A straight answer
My child's tantrums don't stop, and nothing I try works. What do I do?
Alexis Davis, LICSW. Parenting consultation, Medford MA and Greater Boston.
You've tried the calm voice, the sticker chart, the ignoring. Some of it worked for a day. If you're reading this after another one, hear this first: you're not failing. Tantrums that keep coming back are almost never random. They run on a loop, and loops can be broken once you can see them.
What the tantrum is doing
A tantrum that repeats is working for your child. It gets something, gets out of something, or gets a big reaction from you, and for a small child even an angry reaction is worth a lot. Trigger, tantrum, payoff. Your child isn't plotting this. They've learned what works.
Find the loop before you change anything
Most advice fails because it guesses. "Stay calm" doesn't touch the payoff. "Be consistent" doesn't say consistent about what. The first thing I do with every family is find the pattern: when the tantrums start, what comes right before, and what comes right after. Once we can see it, the plan usually gets clear.
What breaks it
Most of the work happens before the tantrum starts. In the moment, say less and don't give in, not even sometimes, because a child will wait a long time for that one yes. Give it two to three weeks of the same response before you judge it. I have two boys, and I know exactly how long two weeks feels at bedtime. You need fuel to hold steady that long, so protect some time that's yours: a friend, a walk, an hour to yourself.
Why I do it this way
None of this is my opinion. Each step comes from programs with decades of research behind them. Here is the research, in plain words, with the study under each one.
Find the pattern first
Triple P, the program I build on, starts by finding the pattern, and across 101 studies and more than 16,000 families it improved children's behavior, with gains that held at follow-up.
Source: Sanders and colleagues, Clinical Psychology Review, 2014
Holding the line without getting harsh
Across 1,435 studies, both harsh control and permissive parenting went with more acting out, which is why I ask for calm and firm instead of yelling or caving.
The red flags I watch for
In a study of 279 preschoolers, the tantrums that went with a diagnosis were the ones with violence, self-injury, and real trouble recovering, which is why the pediatrician list below reads the way it does.
Source: Belden and colleagues, The Journal of Pediatrics, 2008
When to call your pediatrician instead
Call your pediatrician if your child hurts themselves during a tantrum, if they hold their breath until they go limp, if the tantrums are still daily and intense past age six, or if you see a loss of skills your child used to have. Those are a doctor's questions. This page is parenting consultation, not therapy and not a diagnosis.