Temper tantrums

Fewer than 10 percent of preschoolers have daily tantrums according to a Northwestern University professor. (Peter Dazeley, Photographer's Choice)

Call them what you may — tantrums, hissy fits, conniptions — but most parents of preschoolers endure them. They know the tantrums will subside in time, when the kids' language skills improve.

Now, a new study from the Northwestern University Feinberg School of Medicine says daily tantrums are not normal. In fact, having frequent, out-of-control, out-of-the-blue tantrums can be a red flag for mental illness.

"Less than 10 percent of preschoolers have daily tantrums," said Lauren Wakschlag, professor of medical social sciences at Northwestern and lead author of the study that tracked 1,500 kids, ages 3, 4 and 5. "This is true despite the children's gender, socioeconomic and racial differences."

In addition to asking parents about the frequency and severity of the children's tantrums, the researchers asked if the tantrums resulted from predictable causes, like being told to go to bed or get dressed, or if they had no apparent triggers.

"It's about determining patterns over time," said Wakschlag. "Maybe the child had a tantrum every day one week, but he had a fever or a new sibling. What happened after that?"

The study resulted in a questionnaire that doctors can administer to determine if a child is truly struggling, said Wakschlag. It gives them a yardstick they did not have before, she said, especially because the definition of a tantrum is so subjective.

Previously, many diagnostic tools used by doctors were the same used for older children. But teens' and preschoolers' outbursts are apples and oranges, said Wakschlag. Also, a teen's tantrum is often self-reported in studies, while a preschooler's tantrum is reported by an adult and subject to his or her interpretation.

"Over the past decade, there has been more recognition that mental health problems emerge in early childhood," said Wakschlag. "We can use the information about tantrums to identify deeper problems and to not over-identify mental health problems and not over-treat them with medication."

Phase two of this study will measure how children's brains respond to emotionally frustrating situations. And, it will measure variables not counted in phase one, including the preschoolers' diet, social skills, family structure and parental education, all in relation to tantrums.

The study was funded by the National Institute of Mental Health. It was published in the Aug. 29 edition of the Journal of Child Psychology and Psychiatry.