Hello. Welcome to Ask A Doctor . I have read your query and here is my advice. You must have been frightened when you witnessed your granddaughter s behavior. You did the right thing coming for help. I want to give you insight about her problem. Temper tantrums can occur between one year and five years of age. Children who aren t able to express their feelings with words are more likely to continue having tantrums. These types of children include those with speech and language delays and those with autism spectrum disorders. Tantrums that are severe, frequent, or persist after the age of five years can be a sign of depression, low self-esteem, ADHD. Children who hurt themselves, destroy property, or utter phases which express low self-esteem like, I hate myself, no one loves me, may have significant emotional problems. Tantrums occurring frequently in school can be a sign of learning disabilities or speech and hearing problems. From what you have shared with me I feel she is not having the usual kind of temper tantrum. Your granddaughter should be evaluated by a child psychiatrist who can provide talk therapy and prescribe medication should the latter be necessary. Hope I have answered your query. If you have any further questions, I will be happy to help. Arnold Zedd, MD, FAAP