The occurrence of childhood head banging has the potential to be a serious and dangerous behavior. Therefore, treatment of head banging must be closely observed so that the potential for injury is minimized, and actual injuries are taken care of as quickly as possible. The type of treatment for head banging depends upon the cause of the head banging. Possible causes include the desire for attention, attempts to escape from having to do something, enjoyable sensations from the head banging, medical factors (such as seizures, brain tumors, and ear infections), and frustration with one's self. Below are some guidelines for dealing with and reducing head banging. Again, careful monitoring during treatment is important.
Determine if medical factors are involved. If medical factors are suspected as the cause of head banging, these should be brought to the attention of a doctor as quickly as possible. If a medical factor is responsible, treatment of the head banging should follow treatment of the medical condition. If medical factors have been ruled out, then other methods to reduce head banging are required.
Report swelling or blood loss. If swelling or loss of blood is noted following an episode of head banging, these should be reported to a doctor as soon as possible. Severe swelling or blood loss generally requires an emergency room visit.
Remove sharp or breakable objects. In order to prevent head banging on sharp or breakable objects, parents should try to remove such objects from rooms that children are allowed to enter. Parents may have to prevent their children from entering rooms that have non-removable sharp or breakable objects. Another suggestion is for parents to cover sharp and/or breakable objects with towels or other protective materials. When the head banging has decreased, children's access to these objects can be gradually increased.
Reward appropriate behavior. For head banging that results from a desire for attention, an increase in attention for appropriate (non-head banging) behaviors should be given. Episodes of head banging should be ignored, and nothing should be said or given to children while they are head banging. Nobody should look at children or touch them while they are head banging. Ignoring head banging often requires leaving the room. Parents may find that ignoring results in a temporary increase in head banging, followed by a rapid decline. It is important for parents to continue ignoring during the temporary increase and to discretely examine their children for bleeding or swelling following more intensive head banging episodes.
Don’t negatively reinforce. For head banging that results from children trying to escape having to do something, treatment involves not allowing children to get out of doing what they are asked. When children are required to do something but instead begin to head bang, the head banging should be ignored and children should be required to follow the request. Failure to do so should result in implementation of discipline methods that are ordinarily used in the home (sent to room, physically guided to do the task, time-out, etc.)
Explain dangers of head banging. If the cause of the head banging appears to be due to the sensation from head banging, it is important for parents to explain to children the possible dangers of the behavior. A number of the possible alternative activities should be discussed with children, and they should be allowed to think of some things to do instead of head banging. Ample materials and space should be made available to children to engage in activities other than head banging. Attention should be given to children for appropriate behavior other than head banging.
Determine if psychological factors are involved. Head banging due to frustration and the desire to punish one's self may indicate other problems such as depression, poor self-concept, and helplessness. Parents should consult with a mental health professional for help in dealing with these other problems that may result in head banging or more serious problems.
Consult professional help if necessary. Regardless of the cause of head banging, if the head banging does not decrease or becomes dangerous, parents should consult their children's health care provider or a mental health professional.
Reprinted with the permission of the Center for Effective Parenting. © 1998-2004 The Center for Effective Parenting. All Rights Reserved.