Article Information

Navin Kumar Devaraj

Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

Corresponding author: Navin Kumar Devaraj, Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia

Received: 25 August 2019;Accepted: 16 September 2019;Published: 20 September 2019

Citation:

Navin Kumar Devaraj. The Unusual Case of Child Tantrum - A Case Report. Archives of Internal Medicine Research 2 (2019): 026-029.

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Abstract

Keywords

Child tantrum; Red flags; Interventions

Article Details

Introduction

Child tantrum is a common problem seen during the ages of 1-2 and rarely exceed above the age of 4 years [1]. It is mostly uncomplicated and resolves on its own, mainly by parents ignoring their child unruly behaviour.

However, child tantrums can be pathologic. Therefore, prolonged and seemingly complicated child tantrum may need the intervention of physician or even child psychiatrists, before the child are hurt by someone else or their own selves [2].

Case report

This case started in a rather unique manner. An eight years old boy had to be pacified out of the car driven by his mother. He also refused to step into the clinic initially, requiring further pacifying. He looked to be visibly upset, crying in short bursts and, looks to be inconsolable.

He refused to answer any questions the author asked him. His mother was then asked about any significant events that happened prior to the onset of these event. His mother reported that he has been showing this tantrum for the past one month. Initially talkative about his school, he doesn’t answer anymore when asked by his parents about school. He also shows long face more frequently when his requests usually for purchase of toys are denied. Appetite was normal and he continues to communicate in a normal manner with his younger sibling, aged five years.

Digging back into history, his problem started one month ago when he lost the opportunity to win a toy car after his team had loss a football match by just a goal. One week prior to that, he fell off a motorcycle driven by his dad but only sustained mild soft tissue injuries over his legs with no loss of consciousness.

Today proved the last straw for his mother as he has been inconsolable for the past two hours after denied a chance to download his favourite game on his mother’s smartphone. After an initial 10 minutes of trying to pacify him to break his silence about his source of unhappiness, the author went back to some detective work. The child was shown a series of toy car models on the author’s computer that caught his immediate attention. Initially not allowing his mother to come in into the consulting room, he finally allowed his mother to join the consultation that was now starting to bear some fruits.

After another 10 minutes of discussion with the parent and her son, it became visibly obvious the child has been subconsciously wanting that toy car that he lost out in that football game but was expressing it an rather unusual way of child tantrum. The child started to answer some questions about his school, teachers and friends saying all is well at school and he had not suffered any physical or sexual abuse.

Physical examination confirmed the child’s statement with no obvious bruises or swelling over his body. Vital signs were also stable with normal eye and cardiovascular examination. Some bargaining was done with the child in which his mother said she will look hard for his dream toy car and will download the game he wannted so much into her smartphone today.

The child was now looking happy and smiling. His mother’s distraught also turned into a smile and she learned some new lessons about parenting i.e. sometimes child may manifest their wants through tantrums and crying.

Discussion

Any child can manifest tantrums, but it occurs most commonly between the ages of one to four years [3]. It is usually exhibited in the form of crying, whining or screaming. It rarely more than a few minutes, let alone two hours as in this case [1].

Displaying violent behaviours during tantrum, having difficulty in recovering from them or long-lasting tantrum are red flags that may indicate underlying psychological disorder [4,5]. However, with quick thinking and the old trick of test and try, an amicable solution was found in this case.

Other ways of dealing with tantrums include ignoring the child’s behaviour, being a good role model as a parent, acknowledge the child’s frustration and feeling, praise the child for automated resolution of tantrum and teaching child to express their anger or frustration in a more positive manner [1]. A physician help should be engaged if they are presence of red flags as above, child tantrums extends beyond the age of four years or if the parent need to relearn coping skills with their child’s tantrum [1].

Child tantrum is one of the many challenges facing parents and skill need to be developed on how to handle it. The whole concept of parenting is hard to learn from a book or even a workshop, but the pictures starts to unfold when the parents start to understand their child’s behaviour and feelings and, spend valuable time with them.

In summary, this is an interesting and indeed eye-opening case of child tantrum in a rather older child in which swift action taken had managed to provide a solution to the problem.

Acknowledgement

The author like to thank the child’s mother for her permission in publishing this case.

References

1. emedicinehealth.com. Temper tantrums. Available from URL http://www.emedicinehealth.com/temper_tantrums-health/page3_em.htm. Accessed on 11 Jun 2018
2. American Academy of Adolescent and Child Psychairty (https://www.aacap.org/). Recommendations for Pediatricians, Family Practitioners, Psychiatrists, and Non-physician Mental Health Practitioners. Available from URL https://www.aacap.org/aacap/Member_Resources/Practice_Information/
   When_to_Seek_Referral_or_Consultation. Accessed on 11 June 2018
3. Temper tantrums. Available from URL http://www.webmd.com/parenting/tc/temper-tantrums-topic-overview#1. Accessed on 12 June 2018
4. Long, violent childhood tantrums can be a sign of psychiatric disorders. Available from URL www.medscape.org/viewarticle/568157 . Accessed on 11 June 2018
5. Science daily. Excessive Tantrums In Preschoolers May Indicate Serious Mental Health Problems. Available from URL https://www.sciencedaily.com/releases/2007/12/071213194723.htm . Accessed on 12 June 2018