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Children and Head-Banging

"Help, my son is 2, he has been head banging since he was 1,we first tried to associate it with his teething, and earaches, after he got tubes he started doing better, but the past 2weeks have been horrible, we go into the bank and he bangs his head on the glass door until I’m scared it’ll break, we go to the grocery store and he bangs his mouth on the buggy until he busts his lip, he’s got a fat lip and a huge knot on the side of his head from just today, I’m very worried, he’s is also very under-active and he lays around most of the day."

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My firstborn son would bang his head quite often and not just during a tantrum. When he was tired he would sit on the couch and bang his head against the back of the couch in a rocking motion. I became concerned and spoke with the doctor. He told me it was just a nervous habit and there was nothing to worry about. He also told me that my son would grow out of it. Well he didn't, at least not completely. Even as an adult, he sometimes sleeps on his stomach and bangs his head during his sleep.

There are moments in a youngster's development that engender fear in her moms and dads: those weeks before she was born when we wonder if she will really be okay, those moments after you have handed her car keys and she drives off with her boyfriend. For moms and dads whose kids develop head banging, this is one of those moments.

Every week someone mentions this concern to me (usually in an off-hand way) and then watches to see if I am alarmed. The unspoken fear: autism.

Up to 20 percent of healthy kids are head-bangers for a time. Head-banging appears in the latter half of the first year of life and generally ends spontaneously by four years of age. Boys are three or four times more likely to be head-bangers than girls.

The youngster seems compelled to rhythmically move his head against a solid object such as a wall or the side of a crib. Often he rocks his entire body. For most kids it occurs at sleepy times or when upset (often as part of tantrums). This behavior can last for minutes at a time -- or sometimes for hours. It can even continue once the youngster has fallen asleep.

Moms and dads' fear of autism makes sense. Head-banging, head-rolling, and body rocking are each far more common in autistic kids. But these rhythmic motor activities are also normal behaviors in healthy infants and young kids (and young monkeys for that matter!). This behavior is abnormal, though, if it persists beyond the early years. Any youngster who is still head-banging beyond three years of age deserves further evaluation.

How can one tell if the head-banging is a part of normal development or an early sign of autism?

Researchers at Cambridge University have found an easy and early way to detect autism. Three hallmark behaviors are the key signs:

1. Lack of gaze-following -- by fourteen months, infants will often turn to look in the same direction an adult is looking.

2. Lack of pointing -- by fourteen months of age most kids will point at objects in order to get another person to look.

3. Lack of pretend play -- by fourteen months kids will begin to play using object substitution, e.g. pretending to comb the hair with a block.

All three behaviors are typically absent in kids with autism.

If a youngster begins even one of these three behaviors by 18 months, the chances of ever developing true autism are vanishingly small.

Why do children without autism bang their heads?

Many theories have been put forward to explain this common behavior. Perhaps the rocking and even the head-banging provide a form of pleasure related to the movement. This joy in movement is called our kinesthetic drive. All infants are rocked by their mothers when they are carried about in utero. Later on, they enjoy being held and rocked in moms and dads' arms. Movement activities continue as children grow: the pleasure of jump rope, swings, slides, amusement park rides (bumper cars!) and dancing. These activities all engage the vestibular system of the brain.

The amount and type of movement that provides pleasure varies from youngster to youngster.

Children who are under-stimulated (those who are blind, deaf, bored, or lonely) head bang for stimulation. But kids who are over-stimulated (in an overwhelming environment) find these rhythmic movements soothing. These are some of the reasons why we see more head banging in children with developmental delays or neglect.

For some kids, head-banging is a way to release tension and prepare for sleep. Some children head-bang for relief when they are teething or have an ear infection. Some children bang their heads out of frustration or anger, as in a temper tantrum. Head-banging is an effective attention-seeking maneuver. The more reaction kids get from moms and dads or other adults, the more likely they are to continue this habit.

Generally, healthy kids do not head-bang in order to injure themselves.

Will they hurt themselves?

Little ones don't seriously injure themselves from this habit. Pain prevents them from banging too hard, but even if it didn't, kids under 3 don't generate enough force to cause brain damage or neurologic problems. The front or front/side of the head is the most frequently struck. Child heads are built to take all of the minor head trauma that is a normal part of learning to walk and climb. Healthy infants and children who are head-bangers grow up to be coordinated and completely normal kids.

How can you get head-banging to stop?

Most kids will outgrow the habit on their own. You can speed up this process by reacting to it in a matter-of-fact way. Pretend not to notice. And if it is part of a tantrum, do not give her whatever she threw the tantrum to get. When you notice her head-banging, you might be able to get her to stop for the moment by distracting her or engaging her in a different activity. By decreasing the amount of time she spends in this habitual activity, she will outgrow it more quickly.

Will it affect their development?

Curiously, one large study of this habit in 525 healthy kids found head-bangers to be measurably advanced in their gross motor development compared to their peers. Specifically, this study of kids who body-rock, head-bang, and head-roll found that body-rocking and head-banging behavior was associated with a statistically significant difference in gross motor development. For kids who head-bang, the study showed they were able to hold their head up without support and walk without support earlier than kids who do not head-bang. So, the very behavior that was frightening could be a sign of something positive.

Now, of course, this doesn’t mean that teaching our kids to head-bang will make them smarter! But this study reminds us that stimulating our kid’s bodies and minds from an early age can have a profound impact on their development.

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