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Behavior Problems in Toddlers

Behavior problems in toddlers commonly result from the child's need for autonomy and exploration. These needs arise from the child's newly acquired mobility.

Biting

Biting is often the first behavior problem that is brought to the attention of the pediatrician. The initial biting episode often occurs when the child is teething. Later biting may occur when a frustrated child wants a toy.

Adults should interrupt the behavior with a strong "No, we never bite people because it hurts them." Longer, more complex explanations are counterproductive because they will inadvertently provide additional attention.

Interruption and prevention before the biting occurs is important, and it is important to remember to praise the child for not biting.

Temper tantrums

Children in the 18-month to 3-year age group will usually display temper tantrums at some time. Temper tantrums may worsen in severity because parents often mistakenly reward behavior by conceding to the child's demands in order to stop the tantrum.

History should include time, place, possible precipitating factors, duration, frequency.

Parents should understand that tantrums are a normal but unacceptable development. Any type of attention given to the child because of a tantrum can be rewarding to the child. If the child is having the tantrum in a reasonably safe area, the parents should ignore him, continue with their tasks, and not maintain verbal or physical contact such as promising, bargaining with, or threatening the child. It may be advisable to put the child in his or her bedroom.

Breath-holding spells

At 2 years of age, breath-holding spells result from childhood frustration and anger. They may start with crying and temper tantrums and may be associated with stiffening, jerking, cyanosis, and, occasionally, a seizure.

The parent should be reassured that breath-holding spells are not epileptic seizures. Reassurance can be given that breath-holding spells will not develop into epilepsy. Excessive manipulation by the child of overly solicitous parents.

Hitting

Assessment of the child who hits should include when, where, and toward whom the behavior is directed; and how situations are handled. Disruptive family events, health difficulties, child care, and/or school problems should be sought. Intra-family violence can stimulate this type of  behavior.

Behavior management

Specify the target behavior and assess the antecedents and consequences of the behavior.

Measure the baseline degree to which the target behavior occurs. The frequency and duration of the behavior.

Choose the reinforcers. Help parents choose rewards that will be used to maintain a new behavior. Rewards may be objects that the child likes (toys, stickers, money) or activities.

Arrange the contingency

An arrangement should be made by which the rewards are provided when the new behavior occurs. Initially the reward must be easily obtainable. As the child progresses, the requirements to gain the reward can be increased.

Charting the child's progress on a wall chart can provide positive feedback and encouragement for the child. Social approval and praise by the parent.