Three-year-old Merle throws a tantrum in the supermarket whenever her mother refuses to buy something she wants. Little Anna screams wildly when her mother interrupts her playing to put on a jacket so the family can go out. Ben, an adorable towhead, barely two, bites into furniture and toys as soon as anyone drops the word “no.”

Merle, Anna and Ben are in the tantrum phase—sometimes referred to as “the terrible twos”—and they dispense frustration and anger to everyone around them. (All of the names of the children mentioned in this article have been changed to protect their privacy.) Reasoning is useless; threats and punishment fail to stem the bawling, agitation and aggression. And then, just as suddenly as it begins, it is over: the child is cuddling up to Mommy or Daddy for comfort. Small wonder that so many parents feel powerless to control these mini crises.

Virtually all small children throw temper tantrums, typically starting around age 15 to 18 months and sometimes earlier. In most cases, these fits are not worrisome but simply reflect a stage of development in which increasing independence and willfulness collides with emotional and verbal immaturity. “Temper tantrums are a normal part of infant development,” says psychiatrist and family therapist Manfred Cierpka of the University of Heidelberg in Germany.

But a minority of children display more excessive tantrums. The little rebels regularly flip out—in some cases more than five times a day—and are extremely hard to calm. They may become destructive to objects or aggressive toward adults and children and even injure themselves occasionally by, for example, scratching themselves until their skin bleeds or banging their head against the wall.

Frequent rage attacks, together with violent or self-destructive behavior, may signal a more serious problem and warrant professional attention. Not only are such extreme outbreaks emotionally exhausting for the parents and children, but they also may be a harbinger of psychiatric and behavior issues, including depression and a propensity toward violence.

Genetic factors contribute to overly aggressive behavior in toddlers, as do language delays, smoking during pregnancy, socioeconomic factors and certain parenting styles. Studies show, for example, that parents who are more authoritarian and less democratic in their parenting beliefs and actions tend to foster aggression in their children.

Many psychologists recommend that doctors and teachers, along with parents, try to identify young children who display particularly belligerent personalities. Contrary to the conventional wisdom that violence is learned during adolescence, a wealth of recent research has shown that aggressive behavior even before age two can signal persistent problems. Thus, experts are stressing the importance of trying to curtail physically hurtful actions in kids during the first few years of life.

Anger Management
Although toddler tantrums are frustrating and unpleasant, they are usually not a cause for concern. These outbursts are a normal expression of emotions that emerge from an immature brain. Two-and-a-half-year-old Sarah’s parents were concerned because their daughter screamed at day care when her teacher intervened in fights over toys. “And at home,” her mother says, “Sarah falls apart more and more often, and we can’t seem to reach her or calm her down.”

When Sarah’s parents came to see Cierpka at the Institute for Psychosomatic Cooperative Research and Family Therapy, however, Cierpka saw little cause for alarm. After entertaining herself without incident for more than an hour, Sarah started playing with her mother’s pocketbook. Her mother yanked the purse out of Sarah’s hands. Sarah simply looked puzzled and sought out the purse again. Her mother took it away a second time, saying, “Come on, Sarah, do we really have to do this right now?” Only then did the toddler begin to howl.

This behavior is quite typical, Cierpka says. “Children in the tantrum phase are making a giant developmental leap,” he explains. Not only are their motor skills improving rapidly, enabling them to act independently to explore their surroundings, but also, at about age two and a half, kids start to perceive themselves as individuals; for instance, they suddenly recognize themselves in a mirror. This perception enables a child to have independent desires and realize that her actions elicit responses from others, Cierpka says.

The boost in experimentation, combined with awareness of other people’s reactions, is a recipe for frequent distress, as a toddler’s explorations and wishes very often elicit “no’s” from parents and caretakers. Parents typically will not allow a child to eat a cookie before dinner, for example, to grab a shiny knife blade, or to play with Mommy’s purse and wallet. The toddler, for her part, not only can and wants to do these activities but also understands what and who is foiling her—without understanding why.

