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Severe Behavior Problems in Toddlers

Michele Meleen
Tired mom exasperated with toddler

Discerning problem behaviors in toddlers is difficult because children at this age can't describe or explain what they are thinking or feeling. If you have any concerns about your child's behaviors, the best place to start is by gathering information from reputable sources and examining your child's actions with an objective eye - taking into account environmental factors like family situations.

Concerning Behaviors

Kids ages one to three are learning about their bodies, minds, and the world in every moment. With so much information to process, these kids are bound to feel some frustration, which they often exhibit by acting out. Parents can expect toddlers to occasionally have emotional meltdowns, minor tantrums, or even try hurting themselves or someone else, says the Children's Mental Health and Emotional or Behavioral Disorders Project. However, when trusted adults are unable to control these behaviors or the behaviors include severe actions over long periods of time, parents should consider the need for intervention.

If any of these circumstances or concerns describe life with your toddler, the Child Mind Institute suggests you may want to think about getting help from a professional.

  • Your child is excluded from school or social events due to behavior.
  • You have constant concerns about her hurting siblings or other children.
  • The behaviors disrupt daily family life and relationships.
  • Your child shows significant developmental delays of six months or more.

Serious Tantrums

Tantrums are a form of communication for tired, hungry, angry, or frustrated toddlers who can't say what they want to say because their language skills haven't developed to that point.

Screaming toddler looking up into camera

What's Typical:

  • Occur every once in awhile, but not every day
  • Last up to five minutes then child is redirected
  • Involve stomping, lying on the ground, and crying

What's Concerning:

  • You can't control your anger in response to tantrums
  • Occur multiple times per day, nearly every day
  • Last for excessive time periods and child can't be redirected
  • Involve self-injury or injury to others and destructive language like suicidal phrases

Constant Screaming

As your little one learns to use and control her voice, she's likely to experiment with some yelling in different scenarios. While this behavior might seem annoying and disrupt otherwise quiet events, it's usually not a sign of something more problematic. When you do see warning signs of concerning screaming behaviors, they could indicate health problems like ear infections or other concerns like sensory processing disorder.

What's Typical:

  • Yelling when tired, hungry, or injured
  • Lasts five or ten minutes at a time
  • Happens occasionally, but not regularly
  • Occurs when child experiences different emotions from pain to excitement

What's Concerning:

  • Screams that sound different from your child's typical yells
  • Lasts longer than 25 minutes at a time
  • Occurs multiple time per day, every day
  • Is coupled with harmful physical behaviors

Physical Self-Harm

When toddlers don't get their way or strongly refuse to do something, they might throw themselves on the ground and flail around. This type of unintentional self-harm is common. Anytime a child put's herself in danger, parents should intervene and try to prevent the behavior in the future. Child Psychologist Penelope Leach suggests parents should always be concerned when a child is purposefully inflicting injury on himself.

What's Typical:

  • One-time incident of purposeful self-harm during angry outburst
  • Unintentional self-harm resulting from tantrum

What's Concerning:

  • Repeated, purposeful self-injury other than when angry/frustrated or in unprovoked instances
  • Severe self-injury like drawing blood
  • Self-injury as self-punishment for perceived wrong doing

Physical Harm to Others

According to experts from Zero to Three, childhood aggression hits its peak around age two. During this stage, you could see your child use physical aggression to take back toys he has ownership of or to show a parent his anger. In most cases, these infrequent incidences are part of development and parents should redirect and explain why the behavior is not acceptable. To help kids learn to manage emotions, parents can also explain what types of physical expression are acceptable during times of anger or frustration.

toddler pushing older brother isolated background

What's Typical:

  • Occasional kicking or slapping when angry/frustrated
  • Pushing another child down to get a desired toy
  • Throwing an object at another person when frustrated
  • Biting in isolated incidents to get another person to let go of something

What's Concerning:

  • Hitting or biting others, multiple times each week
  • Physical aggression that escalates over time
  • Fearless attitude most of the time
  • Most pretend play is aggressive in nature
  • Uses physical aggression in unprovoked situations

Severe Separation Anxiety

Some separation anxiety is normal, and even healthy for babies and toddlers, as it shows they've developed an emotional attachment to you. However, severe symptoms could indicate a larger issue like an anxiety disorder or abuse at the place your child doesn't want to be left.

