Aggression, Ages 3 to 6

My child hits, kicks, and bites other kids. Should I be concerned?

Not necessarily. Aggressive behavior is a normal part of emotional and behavioral development, and almost every child hits, kicks, and yells when he's overwhelmed by strong emotions. However, if your child is frequently aggressive or is prone to shows of extreme temper, don't dismiss it as "Kids will be kids." He should be beginning to outgrow physical aggression by this age as he discovers that he can use words instead of his fists or feet. Between the ages of 2 and 5, a child's vocabulary and grammar skills grow rapidly, and he learns from trial-and-error (and adults' guidance) that he'll get better results from talking out a dispute than from yanking his playmate's hair.

Some children, however, have trouble developing language skills or have behavioral, emotional, or learning disorders that result in especially high levels of anxiety, fear, frustration, or anger. When such a problem is uncovered, parents, teachers, and counselors can guide the child in ways that don't lead to pent-up fear and fury, thus tempering or even resolving the difficult behavior.

The most common reason children become aggressive, though, is because they've witnessed aggression. If your child has been exposed to violence, whether at home or in a place where you have less control over what happens, take steps immediately both to ensure it doesn't continue and to help him understand that it shouldn't have occurred.

If your child's aggressive behavior is frequent and severe, or your efforts to curb it have no effect, you'll need to consult your pediatrician or a trained mental health professional, such as a child psychologist or psychiatrist.

What are the characteristics of an aggressive child?

Nearly all preschoolers occasionally grab a toy from a classmate or scream themselves into a full-out temper tantrum. But a child who has a problem with aggression typically behaves in these ways:

• Frequently loses his temper, getting intensely angry.
• Is extremely irritable or impulsive.
• Is frustrated easily and has a short attention span.
• Physically attacks and fights other children or adults.
• Is frequently disruptive, argumentative, or sullen.
• Performs poorly in school or can't participate in organized group activities.
• Has trouble taking part in social situations and making friends.
• Argues or fights constantly with family members and inevitably resists parental authority.

What makes a child act aggressively?

Physical fear is one straightforward explanation. Your child may lash out, for example, if he feels cornered by another child. Other reasons have less to do with instinct and more to do with circumstances. These are years when children are learning a vast array of new skills, so they can easily become frustrated. Being asked to adjust to new routines, such as daycare or preschool, can also mean less time at home with their parents. If they feel resentful or neglected, they may react by pouncing on the nearest playmate. In addition, children sometimes bite, hit, or throw a tantrum simply because they're exhausted or hungry. There are still other reasons for especially aggressive behavior. Some of those that warrant particular concern are:

• Family difficulties or discord. Children often act out in response to family strife, whether it's battling parents, a sibling who teases relentlessly, a move to a new area, or the loss of the breadwinner's job. Such tensions and changes stress children as well as parents, and even a youngster who doesn't understand all the details may react by socking other kids on the playground or tearing apart one of his sibling's toys.
• Neurological problems. Sometimes damage or chemical imbalances in the brain lead to aggressive behavior. If you're concerned about this, consult your child's doctor and consider talking to a specialist.
• Emotional trauma. Divorce, the death of parent, domestic violence, or sexual abuse can create a level of anxiety, fear, anger, and depression that a child cannot control or express except by lashing out. Children who are exposed to violence or abuse at home or in their neighborhoods are more likely to act aggressively than other children. (Witnessing violence, even when it's directed at someone else, can be just as devastating for a kid as being a firsthand victim.)
• Behavioral disorders. Nearly half of all children with attention deficit/hyperactivity disorder (ADHD) also have oppositional defiant disorder, a condition marked by aggressive conduct. ADHD needs specific treatment, so that a child can learn ways to perform academically, socially, and within his family.
• Exposure to violent television shows and movies or snippets on a smartphone. Most experts believe that witnessing on-screen violence can temporarily arouse children's aggression. The American Academy of Child and Adolescent Psychiatry recommends that you monitor your child's viewing selections, especially if he's prone to aggressive behavior.

What can I do?

First, don't get aggressive yourself. Yelling, throwing things, and calling your child names will never get him to curtail his bad behavior -- you'll just give him an example of new things to try and get him even more riled up. Show your child that you can control your temper, and he'll eventually learn that he can control his. No matter how angry you feel, never hit your child -- give yourself time to calm down.

