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Caring for the High Maintenance Child
By Kate Andersen.

Coping with High Maintenance Traits. March, 2018.
Dear Kate:
Derek, is now two and has always been a "crybaby". As an infant, he would not nap unless someone held him......
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Coping with High Maintenance Traits: Shifting to a Positive Focus
BEHAVIOR - Temper Tantrums.

Tantrums are common in young children. This is why doctors and others often just tell parents not to worry: "That's normal." But this comment is very frustrating to parents who want to know what to do about tantrums. Tantrums can greatly distress parents. Children who have temperament-related tantrums often have prolonged and intense outbursts that appear quite out-of-the-ordinary and even frightening. In recognition of this fact, in his book called The Difficult Child, Dr. Stanley Turecki made a distinction between 'temperamental' and 'manipulative' tantrums. It's an important, but difficult, distinction.

I prefer to use the term 'natural' for temperamental tantrums. This fits with the term as used in the GET IN GEAR Response. And, rather than use the term 'manipulative', which is all too often part of an unhealthy mind set about children, I prefer to use the term 'learned'. This fits also fits in with the GET IN GEAR Response. If the child has a 'learned' tantrum, then we need to help the child 'unlearn' it and perhaps to teach the child some other ways to express his or her needs. In seeing tantrums divided into 'natural' and 'learned' in this way, you can see why the distinction is somewhat arbitrary and there can be much overlap between one type of tantrum than the other. After all, it is quite natural for children to learn undesirable behaviors.

Tantrums often begin in the second year of life as the toddler becomes more goal-oriented, only to find that his or her goals are frequently blocked by parents' or siblings' interference or simply by the resistance of physical objects. Toddlers are also prone to tantrum because they have little ability to regulate their emotions. They are also battling some paradoxes. While they are working at developing autonomy and independence, at the same time they are very dependent on adults and needy of adult attention. Also, toddlers usually understand a lot more than they can express and this can cause intense frustration. Their conflicting feelings combined with a poor ability to regulate emotions make them volatile indeed.

Any Young Child May Have A Tantrum Physical factors often play a role in the tantrums of very young children, too. Many are going through the stage of giving up their morning nap in favor of one nap a day or giving up the single nap and staying up all day. Food jags are common at this age and toddlers going through a phase of refusing foods may be truly hungry at times. Hot summer nights and sleeplessness often combine with a heat-depressed appetite to produce children (and adults) who are 'on edge'. All of these factors make children of this age very vulnerable to falling-apart-at-the-seams and having tantrums:

Maureen was a family physician with a two-year-old son, Sam, and a three-week old baby daughter, Serena. One summer day during a heat wave, she wearily dropped Sam off to a play group as he was just finishing off an ice-cream cone. "That's his breakfast," she told the provider, sighing. The provider raised her eyebrows and Maureen snapped: "It may not be a perfect meal but it's better than bringing him here on an empty stomach. On the days that I have done that, when I pick him up he falls apart at the seams the minute he gets in the car. The tantrum can last for an hour."

Sam was a child with an 'easy' temperament. The heat wave affected his appetite and his resulting hunger, combined with his mother's tension and the stress of dealing with a new baby sister, made him quite fragile by the end of a busy morning. In spite of the fact that tantrums are common in the toddler age group, some youngsters are more likely to have tantrums than others. Young children are much more influenced by family arguments and family stress than many parents realize and may reflect their distress by being tantrum-prone. In addition to these common factors, temperament can be a key factor in tantrums. And, as toddlers grow into the preschool years, temperament-environment stress is a strong predictor of whether they will continue to have tantrums even into middle childhood.

Not Accommodating to Temperament is a Common Tantrum Trigger

There is not necessarily a specific temperament trait or type that is associated with tantrums although the style of the tantrum will likely reflect the child's specific temperament profile. When any child is forced to go against his or her own temperament, a tantrum is a common reaction, particularly when a poor fit is ongoing and the child is feeling chronically stressed. As we mentioned earlier, illness, hunger and fatigue can exacerbate tantrum-proneness. When any combination of these factors leads to a tantrum, the tantrum truly is a 'natural' one; the child is genuinely distressed and out-of-control. The child may thrash, scream, hold his or her breath, bang his or her head, kick and throw things. Children can be frightened by their own tantrums and parents and other observers may note that the child is flushed, sweating, and otherwise showing signs of physiological over-arousal. For this reason, parents and others who understand development and temperament do not rush hastily to the conclusion that a child displaying this type of tantrum is 'spoiled' or 'manipulative'. These youngsters need empathy. Parents can become very alarmed by these natural tantrums because of their intensity and length and because they cannot 'reach' the child to calm him or her with words or offer a distracting treat. Even a candy bar may be flung across the room.

Holding Helps With Some Children

Some children are best left alone while the tantrums 'blows out'. Indeed, parents' pleadings often refuel the child, causing an intensification. Some children can be held while the tantrum slowly subsides. Holding should be strong enough to calm the child; not so forceful as to cause injury.

Some Children Are Best Left Alone

A more difficult question is whether the child should be confined in a crib or a bedroom while in this state. Most children are quite safe in their cribs or in their rooms, so that is not a genuine concern, even if the child is thrashing. What is a better deciding factor is, if not in the crib or in the bedroom, what will go on around the child while he or she has a tantrum? If parents or siblings become upset, start to consider punishment or to resort to pleading with the child, complications can arise. So sometimes the crib or the bedroom, rather than being places of rejection or punishment, are the safest and wisest solution. Parents may feel more comfortable exercising this choice if they have installed an 'eye' in the door and can watch and see that their child is coming to no harm. Several experts say that it is acceptable to use confinement in the crib or bedroom even if these methods are also used as penalties for real misbehavior. They state that there is no evidence that children develop a fear of their rooms or cribs as a result.

Don't Let Children Earn Rewards By Tantruming

Children can learn to have tantrums in order to get their way. This can happen when a natural tantrum has accidentally or by design earned them something rewarding. These learned tantrums may have a false quality about them or the child can become truly wrought-up and out-of-control. Once young children let go of the little emotional control they do have, they can work themselves up into fearsome states. So it is not always possible to distinguish between natural and learned tantrums by observing how upset the child seems to be. A more objective approach is to examine the processes involved before and after the tantrum.

When a child regularly earns rewards from tantrums the chances are great that the tantrums have a learned component. You may need to do some detective work needed to uncover the hidden rewards of tantrums - or the rewards may be quite obvious. Although young children often have tantrums to gain treats and toys (the "I see it, I want it" rule of behavior), an important type of reward to be aware of is 'escape' from a situation that the child does not like. For example, a child may have a tantrum in the doorway of a store in the hope that this will mean a drive straight home. The apparent distress can be misleading to parents and teachers. This may be a child who truly dreads going to this store or it may be a child who has found a good way to force the issue.

Because figuring out all the dynamics of tantrums is hard for parents to do, prevention is the ideal solution. Learning how to cope positively with your child's specific temperament profile and other areas of difficulty can make a big difference in reducing the number and the intensity of tantrums in children with high maintenance profiles. Even so, tantrums may occur in spite of your best efforts. Responding calmly will help prevent them from growing into bigger problems.

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