Helping your child handle big feelings Part 4: Is this normal?

I’ve established in my previous three blog posts that all children have big feelings. Developmentally, this is completely normal. Learning to calm down when you’re excited or upset is a developmental process just like gaining fine motor skills. But some children continue to have emotional meltdowns beyond the age when this is expected. Children of all ages have big feelings and have a meltdown on occasion (let’s be honest, adults do too!), but in older kids this should look different from a toddler tantrum. Let’s go through what is typical and what are the signs your child may need further help.

The quintessential expression of big feelings – the tantrum – usually emerges some time around age one, and reaches its peak at age two. Two-year-old tantrums can be quite intense. Toddlers will often scream at the top of their lungs, kick, and hit. They may even hold their breath or bang their heads on the floor. This is normal at age two and even three. With two-year-olds, it is potentially concerning if a tantrum lasts more than half an hour, or a child bangs his head hard enough to draw blood or holds his breath until he turns blue or passes out. You should also check in with your doctor if your child has a sudden significant increase in tantrums, or if tantrums are accompanied by other behavioral issues (for example, having trouble with bedtime or toilet training when this had been going well).

Three-year-olds often throw tantrums too, but by age four these should be decreasing significantly. Children age four and up are more likely to burst into tears, cry loudly, and yell things like “I hate you!” “You hate me!” or “Nobody loves me!” but they are far less likely to scream the long, wordless screams of the two-and-three-year-old. They rarely hit and kick, especially not their parents. If an older child throws full-on tantrums regularly, it may be a sign that he has learned to use tantrums as a strategy to get what he wants, or it may indicate that he has a mental health condition like autism, sensory processing disorder, ADHD, anxiety or depression. Your pediatrician should be able to screen your child for some of these conditions to determine whether he needs a full evaluation.

It is also often normal for young children to throw tantrums over seemingly ridiculous and bizarre issues, especially when they are tired. I read this passage from Sophie Kinsella’s novel Finding Audrey when my older daughter was four, and it rang so true!

Felix comes home from a playdate where they made pizza and unveils the most

revolting tomatoey-cheesy mess and makes Mum heat it up in the oven. Then he

refuses to eat it.

Then he refuses to eat anything else, because he wants to eat the pizza he made, even

though he won’t eat it. I know. The logic of a four-year-old is beyond weird.

“I want to eat MY pizza!” he keeps wailing, whereupon Mum says, “Well, eat it then!

Here it is.”

“Noooo!” He gazes at it tearfully. “Nooooo! Not that one! Not THAT one!”

I have also seen some very entertaining Facebook posts along the lines of “Here’s why my toddler is tantrumming today,” which are also very reassuring when you’re going through it yourself.

On the other hand, some children tantrum whenever anything is out of order, and this can be a red flag for childhood anxiety or possibly autism. Autistic children are likely to be very rigid in their play. They may want to line their toys in a row rather than play with them, or they may arrange them in only one particular way, and become very upset if even one toy is not in position. Autistic children usually have other symptoms, like not wanting to be hugged or difficulties interacting with other children. Here’s a quick guide to symptoms of autism. Sometimes Level 1 autism (fairly mild symptoms) is not obvious, so if your child has significant behavioral issues and even a few of these symptoms, you may want to consider an evaluation.

Kids with anxiety can also be rigid in their play, but not to quite the same extent. They usually do like to play with their toys rather than simply organize them, and while they may have strong ideas about how their toys should be organized, they won’t necessarily want to arrange their toys the same way every time. An anxious child may become very upset and angry if someone else touches or moves her toys, or if she can’t quickly learn how to use a new toy. An anxious child might throw a tantrum if she has to do something she is afraid of, like go to school or to a birthday party. Here’s a quick look at symptoms of anxiety and specifically anxiety in preschoolers:

Some children have difficulties with sensory processing, which means that they are overly sensitive to sensory input (sounds, tastes, textures, or light), or sometimes they are not sensitive enough. Children who are overly sensitive may get upset easily because they constantly feel overstimulated, the way we might feel after spending several hours at a loud party. Or they may become very upset if another child bumps into them or makes a lot of noise. Here is more information.

Some kids simply have a very sensitive temperament and are easily upset. Often parents of these children (understandably) work hard not to upset them because it is so distressing for everyone. This can turn into a vicious cycle where the child doesn’t have to experience dealing with distress and getting through it, so she becomes even more easily distressed. These children may not have an actual mental health diagnosis (maybe mild anxiety), but nevertheless they or their parents may need therapy or some sort of additional support to help the children learn to tolerate distress.

In short, it is normal for a child to periodically have very particular demands and become highly emotional when those demands aren’t met, but it may be concerning if a child is highly rigid in general and has regular and frequent meltdowns when something is out of order. Similarly, it is normal for a child to lose control if her Lego tower has fallen down for the fifth time, or if her tower falls down at the end of the day when she’s tired, but if she has a meltdown every time her tower falls down, you may want to get her evaluated. If you are concerned that your child’s behavior may be more extreme than that of her peers, it is a good idea to ask her teacher about it, if she’s in school or daycare. If not, compare notes with your friends.

These ages and stages guides can help you assess what is typical behavior for your child’s age.

The Child Mind Institute’s Symptom Checker lets you enter your child’s symptoms and learn about childhood mental health concerns that may be associated with those symptoms. It’s not a diagnosis, but it can give you an idea of what to ask your pediatrician or child therapist.