What's Typical:

  • Crying that lasts a few minutes when parent leaves
  • Trying to hold on to parent so they can't leave, but is able to be redirected

What's Concerning:

  • Crying when parent leaves that lasts half an hour or more
  • Nausea or vomiting while parent is leaving
  • Shortness of breath due to panicking
  • Excessive worry about losing parent or bad things happening to parent

Absence of Affection

A parent's image of appropriate affection varies by family and culture. For kids, it's an important part of development because they learn so much from sensory cues. Some toddlers engage in overly affectionate behaviors with loved ones, while others shy away from it. Experts at What to Expect suggest a little resistance to hugs and kisses is a normal way toddlers exert independence.

What's Typical:

  • Only wanting to hug/kiss when they want to, not necessarily when you ask for it
  • Prefer other forms of affectionate touch like tickling or stroking hair
  • Avoidance of affection while deeply engaged in play

What's Concerning:

  • Avoidance of all physical touch from others on a regular basis, even when tired or upset
  • Gets visibly upset when hugged or kissed
  • Shows regular disinterest in being physically near others

Complete Withdrawal

Some toddlers are shy or introverted by nature and take a lot of time to warm up to new people of any age. These kids may simply enjoy doing things on their own in their own way or dislike overstimulation, either way shyness or being quiet are normal behaviors for many toddlers. However, withdrawing from social situations can have negative consequences for children now and later in life.

shy, withdrawn blond toddler

What's Typical:

  • Preferring to play alone or with trusted adult in new situations
  • Removes self from large, loud crowds at big gatherings
  • Enjoys quiet hobbies like looking at books

What's Concerning:

  • Abrupt withdrawal by a normally social child
  • Symptoms of anxiety in social situations like shortness of breath or tummy aches
  • Shows no interest in any social interaction, even with trusted family members
  • Constant lethargy or other signs of depression

How to Get Help

If you're concerned about your child's behavior, it's important to have a plan so you can address those concerns. Ask others in your child's life like family members, teachers or caregivers if they are concerned about the behavior. Observe the behavior over a short time, like one week, and keep track of things like frequency, duration and causes. When you head to your child's pediatrician or other professional like a child psychologist or school social worker, they'll ask you to provide this information anyway. If you can gather the information while waiting for you're appointment you'll get to a solution quicker.

Professional Opinions

The easiest place to start for most parents is talking with your child's pediatrician about the behavior. They can give you basic information about whether intervention is necessary and provide resources to help you find more specialized professionals. Thanks to modern rule changes like the Affordable Care Act, many behavioral and mental health services are free or low cost for children. These services are often included under preventive health care stipulations. If you feel like you need a professional opinion on your child's behavior, start by checking with your insurance carrier to see what's covered.

While pediatricians and child psychologists can certainly help, the Child Mind Institute points out most toddler behavior interventions focus on giving parents tools to help their own children. Some might recommend letting behaviors fizzle out on their own, but early interventions are more successful than later ones. Examples of behavioral interventions include:

  • Work on encouraging and building positive relationships for child and family
  • Teaching coping skills and replacement behaviors
  • Functional assessment to understand reasons behind behavior
  • Family counseling with a child psychologist
  • Individual counseling with a child psychologist
  • Parenting classes from a local organization

Resources

If you feel uncomfortable seeking help or are still unsure whether your toddler's behavior is developmentally appropriate, these resources can help.

  • The Child Mind Institute's Symptom Checker asks you a few questions about what specific concerns you have regarding your child's behavior then gives you some disorders that contain those symptoms. This does not serve as a diagnosis, but gives you disorders to find more information on so you can see if your child meets any of the other criteria.
  • The Pacer Center offers a printable handout showing side-by-side comparisons of "normal" behaviors for an age range and "behaviors of concern" with suggestions for parent actions on each.
  • The American Academy of Pediatrics provides information about typical development for toddlers at each specific age on HealthyChildren.org to help parents better understand what's common and what's not.
  • Get support for yourself through a counselor or support group as interventions may take an emotional toll on you.

Know Your Child

Every child develops at a unique and individual rate, so you are your child's best resource because you know them better than anyone else. As a parent or caregiver it is your job to advocate for your child, especially during this stage when he may not be able to speak up for himself. When you allow yourself the opportunity to look at your child's behavior objectively and in comparison to other children his age, you'll have the best idea whether the behavior is natural or concerning.

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Severe Behavior Problems in Toddlers