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Head Banging in Toddlers

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Head banging is one of those behaviors that top the list of Things Kids Do That Freak Us Out.

The biggest concern, of course, is "Will he hurt himself?" Watching your child bang his head again and again on the hard floor is difficult for any concerned parent. But many parents also worry that head banging is a sign of autism.

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While it's true that children with autism and other disorders sometimes bang their heads, head banging is surprisingly normal in typically developing children. In fact, 1 in 5 kids will be affected during toddlerhood. Head banging usually appears by one year, peaks at about 18 months, and disappears before the child's 4th birthday.

For many children, head banging is a self-soothing behavior. Remember that your baby bounced around inside a womb for nine months before he was born, in constant motion during the day. After he was born, you rocked him to sleep, bounced him to soothe him, and maybe even wore him in a carrier. Babies are used to movement, and that movement is a very powerful calming mechanism. Rocking her body or head banging on the mattress or side of the crib is your baby's attempt to reproduce that calming feeling.

More dramatic is head banging that happens during a tantrum. Banging his head on the floor is your toddler's way of expressing frustration, and it allows your toddler to release the inner tension created by whatever led to the tantrum.

So if your toddler bangs his head, what should you do? First, let me say that I am not a medical professional, and anything read here should not be a substitute for advice from your pediatrician. But here's the advice I usually share with families I work with:

It's really important to react to the head banging in a calm, matter-of-fact way.

Babies and toddlers who rock or gently head bang on their mattress at bedtime can be left alone to self-soothe, if you can safely assume they aren't hurting themselves. You can try and redirect their behavior toward gentler self-soothing techniques such as music or a comfort object. But if you run into the room every time your toddler starts to bang his head, you're soon going to have a toddler who forgets how to fall asleep on his own.

Some experts recommend ignoring head banging that occurs during a tantrum altogether. It's really important to react to the head banging in a calm, matter of fact way. We all know what happens when a toddler finds one of your "buttons," and if he feels like the head banging gets a big reaction out of you, he's going to do it again. And again. And again.

But at the same time, I generally don't like to simply ignore a tantrum until it's over. I think that tantrum-ing kids are hurting and that they benefit from connection with the people who love them. So if you are able to stay calm and not react, I think it's OK to move your child to a softer place such as a couch or a carpeted area to let her finish her tantrum, to rub her back and to empathize. "You are mad because you wanted to wear a green shirt and mama gave you a blue one." Empathizing helps your child feel understood and builds emotional intelligence, and may reduce head banging over time.

Head banging can occasionally be a sign of ear or upper respiratory infection, so if your child is pulling on his ear or has a fever, it's worth a call to your doctor.

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Will your child hurt himself? It's very unlikely that a toddler will cause serious damage to his little brain by banging it on the floor. Toddlers are not usually strong enough to hurt themselves. They typically bang the front or back of their heads, and both areas are well protected by the skull. Kids will produce bruises, however, and I have seen at least one cut lip.

And finally, yes, sometimes kids with autism bang their heads, though only a small percentage of them do. If your toddler bangs his head and is also exhibiting other early signs of autism, or is still banging his head after his third birthday, seek out your local early intervention program or pediatrician for further evaluation.

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