If your child hits, kicks or lashes out at other kids, as a parent, you may wonder if you should be concerned.
Children may act out in verbally and physically aggressive ways as a result of feeling threatened or when they have difficulty in regulating emotions, controlling impulses or interpreting social cues.
Tantrums consisting of hitting, kicking and throwing things are often seen in toddlerhood and have resulted in the term “terrible twos and threes.” These behaviors are a part of the normal developmental process of learning to regulate emotions, self-soothe and communicate needs. For instance, biting in toddlers may be due to delayed language development and the resulting difficulty with communicating needs. As children learn these skills, they typically grow out of these tantrums.
However, when physically aggressive behaviors are out of proportion to the circumstances and age of the child, or if they persist, intensify or arise for the first time beyond the kindergarten years, they are a red flag that should raise concerns for parents and teachers.
What are the characteristics of an aggressive child?
An aggressive child is generally not a happy child. An aggressive child may be fearful or falsely perceive threats in the environment. In these situations, the aggressive behavior may represent self-defense in anxiety-provoking situations, also known as the fight response to stress. In older children, physical aggression may be the result of poorly controlled impulses or inability to regulate emotion.
Typically, aggression is followed by remorse. However, some children may not have an understanding of how their aggression impacts others and may not be remorseful after. Some children may have a limited capacity to empathize, even when they realize that they have caused physical harm.
What makes a child act aggressively?
Underlying reasons for aggression in children may include neurodevelopmental disorders like autism spectrum disorder, attention-deficit/hyperactivity disorder, oppositional defiant disorder, anxiety disorder, depressive disorder, or trauma- and stressor-related disorder, to name a few.
Family factors that may contribute to aggression in children may include harsh parenting, abuse, neglect, parental substance use or untreated mental health conditions, and family conflict.
External environmental factors that may cause aggressive behaviors in children range from being bullied at school, the influence of aggressive peers, or exposure to violence in the community or vicariously on TV, in video games or other media.
What can I as a parent or guardian do?
It is important for parents and guardians to maintain their composure to ensure that aggressive behaviors in their child do not worsen and no one gets hurt. Research shows that children learn best through praise and rewarding good behavior, whereas punishment can be harmful and less effective (or even ineffective in some children). Parents and teachers may reap benefits from “catching them being good” and using reward charts to encourage positive behaviors. It is important for parents to coordinate with their child’s school so that all adults involved with the child are on the same page and are able to support the child in a consistent manner.
In cases of extreme aggression, when there is risk of danger to self or others, a parent or teacher can call their state local mobile crisis team to request help. Local mobile crisis intervention services are provided in many states across the country to provide counseling, consultation and triage to care when needed.
When should I seek help?
If aggression and tantrums persist past kindergarten or if the intensity, frequency and duration appears to be more than what is expected for the age group, and/or result in harm to self or others, it is important for caregivers to consult with their child’s pediatrician. The pediatrician would evaluate further and refer to therapy, if appropriate.
In young children, the applied behavioral analysis techniques employed by trained school staff and mental health professionals (such as those at Boston Children’s Hospital) can be helpful in understanding the drivers of aggression. The analysis identifies the antecedents, the specific behaviors and the consequences that maintain or defuse the aggression.
Research shows that therapy can help young children identify their emotions (including frustration), learn to channel them in acceptable ways and communicate their needs. Parents of young children are often included in therapy sessions, so that they can learn about their child’s triggers and practical ways to prevent aggression and de-escalate aggressive behavior when it does occur.
Collaborative problem-solving is a therapeutic technique that teaches caregivers to work with their highly reactive child and come up with safe choices and mutually acceptable solutions for triggering events.
Another form of therapy suitable for young children and their parents is parent-child interaction therapy, or PCIT. This therapy helps parents master the skills of staying calm and consistent, establishing appropriate limits and consistency in discipline based on a foundation of a strong, secure and loving relationship.
Cognitive behavioral therapy (CBT) can help older children understand the connection between their thoughts, feelings and behavior and thereby learn positive coping strategies.
Lastly, some children may benefit from medication in addition to therapy. Medication management of underlying conditions like attention-deficit/hyperactivity disorder can be key to resolving aggressive behaviors in some children.