The result is disappointment and rage—negative feelings that are completely new to the child. Sarah, for example, feels angry about the purse being snatched away, helpless because she cannot do anything about it, and rejected by her mother. “These are all extremely strong emotions that are hard for babies to assimilate,” Cierpka says. Unable to express their feelings with words, toddlers discharge them instead with irrational screaming and a physical frenzy—a temper tantrum.

Cierpka’s advice to parents: acknowledge your child’s feelings. For instance, Sarah’s mother could have calmly said to her daughter, “I know you are angry about the purse, but my purse is not a plaything.” Then she could distract Sarah—say by pulling out a toy from her pocketbook. Or if Daddy wants Sarah to interrupt her play to put on a jacket, he could sweeten the deal by offering to play with her after the shopping trip. Such strategies enable a child such as Sarah to know that her parents are there for her even when she is angry, which will eventually enable her to respond more rationally to her distress.

Escalating Actions
Even if anger and aggression are developmentally appropriate, some children display these traits more than others do. Tantrums may become more seated in willful children, who tend to act and think more independently than their peers do. During a consultation with Cierpka, two-and-a-half-year-old Ben cries and screams without provocation, shakes the leg of a table and then bites into it—a markedly wilder performance than Sarah’s.

Rather than a passing phenomenon, unusually aggressive behavior during the toddler years may be a sign of a persistent problem, psychologists now say. A 1995 review of the literature by University of Pittsburgh psychologist Susan B. Campbell suggests that children with behavior problems at age three or four have about a 50 percent chance of having similar problems in early adolescence.

In these cases, physical aggression is the chief concern. For most boys—boys are far more prone than girls are—hitting, kicking, biting and the like seem to peak in kindergarten and then decline between the ages of six and 15. But in about 4 percent of boys, highly physical behavior persists from an early age, and those males are the most likely to be violent at age 17.

Extreme tantrums might in some cases be a sign of attention-deficit hyperactivity disorder (ADHD). In a 2007 study psychologist Manfred Laucht of the Central Institute of Mental Health in Mannheim, Germany, along with psychologist Gnter Esser of the University of Potsdam in Germany, compared developmental and behavioral profiles at age two of 26 elementary school children who had ADHD-like disorders with those of 241 healthy grade school kids. They found that potential harbingers of ADHD included fidgetiness, irritability and difficulty understanding language. The last two traits may also contribute to acting out, and many (though not all) hyperactive kids are also aggressive. Thus, toddlers who have very wild tantrums may be at risk for both types of behavior problems, although no one has proved a direct link between toddler fits and ADHD.

Both genetics and the environment contribute to a toddler’s temperament. In particular, genetic factors account for more than half of the variation among toddlers in how often they use physical aggression. Psychologist Ginette Dionne of Laval University in Quebec and her colleagues assessed levels of aggression in 562 19-month-old twins. In 2003 the researchers reported that identical twins, whose DNA is almost indistinguishable, shared the trait nearly 60 percent of the time, whereas only 28 percent of fraternal twins, who have about half their genes in common, were similar in levels of belligerence.

Language delays can exacerbate a genetic predisposition toward disruptive and aggressive behavior. Epidemiological studies show that as many as 60 to 80 percent of preschool and school-age children whose speech developed slowly exhibit such behaviors, compared with 20 percent in the general population. Dionne and her colleagues, who assessed the language skills of the twins in their study, did not find a strong association between language and aggression at 19 months. In many cases, aggression appears before any problems with language, suggesting that a language delay does not cause aggression but may increase it: kids may become frustrated by an inability to communicate or use fists when they cannot produce the appropriate words.

Meet the Parents
Parenting behavior, starting in the womb, can have a significant effect on a child’s temperament. In a study published this year, psychologist Richard Tremblay of the University of Montreal and his colleagues reported that heavy smoking (10 or more cigarettes a day) by the mother during pregnancy was associated with aggression in 1,745 Quebec-born children between the ages of 17 and 42 months. Scientists believe that smoking perturbs the development of the fetal brain.

Psychologists are also convinced that certain parenting styles influence a child’s aggressiveness and emotional stability. When a child is distressed, parents who either leave the child to his own devices or respond in an authoritarian manner are looking for trouble. Kids react to neglect or draconian rules with agitation and rebellion and may start to behave aggressively toward other adults or peers, Cierpka says.

