Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Defiant and Angry Three-Year-Old | | | QUESTION | | | Dear Dr. Needlman,
My daughter is three years old and is very defiant. She hits, bites, and throws things when she is angry or doesn't get her way. She gets very angry. Time-outs do not work because she won't stay in her room. I hold the door shut and she continues to scream, kick, and hit the door. Then she gets more worked up and angry. It becomes a vicious cycle. What do we do?— Monica and Tim in Portland, Oregon | | | ANSWER |
July 30, 2001 | | | Dear Monica and Tim,
The problem you write about is very common and also very difficult. The solution will depend on your child's medical history, her developmental history, your family's medical and behavioral history, and the specifics of her behaviors: where do they occur (home and school, or only home), what exactly the behaviors consist of, what sets her off, how precisely you and your spouse respond, and how she then responds to your response.
I cannot give you the answer to your question, but I can point you in the right direction. With extremely defiant and aggressive children, parents need special skills above and beyond good parenting. Reading books and other literature can help somewhat, but to really gain these skills, there is no substitute for working with a skilled professional. This person might be a pediatrician, developmental-behavioral pediatrician, child psychologist or psychiatrist, or social worker. A thorough medical assessment is important, as part of the child's evaluation, because there are medical and psychiatric conditions that can show up in very aggressive behaviors that need treatment.
Many cities also have programs that provide parents with hands-on training to be able to manage extremely challenging behavior. In some locations these programs are administered through the county Board of Education as part of their preschool special education programs. Often, these programs are free. One of the things parents learn is how to gain physical control over their out-of-control children, without doing harm or being harmed themselves. Once children know that a parent is truly in control, they feel safer and can relax somewhat.
I have seen many young children with the behaviors you have described. With hard work and perseverance, they have been able to make remarkable progress. For more on anger in young children, look at the Aggression and Temper Tantrums sections of our site. As a first step in getting assistance, talk with your child's doctor or nurse practitioner.— by Robert Needlman, M.D., F.A.A.P. |
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