Hi Karen I have a four year old daughter as well with CAH, she also has tantrums as I call them, usually in the afternoon after she gets back from school, occassionally in the morning whilst getting ready for school. I have noticed with my daughter that these tantrums are usually triggered by frustration/or impatients, in the morning if she can't do up her buttons up for example(I usually help her), but sometimes she refuses help and wants to try herself, or another time is due to impatients, usually in the afternoons, if I am busy and she need/wants something, if she does not get whatever it is almost as soon as she has asked she will start crying, shouting, screaming, and rolling on the floor. I always feel like I shouldn't give in to her but nearly always do, and try and keep her occupied and busy before I start doing other things, you could try this, but I think you need to find out if and what the trigger is. I am not sure that it is related to CAH and think that it is not. Alisa doesn't have any of these problems at school either, although she has only been going a few weeks.