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Raising children often presents challenges that parents must constantly face, especially when they reach the age of 2 years. A common issue encountered is the stubborn behavior often referred to as “the terrible twos” or “Terrible two”. Despite the difficulties in dealing with the child, the doctor wants parents to feel “joyful” about what they encounter because it shows that “our child is developing 
progressively and growing up”
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The age of 2 is a stage where physical, cognitive, and emotional development is clearly visible. Children begin to show autonomy, wanting to do things according to their own wishes or wanting to engage in activities by themselves. However, sometimes it may be beyond their ability to do or unsafe for them to do, resulting in being prohibited by caregivers. This leads to dissatisfaction, frustration, and inappropriate behavior.
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<h2>How to handle your child</h2>
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<li style="list-style-type: none;">
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<li style="font-weight: 400;" aria-level="1">Every behavior has a cause or trigger. Parents should observe what the “root cause” is that triggers the stubborn behavior at that time, such as wanting a toy but parents refuse to buy it, causing the child to lie down and cry on the floor, or throwing a tantrum refusing to take a bath because they want to keep playing with the toy.</li>
<li style="font-weight: 400;" aria-level="1">Once the “root cause” is known, if possible, avoid facing that situation.</li>
<li style="font-weight: 400;" aria-level="1">If avoidance is not possible, make a clear agreement beforehand, for example, today we will not buy toys. If you throw a tantrum, we will go home immediately. Parents must follow through with the agreement so the child learns the consequences.</li>
<li style="font-weight: 400;" aria-level="1">If the child shows stubborn behavior at that moment
<ul>
<li style="font-weight: 400;" aria-level="2">Reflect the emotions occurring using simple language and briefly explain, for example, “Mom knows you are sad that you can’t keep playing” 
and wait for the child to gradually calm down.</li>
<li style="font-weight: 400;" aria-level="2">If the stubborn behavior is to get parents’ attention, such as screaming loudly, it is recommended that parents avoid responding by turning their attention away or talking to someone else.</li>
<li style="font-weight: 400;" aria-level="2">If there is self-harm or harm to others, such as biting, hitting, kicking, or destroying things, “stop immediately”, reflect the emotion and explain what is not allowed, for example, “Mom knows you are angry, but you cannot hit Mom.”</li>
</ul>
</li>
<li style="font-weight: 400;" aria-level="1">If the stubborn behavior or tantrum occurs during daily routines
<ul>
<li style="font-weight: 400;" aria-level="2">It is recommended that parents “set a daily schedule” with clear times for different activities. 
Use pictures as a medium so the child can easily understand (Visual schedule).</li>
<li style="font-weight: 400;" aria-level="2">Give a warning 5-10 minutes before the time ends as a signal to prepare.</li>
<li style="font-weight: 400;" aria-level="2">You may use an analog clock with a marked point where the hand reaches when time is up, or use an hourglass to make the concept of time clearer.</li>
</ul>
</li>
</ul>
</li>
</ul>
<ul>
<li aria-level="2">When the time is up and the child cooperates, promptly praise them with “Mom is happy that you cooperated and followed the time.”
<ul>
<li style="list-style-type: none;">
<ul style="list-style-type: circle;">
<li aria-level="2">If the child resists when time is up, use the technique of “offering choices with outcomes predetermined by the parents” so the child feels they “have a part in choosing their own activities.” For example, when it’s time to take a bath, offer the choice of using the blue bottle or the yellow bottle of soap today, or at bedtime, offer the choice of whether the child or the parent will turn off the light.</li>
</ul>
</li>
</ul>
</li>
<li style="font-weight: 400;" aria-level="1">Do not teach when emotions are high. Wait until both parents and child are calm, and find a good time, such as before bedtime, to talk and teach the child further through stories or fairy tales.</li>
<li style="font-weight: 400;" aria-level="1">Increase attention and praise when the child shows desirable behavior.</li>
<li style="font-weight: 400;" aria-level="1">Reduce factors that make self-control difficult for the child, such as insufficient sleep, hunger, or illness.</li>
<li style="font-weight: 400;" aria-level="1">When parents respond appropriately, consistently, and uniformly to the child’s stubborn behavior, the child will learn that being stubborn will not get what they want. The stubborn behavior will gradually decrease and eventually disappear.</li>
</ul>
 
If parents are unable to handle their child’s stubborn behavior or if the child’s stubborn behavior becomes more severe, they should consult a developmental and behavioral pediatrician for further evaluation and solutions.
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Dr. Panyachalee Jongpaiboonpatana 
Developmental and Behavioral Pediatrician, Phyathai 2 Hospital
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Raising children often presents challenges that parents must constantly face, especially when the child reaches the age of 2 years. A common problem encountered is the stubborn behavior often referred to as the "terrible twos" or "Terrible two."

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