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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Teens and Sugar Addiction

"My 15 year old daughter seems addicted to sugar. Her terrible diet is affecting her in a very bad way...mood swings, very poor concentration, etc."

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Ideas to stop sugar cravings—

Here are some tips for your daughter that will help curb her appetite for sugary foods:

• Always eat a good, hearty breakfast! Do not think that skipping breakfast will make you lose weight! In fact, eating breakfast kick-starts your metabolism which leads to more weight loss. Breakfast will also help you to concentrate and eat less throughout the day.
• Check food labels. Eat foods that are low in calories (anything below 200 is good) and carbohydrates. Although carbohydrates can help you think better - and they fuel the nervous system and power fat metabolism. Avoid saturated and trans fat (which leads to weight gain). Eat foods that have vitamins and minerals in them. Protein, fiber, and iron are all good for you. If you can't read an ingredient or if you've never heard of it, most likely it is not good for you.
• Do not eat when you are not hungry! Boredom and depression can lead a person to eating things that will lead to weight gain. If you are bored, try reading a book, playing a sport, or talking to friends. Try to avoid your kitchen if you are home all day. Make sure there is no food in sight or you will get cravings. Study, if possible.
• Drink at least 8 glasses of water a day. It curbs hunger, makes you feel better and makes your skin glow!
• Eat only until you are satisfied. Do not over stuff yourself. If you are given a ton of food on your plate, don't feel obligated to eat it all.
• Eat your dinner earlier (in between 4:30 and 7:00) so that you can burn off some of the calories you consumed.
• Every time you go to put something in your body, ask yourself: "Is this going to improve my health, or harm it?" If the answer is the second one, you know what to do.
• Fill up half your plate with veggies.
• If you get the need to crunch or chew food when you are not hungry, eat something low in calories such as fruit or gum. Ask someone like a parent to stop you from over-eating.
• If you have a very sugary diet, you may get a Sugar Withdrawal Headache. These are tough to deal with and hurt a lot, so if you can't just ignore it, keep a single Hershey bar (or other candy bar) in your locker a week. Eat a single square when you get a headache and it'll help. Make sure it doesn't melt, or you'll end up tricking yourself into eating more than one "square" (melted lump). Remember to change it out about once a week or it'll get moldy and make you sick. Even if there's some left.
• Know how to respond to binges. If you have a pig-out and want to burn off the calories you just consumed, go for a brisk walk or any other physical activity. Also, eat a nutritious meal after a pig-out. Alternatively, if you are tempted to binge, try eating something nutritious beforehand. By the time you finish this initial food, you may change your mind.
• Try to avoid stress or learn to deal with it. Stress will cause pig-outs.
• Try to eat salads and ask your parents to make them. Or, make them yourself by whipping together some ingredients. Salads are healthy and with the proper dressings and toppings of your choice, taste great. Toppings should be low-fat and examples are grated cheese, bacon, and diced eggs.
• Try to replace things you usually eat with something healthier. If you're reaching for a handful of chips, force yourself to stop, and go grab an apple instead. (Note: this can be easier said than done.)
• You should also ask yourself WHY you are eating something before you eat it. If the answer isn't "It's time for lunch/dinner/breakfast and I'm hungry," PUT IT BACK.

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Dealing with Oppositional Defiant Behavior (ODD)

ODD is a pattern of disobedient, hostile, and defiant behavior toward authority figures. This disorder is more common in males than in females. Some studies have shown that it affects 20% of school-age kids. However, most experts believe this figure is high due to changing definitions of normal childhood behavior, and possible racial, cultural, and gender biases. This behavior typically starts by age 8, but it may start as early as the preschool years. This disorder is thought to be caused by a combination of biological, psychological, and social factors.

Symptoms include:

• Touchy or easily annoyed
• Spiteful or seeks revenge
• Loses temper
• Is in constant trouble in school
• Has few or no friends or has lost friends
• Blames others for own mistakes
• Argues with adults
• Angry and resentful of others
• Actively does not follow adults' requests

To fit this diagnosis, the pattern must last for at least 6 months and must be more than normal childhood misbehavior. The pattern of behaviors must be different from those of other kids around the same age and developmental level. The behavior must lead to significant problems in school or social activities.

Kids with symptoms of this disorder should be evaluated by a psychiatrist or psychologist. In kids and teens, the following conditions can cause similar behavior problems and should be considered as possibilities:

• Substance abuse disorders
• Learning disorders
• Depression
• Bipolar disorder
• Attention-deficit /hyperactivity disorder (ADHD)
• Anxiety disorders

The best treatment for the youngster is to talk with a mental health professional in individual and possibly family therapy. Moms and dads should also learn how to manage the youngster's behavior. Medications may also be helpful, especially if the behaviors occur as part of another condition (e.g., depression, childhood psychosis, ADHD). Some kids respond well to treatment, while others do not. In many cases, kids with ODD grow up to have conduct disorder as teens or adults. In some cases kids may grow up to have antisocial personality disorder.

Call your health care provider if you have concerns about your youngster's development or behavior. Be consistent about rules and consequences at home. Don't make punishments too harsh or inconsistent. Model the right behaviors for your youngster. Abuse and neglect increase the chances that this condition will occur.

