Friday, July 12, 2013

Bad Habits/Annoying Behavior

What do I need to know about bad habits and behaviors in children?

Parents find many habits and behaviors of their children annoying. When you want to change an unwanted behavior, it helps to first understand why your child is doing it.  Often bad habits are just a coping strategy.  Your child may fall back on these behaviors when they are stressed, bored, tired, frustrated, unhappy, insecure, or falling asleep. Many of these "bad" habits are calming and soothing to the child.  

Most of the time, these behaviors are just "phases" or habits—not serious medical problems—and the child typically outgrows them.  Managing them can be difficult, however.  In general, you should ignore bad habits.  Yelling, calling attention to the habit and punishment do not usually work to stop the behavior (and may even increase it!), but praise, positive rewards, and patience are likely to help. 

What about thumb and finger sucking and pacifiers?

There are different types of sucking kids might do their infancy and childhood.  Thumb and finger sucking typically starts in the first few months of life.  Many babies outgrow it well before their first birthday, and most stop by age five years due to peer pressure.  Other sucking objects include pacifiers and blankets.  (Get some tips on choosing a safe pacifier from the American Academy of Pediatrics (AAP).

Sucking has a soothing, calming effect, and often helps kids get to sleep.  However, it may become worrisome when the permanent teeth start coming in (around age five) if the sucking alters the shape of the child's teeth, palate or bite.  Get more information on this from the American Academy of Pediatric Dentistry.  For more tips on how to help your child quit sucking, see the AAP's page on how to help your child stop.

What should I know about head banging, head rolling, and body rocking?

Rhythmic movements include head banging, rolling, and body rocking.  Head banging is when a child repeatedly hits their head against a solid object such as a crib, as much as 80 times a minute.  This can be distressing to the parents or caregivers for concern of injury.  However, the child does not appear to be in pain, but rather calm and content.  The habit usually begins around age nine months and resolves by around age two years.  The episodes usually last from 15 minutes to a few hours, and typically occur while listening to music or falling asleep. 

Head rolling is when an infant rolls their head from side to side when lying on their back.  They may even rub the hair completely off the back of their head.

Body rocking is when a child rhythmically rocks while either sitting or resting on their knees or elbows.  This behavior usually starts around age six months and disappears by age two.  Most children rock for 15 minutes or less.  Like head banging, it occurs while listening to music or falling asleep. 

Head banging, head rolling and body rocking are common childhood self-comforting habits.  These behaviors are often harmless, but can be worrisome if your child also has developmental delays. Talk about the habit with your pediatrician, who can help you decide whether there is any cause for concern.

What about teeth grinding?

Bruxism, or teeth grinding or clenching, is a habit seen in over half of all infants of normal development.  It usually starts around age six months when the baby teeth come in and again around five years when the permanent teeth come in.  Teeth grinding happens mainly during sleep.  The child usually outgrows it, but the bruxism may continue into adulthood.  It can be concerning if it causes dental problems or a disorder of the jaw joint and may need evaluation by a dentist. 

Info for kids on teeth grinding.
What about nail and cuticle biting or picking?

Nail biting or cuticle biting and picking is a concern if it results in infection of the nail or recurrent bleeding.  Like other habits, positive reinforcement strategies are the most effective way to stop the behavior.  Try to catch your child without their finger in their mouth, and simply describe what they are doing with their hands instead. For example, "I see you are folding origami with your fingers." Or "You are using your fingers to scratch the cat's ears! She likes it!"

Point your kids toward these sites:  "What's Wrong with Biting My Nails?" (also in Spanish) and tips on nail care (also in Spanish).

What about nose picking?

Nose picking is one of the most aggravating behaviors to parents because it is one of the least socially acceptable.  However, it is one of the most common habits among children and adults.  

Nose picking starts when crusting occurs from infection, allergies, or minor trauma.  Picking causes more irritation to the nose and may create a vicious cycle.  Picking is the most common cause of frequent nosebleeds.  

Tell your child that picking is not acceptable in public, but that they may use a tissue to clear out the nose and take care of itchiness.  Explain that they are more likely to get sick and pass their germs to others if they pick their nose.  Insist that they wash their hands after they pick or blow their nose.  Often a little petroleum jelly a couple times a day inside the nose will help to break the vicious cycle of nose irritation and picking.  Keeping the nose moist with a little saline spray can also help, and is a better option for kids with asthma.  Talk to your child's primary care provider to find out what they recommend to reduce your child's nose irritation.

What about hair twirling/hair pulling? 

Hair loss may be a sign of medical problems such as infection or other disease. Your child should see their pediatrician if they are losing hair.

On the other hand, hair twirling or mild hair pulling that results in minimal hair loss is just another self-calming behavior seen in infants and children.  Like thumb sucking, it often occurs when the child is relaxed, bored, or tired.  Children usually outgrow this habit on their own. 