A 2008 study of 1,508 elementary school kids by clinical psychologist Mireille Joussemet of the University of Montreal, along with Tremblay and their colleagues, supports a link between aggression and having a “controlling parent”—that is, one who likes to exert power over a child, values obedience and does not encourage a child to express his own opinions. The study found the usual risk factors for aggressive behavior (judged, in this case, by the kids’ teachers): being male, having a reactive temperament, and family problems such as separated parents. But beyond these contributors, the investigators discovered that having a controlling mother further boosted the odds of belligerence in grade school.

Other parenting strategies tend to lower the risk for unruliness. In a 1996 study of 69 families rearing firstborn sons, psychologist Jay Belsky, now at Birkbeck, University of London, and his colleagues observed that the parents who had more trouble managing their son’s behavior at ages 15 and 21 months tended to give their sons simple directives without embellishment rather than combining such instructions with an explanation, as in: “Don’t touch that knife. It could hurt you.” Parents who promote guidelines and democracy in a household are more likely to have well-adjusted children than are those who utter simple commands, the psychologists suggest.

In addition, however, kids often suffer from socioeconomic and family factors that are more difficult to change. In the 2008 smoking study, for instance, the effects of smoking on aggressiveness were enhanced if the family had a low income or the mother had a history of antisocial behavior. The personality of the father can also play an important role in how well a family manages a toddler’s behavior. In Belsky’s 1996 study more troubled families had fathers who tended to be less friendly and social and more negative than those in households that were coping well. A hostile personality may, after all, equip a person poorly for dealing with temper tantrums.

In addition, marital conflicts added to the mix insofar as they related to parenting. In particular, trouble seemed to flourish when one parent expressed negative emotion while undermining a spouse’s parenting—such as interrupting the other parent or giving the child conflicting instructions. Marital quality, in general, however, did not show up as an important factor in this study.

In Ben’s case, Cierpka speculates that marital issues may partly underlie Ben’s extreme tantrums. Ben’s father, he discovered, is an inconsistent presence. Dad leaves home without notice for long periods and does not tell his wife where he is or what he is doing, making her feel hurt and anxious. Ben’s mother may then inadvertently transmit her own anger and insecurity to her son, whose tantrums may be a cry for the attention he needs as a salve for his own insecurity.

Cierpka also notices a more superficial problem: as soon as Ben breaks down, his mother pulls him to her to console him. This action tends to reinforce the connection between hostile agitation and love. Cierpka advises Ben’s mother to comfort her son only after he has started to calm down, rewarding him for regaining his composure instead.

Expressing Themselves
Anger rears its head within the first six months of life, and as kids such as Ben illustrate, this emotion may lead to aggression within a few years. Because early aggressiveness can portend later violence, programs that quell anger and prevent hostile actions at an early age may help curtail the number of youths who become violent.

Although no preschool program has been proved to prevent chronic physical aggression, studies of childhood aggression and experimental prevention programs hint at what might work. Mental empowerment may be one antidote. An intervention called the Perry preschool experiment that focused on boosting the cognitive development of three- and four-year-olds significantly reduced criminal behavior in males.

Another promising approach might be to exploit the link between language delay and aggression, targeting children who exhibit a delay and working with them to overcome it, perhaps through intensive verbal stimulation. In addition, social workers might teach aggressive children social competencies such as being helpful, comforting others, sharing, and finding alternative ways of dealing with anger. In cases where authoritarian parenting may play a role, targeted psychotherapy may help break the cycle of aggressive-oppositional behavior in the child and punishment from the parents.

At least one gene has been shown to influence aggression in humans. Males who were badly treated as children were more likely to be convicted of a violent crime before age 27 if they had a shorter form of the gene for an enzyme called monoamine oxidase A. [For more on genetics and character traits, see “The Character Code,” by Turhan Canli; Scientific American Mind, February/March 2008.] In the future, as researchers develop more genetic insights into aggressive behavior, these molecular findings may lead to medications that might be combined with behavioral tactics to combat the emergence of violent tendencies in young people.

Note: This article was originally printed with the title, "Tempering Tantrums".