Ask the Expert: Tantrums are really scaring us

Q I am having terrible trouble with my three year old

Q I am having terrible trouble with my three year old. Over the past month or so, she has gone back to biting and kicking, and if she doesn’t get her own way she screams like someone is either killing her or like she is possessed. It is really scary, how can I help her?

A

I am sure it is terrifying to hear your daughter scream like she is being murdered. There is something about our own child’s scream that pierces right to the very heart. Its intensity often leads us to wonder if our children’s distress is beyond the normal.

Of course, the very intensity that children bring to their screams and other tantrum-type behaviour is designed to elicit that exact response. Our children want us to notice and react to the distress that they feel, even if we don’t believe that their distress is warranted.

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So, it may be that the biting, screaming and kicking is all recurring as a means of getting your attention and notice. Because she sounds like she is being murdered you are less likely to ignore her. She may not consciously be aware that this is what she is doing, but unconsciously she learns that certain things she does get a particular response from you.

So think back to when she used these behaviours before and how you responded then. What worked well, what didn’t? What seemed to lead to outbursts, what helped to distract from them? See if there is anything you have learned from before that you can apply to dealing with her now.

I am sure there are times when you react understandingly, others possibly crossly. Other times again you may choose to ignore her because you believe she is just attention-seeking. This dynamic of sometimes reacting and sometimes not reacting actually sets up the most powerful form of reinforcement for her continuing screaming, biting and kicking.

It is almost as if she knows (even though this is all happening for her at an unconscious level) that she has to be extreme to even hope that she might get a response from you.

The key to helping her is to become really consistent in your response to her. It is not that you have to simply ignore her all the time (although planned ignoring of certain behaviours can be very effective) but rather that she has to learn that no matter how extreme or calm she is, you will always react the same.

So, you need to find a way of staying calm and not panicking when she starts to get distressed. Perhaps you might count to five, take some deep breaths or remind yourself that you are the adult and the one in charge.

Then you give her a simple clear message that the particular behaviour (kicking, biting or screaming) is not acceptable (“you may not bite!” for example) and that when she is calm you will help her to sort the problem or issue. Then move slightly apart from her so that you minimise the opportunity to get kicked or bitten, reminding her that when she is calm you will talk to her.

It is important that she realises that you are the one in charge, every time, and that screaming, kicking or biting will not actually lead to her getting her own way. Over time, as she learns that you are reliable and consistent in your response to her she will reduce both the frequency and intensity of the behaviours.

Q

My nine-year-old daughter has never been dry continuously at night. At present she is dry three or four nights per week. The longest dry period she has had is 10 nights. We have tried many different methods including homeopathy and alarms. Our doctor has said there is no physical problem. She attended a child psychologist who could find no reason for bed-wetting. I feel she is making progress, but very slowly. Do you think I should try any other option or should I just leave her be and hope she will grow out of it sooner rather than later? She is not greatly bothered by it herself.

A

Wetting the bed is one of those issues that we commonly consider to be a psychological problem, particularly at her age. However, more than likely her bed-wetting is due to physical immaturity.

Almost half of all children will wet the bed up the age of three. Night-time accidents are very normal up to the age of nine with approximately one in 10 children still wetting at night.

There also seems to be a strong family component to bed-wetting. Research studies show that about three-quarters of children whose parents both wet the bed as youngsters will do the same. Not quite half of children with one bed-wetting parent will follow suit, and only about an eighth of children where neither parent had any trouble staying dry will wet the bed.

The fact that she is progressing, albeit slowly, is a good sign. It is certainly useful for her to restrict her liquid intake in the evenings as what goes in must come out. Perhaps you might want her to avoid drinking after about 6pm.

I wonder if the alarm you speak about was a pad and bell type device that buzzes as soon as she starts to wet. An alternative to this is for her to set a regular alarm clock for about 1am and to get in the habit of getting up to go to the loo when it rings. This is the equivalent of lifting a smaller and younger child, but gives her a real responsibility for avoiding the bed- wetting.

If you find that she is consistently dry by the time it rings you can set the alarm for later in the night, slowly moving it closer and closer to her normal time of waking or getting up.

Another tip is to have her pay close attention during the daytime to the feeling of “bursting to go to the loo”. The more awareness she has of that full bladder feeling while awake, the greater the likelihood that her brain will attend to it (and bring her awake at night) while she is asleep.

While the practical issues of wet sheets, duvets and mattresses may be frustrating, in the interim it is a far lesser evil than her developing low self-esteem because she gets negative feedback about her night-time accidents.

That is not to say that at her age she can’t share the responsibility for taking wet sheets off her bed and bringing them to the laundry and then remaking her bed. But, irrespective of the reason why she still bed-wets, the important thing is to adopt a similar attitude to her own and try not to be too bothered by it.

Even if my few additional suggestions also fail to help her stay dry, it is quite likely that, like most children, she will physically mature to the point of staying dry at night by her early teenage years. So try to remain patient and give it time.


David Coleman is a clinical psychologist, author and broadcaster. His new series of Teens in the Wildis on RTÉ 1 on Monday nights at 9.30pm.

Readers’ queries are welcome and will be answered through the column, but David regrets he cannot enter into individual correspondence.

Questions should be e-mailed to healthsupplement@irishtimes.com