There is a more serious form of hair pulling, called trichotillomania, which involves pulling the hair from the scalp, eyelashes, eyebrows, and/or pubic areas.  This is a rare disorder that often suggests an underlying psychological problem and should be evaluated.

What are Hair loss ?

Hair loss may be a sign of medical problems such as infection or other disease. Your child should see their pediatrician if they are losing hair.
On the other hand, hair twirling or mild hair pulling that results in minimal hair loss is just another self-calming behavior seen in infants and children.  Like thumb sucking, it often occurs when the child is relaxed, bored, or tired.  Children usually outgrow this habit on their own.  

There is a more serious form of hair pulling, called trichotillomania, which involves pulling the hair from the scalp, eyelashes, eyebrows, and/or pubic areas.  This is a rare disorder that often suggests an underlying problem and should be evaluated.

What are tics?

Tics are stereotyped behaviors (twitches or movements) that are frequently repeated.  The movement can involve any body part.  A facial tic, especially blinking the eyes, is the most common.  Temporary tics are a habit that starts during childhood or the teen years, and might last anywhere from one month to a year.  The child is able to suppress the tic voluntarily for minutes to hours.  The tic may occur more frequently at certain times and not at others.  They are fairly common. 

Rarely, there are vocal tics or more complex tics, which suggest a more serious disorder called Tourette syndrome.  If the tic occurs for longer than one year or the child cannot suppress it, it may be a sign of a more serious problem and needs evaluation by your child's doctor. 

What about masturbation?

Most children—both boys and girls—play with their genitals (private parts) fairly regularly by the age of 5-6 years.  To find out more, see YourChild: Masturbation.

What about breath holding?

Breath holding is scary for parents.   Breath holding spells are when a child holds their breath and then may lose consciousness.  The episode may last from a few seconds to a minute.  The spells usually happen most often around 18 to 24 months and stop by age five.  

There are two different kinds of spells, cyanotic (child turns blue) and pallid (child turns deathly pale).  Breath holding is a way for your child to exert control when they do not get their own way.  The symptoms are often confused with a seizure, and the first time you believe that a child has a breath-holding spell you should take your child to their doctor for evaluation.  The symptoms may be a sign of anemia (low number of oxygen-carrying cells in the blood).  When a breath holding spell occurs, keep the child calm and protect them from injury. 

How can I break my child's bad habit?
  • First, try ignoring the annoying behavior.  Your child will probably outgrow the habit with time.  Giving a lot of attention (even though it's negative) may actually encourage the behavior.
  • Praise your child for good behavior.  The best kind of praise simply describes what you see that you'd like to see more of.  Catch your child being good, and tell them you noticed.  For example, tell them you noticed they weren't chewing their nails. 
  • It may be nearly impossible to stop the bad habit until the child becomes interested in stopping.  For example, a little girl may actually get enough "benefit" out of biting her nails that she will not be willing to stop.  When she gets a little older, though, she may be interested in having nice looking nails.  Then you will be able to help her quit.
  • If there are lots of behaviors you want to change, start by focusing on one or two of the most bothersome or dangerous ones. Don't try to make too many changes all at once. 
  • Try to figure out what may be making your child stressed, and help them deal with it. Give your child chances to talk to you about things that might be worrying them—make eye contact and actively listen.
  • Let your child make decisions whenever possible, by giving them acceptable choices.  For example, "Would you rather have toast or cereal for breakfast?"  This will help your child feel in control, reducing stress and frustration. 
  • Redirect your child and help them find a better place, or better way to do what they are trying to do.   For example, if their nose is irritated, have them clean it with a tissue, apply saline nasal spray or petroleum jelly (consult your pediatrician for their recommendation), and then wash their hands. If they simply must go "digging," have them do it in the bathroom, not in public, and wash their hands afterward.
  • Use natural or logical consequences for problem behavior. The purpose here is to get kids to make the right decision, not to bend them to your will. Be patient—it may take time for you to see results.
  • Be firm and kind. Follow through every time on the natural or logical consequences.
  • Have a few positively stated rules, and explain the reasons behind them.
  • Make sure your child understands the results of breaking the rules.
  • Try some of these ten techniques to shape children's behavior.
How can I find out more about bad habits and problem behaviors?
Here are some specific suggestions for how to help break a bunch of common childhood habits.
  • Nice kids, bad habits—has more about why kids do annoying things, and what to do about it.
  • See Understanding Behavior: a Key to Discipline for some things to think about when your child's behavior becomes a problem.
  • Your Child's Habits—talks about nail biting, thumb sucking, hair twirling, nose picking, and breath holding.
  • Find out more about positive discipline on YourChild: Parenting Resources.
  • Find out how pediatric hypnotherapy can help your child on YourChild: Pediatric Hypnotherapy

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