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Q. My 21-month-old daughter head-butts. She has been doing this since about 13 months. She bangs her head on the wall or ceramic floor and doesn’t cry. When told no, she does it again. Sometimes she bangs her head so hard she bruises her forehead. My pediatrician says this is normal. My mother thinks this is abnormal and she should be checked out.
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A. Many children bang their heads in the second year when they begin to have temper tantrums or meltdowns. Some also rock themselves forcefully in their cribs or on the floor. These actions seem to be a child’s way to handle uncomfortable feelings – frustration, disappointment, tension, anger, boredom. But of course such behavior frightens parents.
Even though toddlers bang their heads hard, I have never heard of one who hurt himself. As a precaution, though, I recommend putting carpet or other "shock absorbers" on concrete floors, cinder block walls and other unyielding surfaces – without making a big deal of it.
I don’t think that telling her no will help. If she could stop herself, she probably would. Struggling with her over the issue might give her another reason to bang her head: It not only helps her soothe herself but also gets your attention. Look for opportunities to engage her before she bangs her head. When she is playing quietly by herself, you can help her learn how to prolong her play so she wards off boredom.
Try to protect this quiet time by avoiding interruptions and cutting down on distractions. When she starts to lose interest or to become bored or frustrated, you can move in briefly to help her with what she’s doing or to introduce a different activity.
When she’s ready for a break, cuddle her before she gets to the point of head-banging. Look for sources of tension that you can control and try to minimize them. If you or other family members are under stress, take a break and let off steam. Help your daughter focus on her other ways of calming herself, and teach her new ones. Does she like to cuddle with and talk to a stuffed animal? Look at a storybook? Scribble with crayons? Listen to calming music? Or suck his thumb?
At the first warning signs for head-banging, offer an alternative like cuddling or singing with you. If all else fails, you can’t do much more than sit nearby and say soothingly, "I am here and I would like to help but I can’t."
If a child is otherwise healthy and developing on track, he’s likely to outgrow head-banging. If the behavior persists, there may be a more serious problem. If a parent is concerned that a child’s development is not on pace, it is important to alert the pediatrician as soon as possible. Early intervention can make a big difference for developmental delays and disabilities.
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Distributed originally by The New York Times Syndicate with permission to circulate and redistribute through MI-AIMH.
Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child's health or well-being, consult your child's health-care provider.
Dr. Brazelton is founder of the Brazelton Touchpoints Foundation, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.brazeltontouchpoints.org.
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