Definition

Terrible two is a term used to describe the behavioral changes that parents often notice in two-year-old children. This age is described as terrible or unpleasant because of the rapid changes in the child's behavior and mood and the parents' difficulty in dealing with them. At one moment, your child can be spoiled, and they can throw a tantrum quickly. Although exhausting, this is a normal developmental phase experienced by young children, characterized by tantrums, arguing, and other behaviors that make parents often impatient.

Despite the name terrible two, this condition does not only occur in children who are two years old but can begin to occur when the child is 18-30 months old and can remain until the age of 3 years, even 4 years. However, tantrums will usually become less frequent at three because the child's language and motor skills will be much more developed to express themselves, understand instructions, and follow orders from parents, teachers, and caregivers.

Some children go through terrible two without significant tantrums, usually because the child has better language skills, so it is easier to communicate their thoughts, and they are less frustrated.

Causes

The toddler years are an important period of intellectual development and growth. During this time, children experience significant development in motor, intellectual, social, and emotional skills. Children begin to walk, talk, have opinions, and have emotions. Children are also curious about their environment and want to do things their way. This is very normal behavior.

However, since toddlers' verbal, physical, and emotional skills still need to be fully developed, children are more likely to get frustrated when they fail to communicate their wishes or do something they want.

Some examples of situations that can cause frustration in a two-year-old:

• The child is unable to name the item they want
• The child is impatient to wait for their turn
• The child tries to do something, such as pouring milk into a glass, but because their coordination of movements is imperfect, they fail to do it.

Risk factor

Several factors can increase the likelihood of a child behaving more aggressively or experiencing terrible two, including:

• Exposure to alcohol while in the womb
• Exposure to violence at a very early age

Symptoms

Symptoms of Terrible Two in children can vary, but some patterns of behavior can be a reference for parents to recognize the presence of Terrible Two in children. The following are symptoms or behaviors of children with Terrible Two:

• Tantrums can range from simple whining to hysterical emotional outbursts. During tantrums, children often cry and shout or do things like hitting, kicking, biting, or throwing things. According to studies, this tantrum phase usually ends within five minutes in 75% of children with tantrums.
• Argue. Every day, a child gains new skills, so naturally, the child wants to try new things. This will make the child refuse things that usually do not cause problems; for example, the child will refuse to be held while walking. Children will also become more independent, so they choose to do everything themselves, even though they may not be able to do some things alone.
• Mood swings from happy tantrums to crying, and so on. At one moment, the child can play happily and, in a short time, will throw a tantrum and cry. This results in frustration in children who want something but do not yet have the ability or cannot communicate it.
• Fighting with siblings or playmates more than usual. 

Diagnosed

Terrible two are determined not by the child's age but by the child's symptoms and behaviors. It is important to distinguish between terrible two and more serious behavioral problems. Signs that suggest a tantrum may be a more serious problem are

• Tantrums are persistent (more than half the time the child is awake) and are accompanied by hitting, kicking, biting, or other physical behavior toward parents or caregivers.
• Tantrums where the child tries to hurt themselves
• Frequent tantrums (more than 10-20 times per day)
• Frequent tantrums lasting more than 25 minutes
• The child is unable to calm themselves during tantrums
• Tantrums that do not decrease when the child is older than two years of age

Management

During the terrible two, it is normal for parents to lose patience with their children. There are some tips for dealing with terrible twos, including:

• Distract the child during a tantrum, if you can't let the child stop the tantrum. Children will slowly realize that their bad behavior will not get a response.
• Do not give what the child wants during a tantrum
• Discipline children by giving time out or prohibiting activities that children like temporarily
• Calm yourself when the child tantrums. Your emotions will not help reduce the child's tantrum. Sit down and take three deep breaths.
• If the tantrum occurs in a public place, pull your child to a quiet place without scolding them and wait for them to calm down.

Complications

Extended and frequent tantrums can disrupt regular eating and sleep patterns, potentially challenging a child’s learning process.

Prevention

The way to prevent terrible two is to avoid triggers that generally cause emotional outbursts. Examples of what can be done are : 

• Praising the child's good behavior and not responding to bad behavior
• Creating a regular eating and sleeping schedule. Limiting children's activities beyond bedtime can be useful because fatigue or drowsiness is one of the triggers for tantrums. Also, do not tell the child to do something when hungry, as hungry children tend to throw tantrums.
• Do not hit or yell at the child. It would help if you modeled gentle behavior to the child.
• Allow children to express themselves by giving them two choices, for example, asking if they want to wear shoes or sandals today.
• Make simple rules, and explain in simple language if the child does not understand.
• Create a safe environment for the child to avoid unwanted things such as falling and causing tantrums.
• To avoid tantrums in public places, avoid traveling with your child during bedtime.

When to see a doctor?

Tantrums and defiance at the age of two are normal, but if you feel that your child's behavior has become excessive or you feel overwhelmed, you may consult a doctor. You should also consult a doctor if your child's school teacher or caregiver reports any of the following in your child:

• Withdrawing from the social setting
• Does not show eye contact when communicating
• Is very aggressive or argues frequently
• Is violent or tries to hurt themselves or others
• Overwhelms teachers or caregivers

Toddler Bedtime Routine: Establish Sleep Patterns. Healthline. (2022). Retrieved 4 February 2022, from https://www.healthline.com/health/parenting/toddler-bedtime-routine#bedtime-chart. 

Terrible twos: Why are 2-year-olds so difficult?. Mayo Clinic. (2022). Retrieved 4 February 2022, from https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/terrible-twos/faq-20058314. 

Helpful Tips to Manage the Terrible Twos. Verywell Family. (2022). Retrieved 4 February 2022, from https://www.verywellfamily.com/terrible-twos-and-your-toddler-2634394. 

Tips to Help You Survive Your Toddler's 'Terrible Twos'. Cleveland Clinic. (2022). Retrieved 4 February 2022, from https://health.clevelandclinic.org/tips-help-you-survive-your-toddlers-terrible-twos/.