Temper tantrums, aggression and emotional dysregulation — formative SAQs

SAQ 1 — Sorting expected tantrums from impairing dysregulation (10 marks)

A mother of a 30-month-old says tantrums are “constant.” Development is reported as normal. There are no injuries. She wants “something stronger than time-out” and asks if smacking is acceptable. [2] [4]

Questions

1. List five history features that separate expected temper loss from impairing dysregulation. (3 marks) [4] [5]
2. Outline first-line non-pharmacologic management for impairing preschool externalising behaviour, naming the evidence class for parenting programmes. (4 marks) [6] [7]
3. How do you counsel regarding corporal punishment, with guideline and outcome evidence? (3 marks) [2] [3]

Model answer

History discriminators (3). Ask frequency, duration, intensity, recovery time, and settings (home/childcare). Add injury/property damage, developmental red flags, sleep, and caregiver strategies. Expected tantrums are brief and recoverable; impairing patterns are frequent, prolonged, multi-setting, slow to recover, or unsafe. [4] [5]

First-line management (4). Validate caregiver distress; map ABC function; coach routines, labelled praise, planned ignoring of safe attention-seeking tantrums, and calm consistent limits; treat modifiable drivers (sleep, pain, language). Refer to behavioural/cognitive-behavioural group parenting programmes (Cochrane support for early-onset conduct problems) or PCIT-type interventions with meta-analytic/RCT support. Medication is not first-line for typical or many preschool tantrum presentations. [1] [6] [7] [15]

Corporal punishment (3). Do not recommend smacking. AAP effective-discipline guidance centres positive parenting and does not support corporal punishment. Gershoff meta-analyses associate spanking with detrimental child outcomes. Offer practical alternatives and safety-net. [2] [3]

SAQ 2 — Function, language delay and safety conversion (10 marks)

A. A 3-year-old with language delay hits to obtain toys. B. A 5-year-old destroys property at home and childcare and has injured a sibling. C. A child arrives encephalopathic after a “behaviour” referral. [1] [15]

Questions

1. Name the likely behavioural function in scenario A and the paired developmental action. (3 marks) [15]
2. Build an immediate and stepwise plan for scenario B, including closed-loop elements. (4 marks) [1] [6]
3. What is the correct first move in scenario C and why? (3 marks) [1]

Model answer

Function and language (3). Hitting that obtains toys is often tangible-maintained; with language delay it also communicates need. Provide behaviour strategies and concurrent speech/language and developmental supports rather than punishment alone. [1] [15]

Multi-setting injury risk (4). Safety plan now (supervision, remove unsafe objects, who to call). Structured ABC assessment multi-informant. Parent-training referral, childcare behaviour plan, developmental/mental-health assessment as indicated, treat drivers. Name owner, date, interim coaching and return precautions — no open-loop referral. [1] [6]

Medical convert (3). Encephalopathy is not a parenting problem. Convert to acute medical assessment and stabilisation; defer routine behaviour counselling until the child is safe and a medical cause is addressed. [1]