Dear Dr. Sylvia

Complex Tantrums Need Anger Management

July, 2016


My 10-year-old granddaughter has been diagnosed with Autism Spectrum Disorder (ASD) and has many medical problems as well. She has been doing extremely well in a regular, private school. She is the model student, excels academically in music and art, and has won many awards. She tests above the 95 percentile academically, and her thirst for learning is huge. While she is not socially popular, she has a few friends and is included by the other children. The school has zero tolerance for bullying.

Our concern is that my granddaughter has huge temper meltdowns. At school she has complete control, but at home she is dangerous to herself and her siblings. She goes to extremes in no time at all. She will hurl objects at people, scream dangerous threats, and threaten suicide.
She has these outbursts in public with her mother, hurling herself to the floor kicking and screaming in places such as the grocery store. She hasn’t had a meltdown in public with her dad, but she does have meltdowns at home with him. Time-outs do not work. She kicks holes in walls, and locks have had to be placed on windows. Therapy and medications have not helped so far. 

My granddaughter is a lovely, bright, charming child when she is not having a meltdown. She has had a small job working in her dad’s store this summer and has done very well. She is polite, meticulous, and charming; and she seems sensitive to others. Seeing how she works with the public, you would never know about these meltdowns.
In order to get an Individualized Education Plan (IEP), my granddaughter will be switching to a public school. She is excited about the prospect of new friends, but we are terrified about a low self-image child being brought down even more by having to go to public school. She has tics, is partially blind and wears a shoe lift and therapeutic sneakers. We fear that this host of obvious disabilities will make her a target for bullies. Her parents plan to return her to private school if the public school does not work out.  

Any suggestions would be appreciated. This could be the loss of a very bright, young life if we cannot figure out how to save her. Thank you!



Your granddaughter’s behaviors are so serious and problematic, it would be impossible for me to give a solution by letter. I can tell you that her parents seem to be using resources well and should continue to search out other possibilities. There are a few techniques that I can suggest to add to your already large bag of tricks, but all should be discussed with her present therapists before attempts to use them.

Because your granddaughter is absolutely capable of holding things together in school, you know that she is embarrassed for other important people to see her behavior. She is old enough for capable therapists to teach her anger management tools for self-control. She will need to choose a quiet time-out space for herself and an activity that calms her while in time-out. As she learns to use her tools, her parents can video any tantrums when she fails to use her management tools. They can share the videos with her and her therapists. This technique of helping a child to view her own behavior sometimes causes sufficient awareness and embarrassment to motivate her to manage her own anger. Behavioral rewards can be added to encourage her positively for each good day at home.

In addition, parents should note any behavior or food triggers that may occur on days where she can’t control her behavior to see if they can identify a pattern. Sibling issues also need to be carefully observed because they may be an important part of her problem. A regular exercise routine can also reduce anxiety. It would be important for all adults to monitor talks about her issues within her hearing (referential speaking) so that she doesn’t feel helpless to control her anger.

Dr Sylvia RimmDr. Sylvia Rimm is a child psychologist and clinical professor at Case University School of Medicine, author, newspaper and magazine columnist, and radio/TV personality. For free newsletters entitled How to Parent So Children Will Learn and/or Sibling Competition, send a self-addressed, stamped envelope for each newsletter and a note with your topic request to P.O. Box 32, Watertown, WI, 53094. Read Dr. Rimm’s Articles for Parents and Teachers and submit family questions online at All questions are answered.

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