It’s normal for young children between the ages of 5 and 10 to get frustrated from time to time, throw a temper tantrum, and even throw toys or yell at friends and family. However, when those Tantrums are excessively violent and aggressive, and they are highly disproportionate to the event that caused them, often without a realistic or socially acceptable cause, it could be indicative of intermittent explosive disorder.
Intermittent explosive disorder in children is a behavioral disorder that has to do with impulse control and behavior. If your child shows symptoms, it’s important that you get a correct diagnosis and start an individualized treatment plan to help them learn how to manage their emotions and behaviors.
What is Intermittent Explosive Disorder?
Intermittent explosive disorder (IED) is a mental health disorder. In the DSM, it is listed under the category of disruptive, impulse-control, and conduct disorders. Children with IED have symptoms of recurrent outbursts that can be physical or verbal, relating to an inability to control aggressive impulses.
The symptoms often cause significant distress to those around them as well as the individual with intermittent explosive disorder.
Recognizing Intermittent Explosive Disorder in Children Aged 5-10
In children between the ages of five and ten, you can recognize childhood intermittent explosive disorder by way of things like frequent outbursts which happened two or more times per week, for 3 months straight, or three or more outbursts in a given year,
Additionally children will have marked distress from those outbursts that can cause disruptions at home or at school. The outbursts themselves are always disproportionate to the situation and typically not premeditated.
These outbursts are often characterized by property damage, harm to animals, physical fights, temper tantrums, and verbal arguments with others.
Causes and Risk Factors of Childhood Intermittent Explosive Disorder
The most common causes and risk factors for childhood intermittent explosive disorder include trauma as a child, particularly exposure to violence or abuse.
Children with certain medical conditions, particularly TBIs, are more likely to develop childhood intermittent explosive disorder, as are those with a family history of mental illness, particularly mood disorders.
It is also more likely in males, especially males who grow up in chaotic or otherwise harmful environments like those filled with substance abuse.
Diagnosing Intermittent Explosive Disorder in Children
Intermittent explosive disorder in children 5-10 years old has to be diagnosed by a healthcare professional.
For intermittent explosive disorder, children are diagnosed based on the following criteria:
- Individuals exhibit recurrent behavioral outbursts that indicate a failure to control their aggression, including either of the following:
- Verbal aggression, including verbal fights, tirades, or temper tantrums; physical aggression toward individuals, property, or animals. Either taking place a minimum of two times per week for an average of 3 months at a time. Physical aggression does not need to result in damage or destruction nor cause any injury to individuals or animals to qualify.
- Three behavioral outbursts that involve destruction or damage, including physical assault involving personal injury, within a 12-month time frame.
- The aggressive nature of outbursts is significantly disproportionate to the provocation or stressors.
- The recurrent aggressive outbursts cannot be premeditated, nor can they be committed to achieve an objective.
- The recurrent aggressive outbursts must cause significant distress or have other consequences.
- The chronological age of the individual experiencing the outbursts must be at least six.
Note:
The symptoms of childhood intermittent explosive disorder are very similar to other conditions like conduct disorder and oppositional defiant disorder.
For this reason, the diagnosis process will utilize assessment methods, including behavioral observations and parental input, to rule out other conditions and determine whether there are any co-occurring conditions alongside intermittent explosive disorder in children.
Treatment Options for Intermittent Explosive Disorder in Children
With intermittent explosive disorder, children will be provided individualized treatment options that include things like behavioral therapy, parent-child interaction therapy, and medication if necessary.
Behavioral Therapy
Research indicates that behavioral therapy can be very successful in treating childhood intermittent explosive disorder. Things like cognitive behavioral therapy and anger management can help children recognize the situations where they most commonly have explosive episodes and then find healthier ways to manage the feelings, both physical and emotional, associated with those episodes.
During cognitive behavioral therapy, children and parents or guardians will participate in the therapy sessions and learn how to better understand triggers for certain outbursts and the most successful ways to manage those triggers without resorting to verbal tantrums or violent behaviors.
Parent-Child Interaction Therapy (PCIT)
With intermittent explosive disorder in children 5-10 years old, the prognosis is better when there is family involvement, particularly with parents.
Parent-child interaction therapy is done with coaching sessions where a parent and child come to the same playroom and get observed by a therapist with things like live video feeds or one way mirrors. Parents will wear devices in their ear and be led through coaching skills from the therapist in real time.
This type of treatment works to:
- Decrease the frequency or severity of tantrums
- Decrease negative attention-seeking behaviors in children
- Decrease frustration in parents
- Increase prosocial behaviors
- Improve attachment, security, and safety with parents
- Increase attention span
- Provide more positive interactions between parents and children
All of these goals are completed in two types of treatment phases, the first of which focus is more on establishing that warmth and security with the parent so that the children learn how to be calm and the second of which teaches children to maintain good behavior through consistent disciplinary approach and respect for things like parental rules and house rules.
During the second phase of treatment, children and parents work together to:
- Decrease destructive behavior
- Decrease aggressive behavior or defiance
- Increase compliance with rules and adult requests
- Improve public behavior
- Increase confidence in parents as they discipline their children consistently
Much like the cognitive behavioral therapy above, parent-child interaction therapy also has a set number of sessions with homework.
Medication Option
With childhood intermittent explosive disorder, there might be medications that can help treat secondary symptoms, although there is no specific medication for the condition itself.
Antidepressants can be prescribed to help adjust serotonin in the brain, which can cause mood stabilization.
Anticonvulsant mood stabilizers can help reduce nerve impulse excitability, which reduces extreme mood episodes.
Antianxiety medications can reduce anxiety and adrenaline and regulate high blood pressure that often leads to feelings of anger and subsequently fuels the angry outbursts and violent tantrums that children have.
When to Seek Further Professional Help
There is no set line at which point you should seek professional help for intermittent explosive disorder in children. If you see signs of behavioral problems, don’t hesitate to get a professional diagnosis to determine whether or not it is an intermittent explosive disorder or another condition.
The sooner you reach out and consult with a mental health specialist, the sooner a personalized treatment plan can be developed, giving both parents and children the resources they need.
Resources are available, such as pediatric psychologists and behavioral therapists, who can help manage symptoms effectively and improve overall outcomes with early intervention.
Summing Up
Overall, there are key strategies for managing intermittent explosive disorder in children, including medication, therapy, and parent-child interaction therapy, as well as support groups and other resources. As a parent, seek support as soon as you notice symptoms and find ways to remain consistent with your treatment to optimize outcomes for your child.