Q: Our son seems easily stressed and has terrible tantrums. What can we do to deal with this?
A: As a behavioral pediatrician I have seen and heard it all. Kids having tantrums to end all tantrums in the middle of a store. Children who refuse to eat or don’t want to sit still in a restaurant, which quickly escalates to yelling and throwing food. Children who disengage 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 ashamed.
“Why isn’t my child listening to me? What did I do wrong? Is there something wrong with my child?”
Sometimes a child’s behavior is the result of something that happened or has happened to the child or someone in the family.
For kids who throw tantrums, they may not yet have the words to tell you what’s bothering them. Or maybe they don’t understand what’s going on 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 difficult decision to break up or divorce, it can be very confusing for young children. They may behave, cry or be sad, lose developmental skills, or have trouble sleeping. Some have concentration problems and have a hard time at school.
Potentially traumatic events like these are called negative childhood experiences (ACEs). It could be neglect, parental substance abuse, domestic violence or a death in the family.
Experiences of social inequality can also 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, sure, the COVID-19 pandemic has caused children many troubling losses.
Our bodies have stress systems in place 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 when a child is afraid of a number of things, such as dogs, the dark, or spiders. This same system can also be activated when a child has a negative experience.
However, negative childhood experiences likely last longer than a single moment, leaving children’s stress systems on for a long time. When this happens, the stress becomes toxic to their overall health. The more ACEs children encounter, the more damage they can take over time.
Likewise, chronic ongoing adversity can have an equally negative effect. Adults who have had one or more ACEs as children or who have been exposed over time to persistent chronic social inequality are at greater risk of depression, cancer, heart disease, diabetes and other health problems during their lifetime.
The good news is that parents can protect children from this stress before it becomes toxic. Providing safe, secure and nurturing relationships (also known as relational health) helps reset the body’s stress system. In addition, research suggests that positive childhood experiences are just as important.
One of the most important is to create moments of connection. This could be, for example, reading books together or participating in family routines and community traditions. You can also model how to accept all emotions. Relational health is key to fighting adversity and fostering skills such as collaboration, connection and communication that are essential to help children develop resilience and thrive.
When parenting becomes a challenge, talking to your child’s pediatrician is a great first step. Pediatricians are trained to monitor not only your child’s physical growth, but also their socio-emotional health.
We want to ensure that all children and their families have the resources and skills they need to thrive. To do that, we will always be willing 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, visit HealthyChildren.org, the AAP’s parenting website.