Symptoms

Usually, temper tantrums last 30 seconds to 2 minutes and are most intense during the first 30 seconds. During a tantrum, a child may:

• Cry, scream, or shout.
• Arch the back or tense the body.
• Flail the arms.

Temper tantrums are most likely to occur when a child is afraid, overtired, or uncomfortable. Breath-holding spells may sometimes occur with tantrums.

Difficult behavior that frequently lasts longer than 15 minutes, occurs more than 3 times a day, or is more aggressive may indicate that a child has a medical, emotional, or social problem that needs attention. These are not considered typical temper tantrums. Difficult behaviors may include:

• Kicking, hitting, biting, scratching, hair pulling, or pinching other people.
• Throwing or breaking things.
• Head-banging or inflicting self-injury.

Exams and Tests

Talk to your doctor if you are concerned about your child's temper tantrums or other difficult behavior. A doctor can assess your child's behavior based on:

• Your descriptions. It may be helpful to keep a record of the temper tantrums for a few days before an office visit.
• A physical exam and medical history. Your child's doctor will examine your child and ask questions to help find out whether temper tantrums are part of normal growth and developmental patterns or if it's possible that other behavioral or medical causes are responsible.

To eliminate other behavioral or emotional problems as the cause, the doctor may also ask you to complete a behavior assessment questionnaire. Sometimes the child's care provider or school teacher is asked to complete a similar form. Preteens and teens may be asked to complete a questionnaire about their perception of their own behaviors. The doctor can use the completed questionnaires to determine whether the child needs professional help and whether you need help dealing with the child's behavior.

If a doctor suspects that your child's temper tantrums are a sign of another disorder, he or she may order tests to check for other illnesses or conditions, such as seizures, learning problems, or attention deficit hyperactivity disorder (ADHD).