In my practice one of the more common presenting problems is severe tantrums, or meltdowns, in children. Common reactions among adults who care for these children include frustration, embarrassment, desperation and helplessness. Typically, these otherwise competent parents have tried a range of strategies without finding a strategy or strategies that consistently work. They invariably pose one simple question: what do we do when our child is having a severe tantrum or meltdown? What they really want to know is, what works?

The first answer I provide is that there is no known universally effective strategy for managing severe tantrums and meltdowns. If there was, someone would have written about it by now and made a lot of money! The second answer I offer is that effective management of children’s severe tantrums and meltdowns begins with developing an understanding of what is actually going on in the nervous system of a…