My 3 1/2-year-old is often violent with his siblings and occasionally other kids. He bites and punches his sisters at least once a day. He has punched other kids at the park. He hits others when I give them attention. I’ve tried taking away screens, taking away toys, time out…nothing works. Today he punched his sister so hard in the mouth that he knocked a tooth out. I’m at my wit’s end. What can I do?

Toddlerhood is a time of BIG emotions. Behavioral concerns — tantrums and even occasional aggression including hitting or biting — are not at all uncommon. There are many simple behavioral strategies and techniques that can effectively curb these typical behaviors in a relatively short period of time, when implemented calmly, clearly and consistently. You mentioned time out and punishment in terms of withdrawing preferred activities, which are common strategies, but these aren’t likely to be helpful at this point, in the scenario you’re describing.

Children desire attention and they will work to get it — be it positive or negative attention — in any way they can. Right now, your son seems to be seeking and gaining a lot of attention for bad behaviors. I imagine there is a lot of verbal and physical attention paid to him as you constantly have to intervene throughout the day and try to discipline in a variety of ways. His attention bucket is getting filled every day with these negative behaviors. I wonder if you can think of ways to provide him positive attention so that the he can start to see his bucket can be filled that way too. Can you “catch him being good,” during the day? Comment positively on how quickly he got dressed when you asked, how you like the outfit he picked, what a good job he did brushing his teeth, thank him for clearing his meal plate from the table. “Catch him” in a positive interaction with his siblings or a peer and tell him how you liked it when he helped his sister or when he took turns with another child on the playground. Praising him in these very specific ways will give him attention for positive and pro-social behaviors. When he is more fulfilled this way, removal of attention and social opportunities (a time out strategy) or preferred activities (screen time, toys), will carry more weight and be more effective.

Ultimately, it is likely time to seek professional help in not just managing his aggressive behaviors but rather working on the underlying cause of them. Getting a handle on this now will be better not just for him, but for the whole family system that is obviously being affected right now. Your pediatrician can refer you to a psychologist or mental health professional with experience in working with young children and their families. There are several types of intervention that will help you understand his behavior and will help you help him manage his emotions and behaviors.