Ask Doctor Cory.

FOR PARENT AND TEACHER

Dear Dr. Cory:

I have a nineteen-month-old son. He loves to ram his head into anything and everything that he possibly can. Even if he gets hurt, he only cries and runs his head into something else. Is this normal? What can I do to prevent him from doing it?

Gloria Howard Brandon, South Dakota 

Dear Ms. Howard,

We asked Dr. Annette Lansford, a developmental pediatrician and a spokesperson for the American Academy of Pediatrics to address your question:

"Head-butting is seen occasionally in young children. Often these children have a need for additional tactile sensory input (touch and/or pressure). Other toddlers who butt with their heads are not yet adequately verbal to express their frustration using language; they may show their frustration by throwing tantrums, including butting the head.

You don't say if your child is talking much yet. Does he engage in butting when he is frustrated? If so, distract him at the first sign of frustration by getting him interested in something else. (The easy distractibility of a toddler can be used by the parent to direct his attention elsewhere.)

If your child does not appear to be frustrated when butting his head, he may have a desire for increased tactile pressure/input. You may substitute other ways for increased pressure to replace his head-butting behavior, such as putting a fairly snug hat or a helmet on him, encouraging him to play under and between your sofa pillows, getting a beanbag chair for him, and giving him "bear hugs" often. You can obtain additional ideas for increased tactile sensory input by consulting a pediatric occupational therapist.

Additionally, ask your doctor to do developmental screening on your child to be sure he is developing as expected. It would be wise also to make sure that his hearing and vision are normal. Head-butting in young children, however, does not automatically mean that there is something seriously wrong."

Dr. Nathan J. Blum, a developmental behavioral pediatrician with Children's Hospital of Philadelphia, adds, "Head-banging or head-butting objects is not uncommon, especially during periods of low-level stimulation. Children often hit their heads on the mattress as they are falling asleep. This type of behavior usually goes away on its own and does not signify a developmental problem. Children may get local bruising or scrapes from banging their heads, but the vast majority do not experience intracranial injury. In rare situations, older children with severe disabilities will cause significant injury by head-banging. These children should be seen by a developmental behavioral pediatrician, child neurologist, or psychiatrist. Head-banging should not be reinforced by giving the child a lot of attention when the behavior occurs or by giving in to the behavior."

And Speaking of Head-banging ...

A soon-to-be-published report from the Institute for Preventative Sports Medicine in Ann Arbor, Michigan, found that heading a soccer ball can cause symptoms of headaches, concussion, and small but measurable verbal deficits among children. Dr. David Janda, an orthopedic surgeon and one of the authors of the study, recommends the use of helmets and lightweight balls in instructional leagues, when children learning to head the ball are most likely to bounce it off the vulnerable top or sides of the head.

Sincerely, Cory SerVaas, M.D.

Do you have a question about your child's health? Send it to:

"Ask Doctor Cory" Humpty Dumpty's Magazine P.O. Box 567 Indianapolis, IN 46206

This column is not intended to replace the advice of your physician.