My Out-of-Control Child: Parenting Children with Oppositional Defiance

How To Stop Your Teen From Sneaking Out At Night

"Our 14 year old keeps sneaking out in the middle of the night. We've screwed the windows shut, called police. She says she sorry...but she can't be that sorry if she keeps doing it. What is the best way to handle this? We've told her it is a safety issue more than anything else."

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==> My Out-of-Control Teen: Help for Parents

Teens Who Refuse To Get Out Of Bed In The Morning

"What is done in a case where my teenage son (16 years old) will not get out of bed for either school or work without a huge fight everyday?"

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==> My Out-of-Control Teen: Help for Parents

Home Drug-Testing Your Teenager

"What are your thoughts on testing a teen suspected of using drugs through the use of a home drug-testing kit that can be purchased online?"

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==> My Out-of-Control Teen: Help for Parents

How can I get her to get up in the mornings...

Hi Mark,

I continue to have struggles with my 17 year old. She has not gone to school for this past semester as she was supposed to be taking her classes by correspondence. Unless I stood over and watched her do the courses, she wouldn't do them. I wasn't about to do that as she needs to learn to be responsible. So, needless to say, she is now behind 3 classes in order to graduate next year. She is going to register for regular school for September as this other method does not work for her. She is not motivated at all.

My one big problem with her is that she will not get out of bed in the morning. She has a part-time job that she is supposed to be at 3 days a week. She maybe goes to it 2 times a week if lucky because she just won't get out of bed. She calls in sick so she can sleep in. She will end up losing this job soon. I know she will be exactly the same way once school starts again. She refuses to get out of bed. Then when she does, she thinks she can just go out and hang out with her boyfriend in the evening. Even if we say no, she will leave and go anyways. I am so upset and frustrated by all of this as it has me so stressed out all the time. I dread mornings as I know the hassles we will have. I know that there are "natural consequences" of her actions and she has to be the one that has to live them but we are all living them. Plus, I don't want her to be a high school drop-out and still living at home once she turns 18.

How can I get her to get up in the mornings and to understand that she needs to be more responsible and motivated or she will get nowhere in life?

Thanks,

P.

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Adolescents are notorious for staying up late at night and being hard to awaken in the morning. Your adolescent is probably no exception, but it's not necessarily because he or she is lazy or contrary. This behavior pattern actually has a physical cause — and there are ways to help mesh your adolescent's sleep schedule with that of the rest of the world.

Everyone has an internal clock that influences body temperature, sleep cycles, appetite and hormonal changes. The biological and psychological processes that follow the cycle of this 24-hour internal clock are called circadian rhythms. Before adolescence, these circadian rhythms direct most children to naturally fall asleep around 8 or 9 p.m. But puberty changes an adolescent's internal clock, delaying the time he or she starts feeling sleepy — often until 11 p.m. or later. Staying up late to study or socialize can disrupt an teen's internal clock even more.

Most adolescents need about nine hours of sleep a night — and sometimes more — to maintain optimal daytime alertness. But few adolescents actually get that much sleep regularly, thanks to part-time jobs, homework, extracurricular activities, social demands and early-morning classes. More than 90 percent of adolescents in a recent study reported sleeping less than the recommended nine hours a night. In the same study, 10 percent of adolescents reported sleeping less than six hours a night.

Big deal? Yes. Irritability aside, sleep deprivation can have serious consequences. Daytime sleepiness makes it difficult to concentrate and learn, or even stay awake in class. Too little sleep may contribute to mood swings and behavioral problems. And sleepy adolescents who get behind the wheel may cause serious — even deadly — accidents.

Catching up on sleep during the weekends seems like a logical solution to adolescent sleep problems, but it doesn't help much. In fact, sleeping in can confuse your adolescent's internal clock even more. A forced early bedtime may backfire, too. If your adolescent goes to bed too early, he or she may only lie awake for hours.

So what can you do? Don't assume that your adolescent is at the mercy of his or her internal clock. Take action tonight!

• Stick to a schedule. Tough as it may be, encourage your adolescent to go to bed and get up at the same time every day — even on weekends. Prioritize extracurricular activities and curb late-night social time as needed. If your adolescent has a job, limit working hours to no more than 16 to 20 hours a week.

• Nix long naps. If your adolescent is drowsy during the day, a 30-minute nap after school may be refreshing. But too much daytime shut-eye may only make it harder to fall asleep at night.

• Keep it calm. Encourage your adolescent to wind down at night with a warm shower, a book or other relaxing activities — and avoid vigorous exercise, loud music, video games, text messaging, Web surfing and other stimulating activities shortly before bedtime. Take the TV out of your adolescent's room, or keep it off at night. The same goes for your adolescent's cell phone and computer.

• Curb the caffeine. A jolt of caffeine may help your adolescent stay awake during class, but the effects are fleeting. And too much caffeine can interfere with a good night's sleep.

• Adjust the lighting. As bedtime approaches, dim the lights. Turn the lights off during sleep. In the morning, expose your adolescent to bright light. These simple cues can help signal when it's time to sleep and when it's time to wake up.

Sleeping pills and other medications generally aren't recommended for adolescents.

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