If you have trouble with this, try to identify the thoughts that infuriate you. Maybe every time your child disregards what you say, you infer that he's waging a war against you, and that thought triggers your anger. Remind yourself that, realistically, most kids in this age range don't follow instructions quite frequently; they may be trying out their growing independence or may simply be distracted by an interesting sight or activity. Decide that the next time you have that thought you'll take a deep breath, count to 10, and tell yourself, "This isn't a war. I'm not going to get angry." If necessary, walk to the other end of the room and wait there until you've cooled off.

Second, you need to teach him to recognize and understand his emotions and guide him toward acceptable ways of letting his anger, fear, and disappointment show. These tips may help:

• Respond immediately when your child acts aggressively. Don't wait until he punches his brother to say, "Okay, that's enough!" Your child should know instantly when he's done something wrong.
• Cool down; then discuss what happened. The best time is after your child has settled down but before he forgets the episode -- ideally, an hour or so. Calmly and gently review the circumstances that led to the aggressive behavior. Ask your child to explain what triggered it. Emphasize that it's perfectly normal to have angry feelings but it's not okay to express them by hitting, kicking, or biting. Suggest better ways of responding, for example, by verbalizing his emotion ("I feel really mad because you took my basketball") or by seeking out an adult to mediate the dispute. You might also recommend that he walk away from the situation or person that's infuriating him in order to think about how best to respond.
• Discipline consistently. As much as possible, respond to each episode the same way. Over time, your boringly predictable response ("Okay, you punched Billy again. That means another time-out") will set up a pattern that your child will recognize. Eventually, he'll internalize this pattern and anticipate consequences before he acts, which is the first step in controlling his own behavior.
• Promote self-control. Instead of paying attention only when your child is bad, try to catch him being good -- for example, when he asks to have a turn at the computer game instead of snatching the joystick away. Show him that self-control and conflict resolution are more emotionally satisfying -- and get better results -- than bashing someone over the head. You might also suggest blowing bubbles together to cool off -- the deep breathing will help calm your child.
• Teach the moral reasons for not acting aggressively. Tell your child that acting out physically isn't right because it hurts other people. Even if he can't quite grasp the concept of right and wrong, it's important that you lay the groundwork now for him to develop empathy and ethics.
• Try to spend more close time together. Sometimes children act out because they feel neglected. If you don't already have them, create some anchoring rituals they can count on, like playing outside together, talking while you make dinner, and a daily bedtime routine that includes a storybook and a cuddle. Be sure to give them some undivided attention every day -- without a cell phone in your hand.

When should I seek help?

Consult your pediatrician if the techniques above don't make a difference or if your child's aggressive behavior is making it difficult for him to participate in school, family, or other activities.

Your pediatrician may refer you to a child psychologist or psychiatrist, who can assess your child for emotional or behavioral problems or a learning disability that may be leading to aggressive behavior.

Depending on what problems are uncovered, treatment may include behavioral therapy, a specialized instructional approach in school, and family counseling.

Dealing with aggression in your child is unsettling and demands great patience. Get yourself some help, too, whether through individual counseling, a support group, or just long talks with close friends. When you feel supported yourself, you can give your child the steady, loving guidance he needs.

References

American Academy of Child and Adolescent Psychiatry. Facts for Families: Conduct Disorders.http://aacap.org/cs/root/facts_for_families/conduc...

American Academy of Child and Adolescent Psychiatry. Facts for Families: Understanding Violent Behavior in Children. http://aacap.org/cs/root/facts_for_families/unders...

American Academy of Child and Adolescent Psychiatry. Facts for Families: Fighting and Biting. 2008. http://www.aacap.org/cs/root/facts_for_families/fi...

American Academy of Child and Adolescent Psychiatry. Children and Watching TV. http://www.aacap.org/cs/root/facts_for_families/ch...

US Food and Drug Administration. FDA Alert Suicidal thoughts or actions in children and adults. http://www.fda.gov/cder/drug/InfoSheets/patient/Bu...

National Alliance on Mental Illness. Attention-Deficit/Hyperactivity Disorder. http://www.nami.org/Template.cfm?Section=By_Illnes.../ContentManagement/ContentDisplay.cfm&ContentID=9554

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