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Unruly Behavior: When to Seek Help

Amanda Rogers (not her real name) started throwing tantrums when she was 3. "Over time they grew worse, until she was having up to five fits a day," her mother reports. "There was lots of uncontrolled screaming and writhing on the floor. Sometimes she would yell, 'Help me! Help me!'"

One afternoon, in the midst of such a meltdown, a police officer knocked at the door; someone had reported a child in distress. He gave Amanda's mom the name of a child psychologist. Eleven counseling sessions later, the girl's hysterics were history.


All preschoolers can be difficult, but some behavior crosses the line. If a child's actions are placing himself or anyone else at physical risk  -- for instance, he often bites when being reasonably disciplined  -- parents should seek help, says Mark Roberts, Ph.D., director of clinical training in the psychology department at Idaho State University.

And as they get closer to 5, children should understand and obey most rules; if they have persistent emotional reactions to gentle discipline, such as time-outs, or frequently show aggression past age 4, you should consider outside help. Also, if a child's behavior disrupts the household to the extent that his parents are constantly exhausted, it's time for a consultation.


Uncomplicated behavior problems, such as tantrums thrown by a 2-year-old, can usually be handled in three to five sessions; more severe problems may take six to a dozen meetings, says Michael Rapoff, Ph.D., chief of behavioral pediatrics at the University of Kansas Medical Center. The length of each session and whether parents are present depends on the counselor's philosophy.

Don't worry  -- a child's therapy session won't involve lying on a couch recounting dreams. Typically, at first the counselor will ask you questions, observe how you and your child interact, and then screen her for developmental problems or mental health disorders that may need special treatment, according to Roberts.

After that, the focus turns to changing and managing the child's behavior. Sometimes the secret to resolving a discipline problem is not in changing how she behaves, but rather in learning new ways to interact with her.

In Amanda's case, the psychologist instructed her mother to spend 20 uninterrupted minutes (no siblings or other distractions) with Amanda each day, allowing her to call the shots regarding how they'd play. "After I followed through, Amanda stopped having writhing-on-the-floor tantrums," her mom reports. "She still gets upset, but now her outbreaks are more like those I've heard other mothers fretting about."<p