the moment, and in the calm hours in between, shapes how quickly tantrums fade. The approaches below have good evidence behind them, and none of them involves shouting or hitting.
What is normal at each age
| Age | Usually normal | Worth discussing with a doctor |
|---|---|---|
| 1–2 years | Frequent short tantrums, crying, lying on the floor; hitting or biting when frustrated | No words at all by 18 months to 2 years, or not responding to their name |
| 3–4 years | Fewer tantrums; can be distracted or talked down; recovers within minutes | Several long tantrums every day; hurting others or themselves; cannot calm down without an adult |
| 5 years and over | Occasional meltdowns when very tired, hungry or overwhelmed | Regular tantrums like a toddler's; aggression at home and at school; the child seems unhappy most of the time |
Why tantrums happen
— the ability to notice a feeling and manage it — depends on parts of the brain such as the that take years to mature. A two-year-old simply does not yet have the equipment to wait, share or accept 'no' calmly. Tantrums are more likely when a child is:
- Tired, hungry or unwell
- Frustrated because they cannot do something or cannot make you understand
- Facing a sudden change — leaving the park, turning off the TV
- Jealous of a new baby or a cousin getting attention
- Seeking attention, especially if tantrums have worked before
- Overwhelmed by noise, crowds or a long wedding
What to do in the moment
- Stay calm. Your calm is the model. Shouting back makes the tantrum longer, not shorter.
- Keep everyone safe. Move the child away from danger, or move breakable things away from the child.
- Do not give in to the demand that started it. If screaming gets the biscuit, your child learns that screaming works.
- Use few words. 'I can see you are angry. You can have the biscuit after dinner.' Then stop talking.
- Wait it out. Stay nearby. Some children want to be held, especially if they are upset rather than angry; others need a little space.
- Ignore the audience. Relatives, neighbours or shoppers may comment. Your job is your child, not their opinion.
- Reconnect afterwards. A hug and a fresh start, without a lecture. Toddlers cannot learn from a speech after the event.
Preventing the next one
- Protect the basics. Regular meals and snacks, naps and early bedtimes prevent a large share of tantrums.
- Warn before transitions. 'Five more minutes in the park, then we go home.'
- Offer small choices. 'Red cup or blue cup?' gives a child some control without giving up yours.
- Praise specific good behaviour. 'You waited so nicely for your turn' teaches far more than 'good boy'.
- Give attention before it is demanded. Ten minutes of undivided play a day, following your child's lead, reduces attention-seeking behaviour.
- Keep rules few, clear and the same from everyone. In a joint family, children quickly learn which adult will say yes. Agree the main rules with grandparents and other carers.
- Use calm, predictable consequences — losing a toy for a short time, or a brief time-out in a safe place — rather than threats you will not carry out.
Parenting programmes that work
Structured parenting programmes based on social learning theory teach exactly these skills — play, praise, clear instructions, consistent consequences — through practice and feedback in a group of parents. NICE recommends group parent-training programmes for parents of children aged 3 to 11 whose behaviour is a serious problem. Well-known examples include Triple P and Incredible Years.
A Cochrane review found that group-based parenting programmes reduce children's behaviour problems and also improve parents' own mental health. A large meta-analysis of Triple P, covering more than 100 studies and 16,000 families, found moderate improvements in children's behaviour and in parenting — though it was written by the programme's developers. These programmes are not widely available in Pakistan yet, but some are offered online, and a child psychologist can teach the same principles.
Why smacking backfires
Many Pakistani parents were smacked as children and believe it did them no harm. The evidence is clear, however, that physical punishment does not improve behaviour and makes it worse over time.
- The World Health Organization states that corporal punishment harms children's physical and mental health, increases behaviour problems over time and has no positive outcomes.
- A 2016 meta-analysis covering more than 160,000 children found that ordinary smacking was linked to worse outcomes — more aggression, more mental health problems, poorer relationships with parents — and that the effects looked similar to those of physical abuse, only smaller.
- Physical punishment also risks escalating: parents who smack are at higher risk of more severe violence.
- The American Academy of Pediatrics adds that yelling at and shaming children is also ineffective in the long term.
Children learn from what we do. Hitting a child for hitting teaches that bigger people solve problems by hurting smaller ones. The alternatives above take more patience but actually work.
When behaviour needs an assessment
A US study comparing healthy pre-schoolers with those who had depression or behaviour disorders identified tantrum patterns that should prompt an assessment rather than more patience:
Sudden changes in behaviour in a previously settled child — new aggression, fearfulness, bedwetting, not wanting to go to a particular place or person — can be a sign of stress, bullying or abuse. Listen carefully. If you think a child is being harmed, contact the Child Protection & Welfare Bureau helpline on 1121, or the police on 15 in an emergency.
Assessment may look for hearing and speech problems, , , anxiety, sleep problems, or stress in the family. Your family doctor or a paediatrician is the place to start.
What you can do today
- Pick one daily routine that often goes wrong — bedtime, leaving for school — and make it predictable with the same steps every day.
- Spend ten minutes playing with your child, letting them lead, with no phone.
- Catch them being good at least five times today, and say exactly what you liked.
- Agree one or two house rules with every adult in the home.
- Decide in advance what you will do at the next tantrum, so you are not deciding while angry.
- Look after your own sleep and stress. Calm children need adults with something left in the tank.
Common questions
Still not sure what to do?
Reading about a symptom only goes so far. A doctor who can ask you questions and examine you will get further in ten minutes than any article can.
