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Parents of all toddlers are well acquainted with tantrums that end as suddenly as they begin. Most children throw tantrums when they are frustrated, holding their breath, crying or screaming to get their way. But in children with autism, tantrums are more frequent and go even deeper, according to a study in the February issue of Developmental Rehabilitation.

The new study suggests that children with autism who communicate well are just as likely to have tantrums and other aggressive behaviors as those who struggle with language. This finding contradicts a common perception that the latter are more likely to act out because they have trouble expressing themselves.

In the study, the parents of 247 toddlers with autism were about twice as likely to report conduct problems in their children than were parents of 211 toddlers with pervasive developmental disorder not otherwise specified, an autism spectrum disorder. They were also four times more likely to report these behaviors than were the parents of 316 toddlers with other forms of atypical development.

The results suggest that autism inherently increases the likelihood of tantrums in children. Autism is thought to result from an imbalance between excitation and inhibition in the brain, which could lead to certain behavioral problems.

Whatever the cause, tantrums in autism are likely to be unique to the disorder: children with autism and their parents are dealing with more than just a bad case of the ‘terrible twos.’