How to Approach Your Child’s Behavior Issues When You Can’t Leave the House

By Courtney Smith, MD, FAAP, The Children’s Hospital of San Antonio Primary Care – Dominion Crossing

If you are noticing more tantrums from your toddlers, more attitude from your teens, or rising frustration within your family as a whole, you are not alone. Because of stay-home guidelines, many parents and children have been forced into a “new normal,” now doing school and work from home or shifting into new roles within the family. Add a grumpy, defiant, or exhausted child to the mix and it’s easy to feel like you are drowning.

First, let’s start with some behavior basics. While at times it may seem like your child is pushing your buttons just to test you, most children are not being intentionally disobedient. We know that behavior in kids is an outward manifestation of what is going on within that child. Think of behavior as the tip of the iceberg, or the part you can see above the water. However, the bulk of the iceberg lies below the water and keeps the ice afloat. That part is made up of things like anxiety, fear, sleep deprivation, and other factors that ultimately shape the behavior. Many of those underlying factors are hard for children to identify or talk about, but looking at the cause of behavior change is key to redirecting and reshaping that behavior.

So how do we address the causes of unwanted behavior? Anxiety and fear are important drivers of behavior. Toddlers and younger children are often very dependent on a predictable schedule. There aren’t many things under their control, so knowing “what comes next” is important. Creating a predictable routine can often help decrease anxiety about the unknown and reduce tantrums. For older children and teens, routine is also important, but watching the COVID-19 pandemic unfold is enough to create high levels of anxiety. Talk to your kids. Ask them what they think about the events going on and what they understand about them. You may be able to correct misinformation and reassure them at the same time. Let kids know it’s OK to be frustrated or worried and show them outlets to express those emotions rather than ignoring those feelings.

Healthy meals and exercise are important for growing brains. It’s hard for kids (and adults) to keep their cool when they are hungry or just need to move!  While eating out or going to the playground may not be an option right now, there are a lot of activities you can do as a family to work those muscles and prevent hunger from driving that difficult behavior. Sleep is also important, and just because kids may not be waking up as early for school, staying up all night watching movies or playing games can have major consequences when it’s time to do homework or school assignments the next day. Daily schedules should include meals, wake up time and bedtime as well.

Lastly, help kids connect with one another and family members who they may not be able to see in person right now. Kids can feel isolated just like us, especially when they are used to being at school and extracurricular activities. Create virtual meetings among family members, share a meal together via Facetime, or involve friends or family members for “virtual” story time. Write letters or send words of encouragement to others and show your kids the importance of thinking about others during times of crisis.

So next time you find yourself ready to pull your hair out because of your child’s behavior, take a moment to think about the causes behind that behavior. And if you need some help (which we all do sometimes), reach out to your pediatrician! We are here for you, and many of us are navigating those toddler tantrums and teen angst right alongside you.

Dr. Courtney Smith practices at The Children’s Hospital of San Antonio Primary Care – Dominion Crossing. We are accepting new patients and taking extra precautions at all of our clinics to keep children and their parents safe and healthy. We carefully screen all patients by phone and during each visit, separating our days into morning well visits and afternoon sick visits, minimizing waiting room time and practicing safe social distancing and masking. We also have the ability to do video visits, allowing families to talk with a doctor without leaving home whenever possible. To learn more about our services and locations, find us at

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