Usually, temper tantrums last 30 seconds to 2 minutes and are most intense during the first 30 seconds. During a tantrum, a child may:

• Cry, scream, or shout.
• Arch the back or tense the body.
• Flail the arms.

Temper tantrums are most likely to occur when a child is afraid, overtired, or uncomfortable. Breath-holding spells may sometimes occur with tantrums.

Difficult behavior that frequently lasts longer than 15 minutes, occurs more than 3 times a day, or is more aggressive may indicate that a child has an underlying medical, emotional, or social problem that needs attention. These are not considered typical temper tantrums. Difficult behaviors may include:

• Kicking, hitting, biting, scratching, hair pulling, or pinching other people.
• Throwing or breaking things.
• Head-banging or inflicting self-injury.

Although breath-holding alone is not a sign of a an underlying health or behavioral problem, it may need evaluation if it occurs with other more violent symptoms.