Q: Our son seems easily stressed out and has awful tantrums. What can we do to deal with this?
A: As a behavioral pediatrician, I have seen and heard it all. Children who have tantrums to end all tantrums in the middle of a store. Children who refuse to eat or won’t sit still at a restaurant, which quickly escalates to screaming and throwing food. Children who unbuckle themselves from car seats or kick other children at school for no apparent reason.
It can be scary, overwhelming and challenging to confess these situations out loud. Parents often feel confused, bewildered and embarrassed.
“Why won’t my child listen to me? What did I do wrong? Is there something wrong with my child?”
Sometimes a child’s behavior is because of something that has been happening or has happened to the child or to someone in the family.
For children who have tantrums, it can be because they don’t yet have the words to tell you what is bothering them. Or maybe they can’t make sense of what is happening around them, and the strong feelings are hard to control.
For many families, unpredictable events happen, which can be traumatic and affect how a child feels and behaves. For example, when parents make the hard decision to separate or divorce, it can be very confusing for young children. They may act out, cry or feel sad, lose developmental skills or have trouble sleeping. Some have problems concentrating and have a hard time at school.
Potentially traumatic events like these are referred to as adverse childhood experiences (ACEs). They can include neglect, parental substance abuse, domestic violence or a death in the family.
Experiences of social inequities also can be traumatic and trigger toxic stress responses. Examples include living in poverty, family separation, being the target of racism or rejection because of sexual orientation or gender identity. And, certainly, the COVID-19 pandemic has caused children many troubling losses.
Our body has stress systems to protect us so that when faced with a scary situation, we are ready to run and hide. This fight-or-flight response can be triggered whenever a child is scared of any number of things such as dogs, the dark, or spiders. This same system can also be turned on when a child has any adverse experience.
However, adverse childhood experiences are likely to last longer than a single moment, which causes children’s stress systems to be turned on for a long time. When this happens, the stress becomes toxic to their overall health. The more ACEs children face, the more harm they can have over time.
Likewise, chronic ongoing adversity can have an equally negative effect. Adults who’ve experienced one or more ACEs as a child or are exposed to ongoing chronic social inequities over time are at higher risk of depression, cancer, heart disease, diabetes and other health conditions during their lifetime.
The good news is parents can help buffer children from this stress before it becomes toxic. Providing safe, secure and nurturing relationships (sometimes called relational health) helps reset the body’s stress system. In addition, research suggests positive childhood experiences are just as important.
One of the most important is to spark moments of connection. This may be through shared book reading, for example, or participating in family routines and community traditions. You can also model how to accept all emotions. Relational health is key to combating adversity, and promoting skills like collaboration, connection and communication that are essential to help children develop resilience and thrive.
When parenthood gets challenging, talking with your child’s pediatrician is a great first step. Pediatricians are trained to not only monitor your child’s physical growth, but also their social-emotional health.
We want to ensure all children, and their families, have the resources and skills needed to thrive. To do that, we will always be ready to listen, without judgment and with compassion.
Dr. Nerissa S. Bauer is a behavioral pediatrician in Indianapolis, Indiana, and a member of the American Academy of Pediatrics. For more information, go to HealthyChildren.org, the website for parents from the AAP.
