Eliminating Tantrums

November 3rd, 2015

A large tantrum in a public place – like a supermarket or store – can be a parent’s worst nightmare. Even worse, sometimes a child in mid-tantrum can either run away or hurt someone (self or others).

This happened with my son on New Year’s Eve during a quick run to my local supermarket. We were in a hurry, I did not allow him to buy a toy, and he threw an out-of-control tantrum. He ran away from me, I ran after him, and then slid across a wet floor. Someone eventually caught my son and two men had to help me carry him to the car while he screamed and cried. Hands down, this was my most traumatic parenting experience. I drank my weight in champagne that night and prayed for the New Year to be better.

I had experienced tantrums before, but this one convinced me I needed a new strategy. Jeff was about 5 years old; it was time to nip the tantrums in the bud.

Tantrums and outbursts can be one of the hardest, most pressing issues for parents and professional team members to address with children affected by autism. They often crop up at the worst times, in public locations, and can go on for hours. Tantrums also can be much more intense and longer-lasting than those of a typical child.

Tantrums are a form of communication. They just happen to be a form that most parents don’t like. Tantrums typically build up from frustration, often stemming from communication issues.

Taming and troubleshooting tantrums takes time, consistency and hard work.

Providing ways for a child affected by autism to communicate, understand daily schedules and routines, and make choices can help prevent tantrums. Behavioral support and services for shaping and encouraging desired behaviors while minimizing undesirable ones are also important. It is important to figure out your child’s triggers, and to remember that tantrums become more likely when your child has had a long day, is not feeling well, is hungry, or feels tired. Reading your child’s signs of escalation can help you stop tantrums before they happen. As tantrums decrease in frequency, parents can introduce more activities that require flexibility.

Addressing tantrums while a child is young – preferably under age three – is important. Tantrums can become violent and dangerous for everyone, including the child on the spectrum, as the child ages. Letting outbursts go on or avoiding outings altogether will simply make the problems more difficult to address later on.

What to do

The biggest area of need for my family was helping my non-verbal son communicate his needs more effectively. My son had a great team of specialists; their experience was invaluable as we developed a strategy and updated it as his needs evolved.

Four key areas to examine:

1. Has anything changed?

  • When something (behaviors, bodily functions, etc.) dramatically changed, we carefully examined diet, medical issues, and any new treatments. All additions and changes were carefully scrutinized to rule in or out any possible cause of an increase in tantrums.
  • Documenting a child’s daily food, drink, and supplement intake goes a long way toward finding the culprit. See our Sample Daily Log.
  • Not doing any biomedical intervention? That can also be part of the problem. Medical issues can exacerbate behaviors. See Parents Role in Biomedical Treatments.

2. Behavior modification and communication facilitation

  • After Jeff’s New Year’s Eve tantrum, our team created a social story to address the problem. The story portrayed the tantrum as not a good event or strategy. The outcome left both mom and child crying, Jeff could have been hurt or worse, and he did not get the toy! Pictures were used to explain these concepts and provide alternative actions.
  • For about the next six months, every time we went out to do errands, I gave Jeff a list of where we were going and what we were buying at each location. We used the ‘no’ symbol (red circle with an X or slash) with pictures of Disney characters and other toys to show him what we were not buying.
  • Start with pictures, then move to words paired with pictures, and then move to using only words. This process can be a great help with pre-reading skills. Jeff’s job was to check off the errand locations and items bought at each stop. He loved being helpful.
  • Important note: If it was not on the list, we did not buy it. If the errand location was not listed, we did not go there. I REALLY had to plan my day and carefully list what we needed, because if it was not on the list, I could not buy it either. (This turned into behavior modification for both mom and child!)

3. Create clear house and school rules

  • Use social stories for definition and explanation of rules. Video modeling paired with a discussion is also effective.

4. Help your child communicate emotions

  • Use visuals to help your child communicate their emotions. Even verbal children on the spectrum have a hard time communicating their needs or emotions when they have escalated to a point of anger or frustration.

Must we live with lists forever?

Over time, as routines become familiar and tantrums decrease, changes and tasks requiring flexibility can be introduced.

Some suggestions include these next steps:

  • Adding items to the list like “Mommy’s free choice x3” gave me leeway to buy unlisted items and helped Jeff learn to be flexible.
  • I added things that were not available at the store, such as ‘pink elephant’ and ‘orange grapes’ to practice skipping unavailable items. I made a big deal of saying, “Oh well, we cannot find that one! That is silly. That’s ok! What’s next on the list?” The silly items made the shopping trips more fun.
  • On the way to a destination, I started to switch the order going to the second errand location first and the first location last. As I communicated the changes, I also said, “Don’t worry, we will get to it. I love how flexible you are being!”
  • Finally, I faded the list away and began telling Jeff verbally where we were going and what we’d be buying. I started with a short list of two or three items and made it Jeff’s job to remember the list. I repeated the list items in the car and prior to entering the store.

These steps helped Jeff handle change and increase flexibility. Over time, these twists and turns became silly stories and funny for both of us.

Create a reward system

Implementing a reward system for everyday life works for every child, but is especially effective for children on the autism spectrum. A reward should be something your child really wants. To ensure your child’s buy-in, allow the child to earn the first reward quickly. Have the initial prizes ready to go, wrapped and waiting. You can cause a tantrum early on if the prize is not immediately available.

For young children

The first reward system we used for Jeff was a puzzle piece board. A small picture at the top of the board showed the reward he was trying to earn. At the end of each day, Jeff earned one to two puzzle pieces. When the puzzle was complete, he earned the reward. A puzzle piece board can be anywhere from 5-20 pieces to start, depending on the child’s abilities.

Jeff received frequent reminders that good behavior or finishing a job would earn the desired puzzle piece. We also took the reward system on the road for quick visual reminders.

Over time, the puzzle pieces increased in number and took longer to earn. About 6 months in, we started to take away puzzle pieces as a consequence for negative behaviors. Maintaining good behavior became highly motivating.

For older children

When Jeff was ready to graduate from the puzzle piece board, we moved to money, and he worked to earn the price of a desired item.
The puzzle piece system became the “I am Working for” poster, which was updated and managed to allow Jeff to achieve the reward about once a month.

Reward ideas

The reward system options are endless. The goal is to keep them highly motivating for your child and have them help pick out the next “I am working for…”. They also can be designed to meet every budget – whether you have one or not!

Ideas include:

  • A meal at a favorite restaurant
  • A favorite meal at home including a favorite dessert
  • A new toy or movie
  • A movie rental
  • A trip to the movie theater
  • Atrip to a zoo, amusement park, beach, or park
  • A visit to see a much-loved relative
  • Any other highly preferred activity or item

Make sure your entire team is on board with the reward system, including all family members and professionals.




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