Autism, Head Banging and other Self Harming Behavior

Headbanging is an alarming issue for families with children on the spectrum. Caregivers and parents should get help before addressing headbanging and autism. Autism does not need to be synonymous with self-harm. Read on for tips and strategies to help your child reduce self-injurious behavior.

Why do autistic children hit themselves?

For children with autism, headbanging is a way to self-soothe and communicate needs. Babies and toddlers soothe themselves and want to feel the same as they did in their mother’s womb. This is called kinesthetic drive. Other habits that feed a child’s kinesthetic drive include head rolling, body rocking, biting, and thumb sucking.

According to Dr. Harvey Karp, MD, rhythmic habits trigger the calming reflex in infants and toddlers. Many babies with autism headbang around six months of age, but their neurotypical peers stop doing so by three years of age.

Noha F. Minshawi, Ph.D., assistant professor of clinical psychology in at Riley Hospital for Children, says children with autism spectrum disorders show self-injurious behaviors at high rates.

Autism, Head Banging and other Self Harming Behavior https://www.autismparentingmagazine.com/autism-self-harm

How to stop an autistic child from hitting

It’s important to determine why a child on the spectrum is engaging in hitting before you can remedy it. First, you need to make sure your child does not have any other medical issues that would lead to him/her inflicting harm. Ear infections, stomach ailments, and other pains in the body might also be the culprit.

It’s also possible that the child uses this behavior as a way to communicate. Anxiety and hyperactivity are two other factors to consider.

You can work with a doctor or autism specialist for the right response once the reason is clear. You can then work on sensory strategies for headbanging that makes sense for your child.

What triggers headbanging?

Minshawi also makes the distinction that self-injurious behaviors, such as headbanging in those with autism, is usually classified as a “highly repetitive behavior (occurring at frequencies up to dozens of instances per minute).”

She also notes that headbanging can be episodic and triggered by the same stimuli or appear to start of nowhere. Monitoring your child and taking note of what happened right before headbanging can help identify triggers.

When a child diagnosed with autism headbangs past the age of two and a half or three, there is likely one of four things happening:

  1. The child is in pain
  2. The child is attempting to communicate
  3. The child is attention seeking, or
  4. The child is experiencing sensory overload or a sensory deficit.

Self-harming behavior as a response to pain

Many parents are confused about why a child would inflict more pain via headbanging if a child is already experiencing discomfort. They fail to understand the significance of autism and self-harm. It’s important that parents recognize headbanging as a distraction from pain.

If you discover that your child regularly uses headbanging to manage pain, a pediatrician can suggest ways to ease your child’s discomfort. This may include checking your child’s body for cuts, bruises, redness, swelling, or other physical signs of injury. Working with a communication specialist to help your child develop new ways to show you where he/she is experiencing pain could be helpful as well. Some children are able to point to where they are feeling pain, draw a picture of what hurts, or communicate verbally using short phrases. Verbal children may need prompting to tell you where they are experiencing pain, as headbanging may be their first instinct.

Headbanging in an attempt to communicate

In some cases, autism and headbanging go together so a child can feel in control. A secondary reason may be that the child is trying to communicate. Nonverbal children will seek ways to communicate, often through movement. If a child knows headbanging will cause a caregiver to rush over and intervene, he/she is likely to use this to his/her advantage to help get needs met. This goes hand-in-hand with attention seeking.

Headbanging to seek attention

Children who headbang for attention may be experiencing sensory overload or deficit. In the moment, they may be unable to otherwise communicate their needs.

When children with autism experience sensory overload, their neurotransmitters cannot process the sensation. Noise, visuals, smells, and tastes can be uncomfortable and overwhelming for children with autism. The sensation of headbanging is one they can control and on which they can place their focus.

Self-harm due to sensory overload or sensory deficit

Children who are understimulated, lonely, or bored might headbang to stimulate their vestibular systems. They stimulate themselves in a way the feels good to them. Understimulated children may often seek attention from headbanging, even if they know they will not receive positive reinforcement.

Parents can provide a distraction from headbanging. A vibrating pillow, weighted blanket, gentle touch, or a well-secured bouncing chair, yoga ball chair, or rocking chair are some examples. Providing your child with attention including positive reinforcement, appropriate activities, and options on how to spend his/her time, may help redirect a child who is headbanging.

Additionally, some children headbang as a part of a routine they have developed to prepare for sleep. Autistic children often find the repetitive movements tire and soothe them. Establishing a bedtime routine with your child that includes some form of exercise or kinesthetic movements may help prepare him/her for sleep. Stretching, yoga poses, leg flutters, or balancing on alternating legs are popular options.


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Physiological reasons for headbanging in autistic children

There are also some physiological aspects of autism and self-harm. Stephen M. Edelson, PhD, has some theories regarding autism and headbanging. He suggested physiological reasons autistic children headbang including biochemical and genetic factors. He says that research has found that neurotransmitter levels may have a link to headbanging and other self-injurious behaviors.

Edelson writes, “Beta-endorphins are endogenous opiate-like substances in the brain, and self-injury may increase the production and/or the release of endorphins. As a result, the individual experiences an anesthesia-like effect and, ostensibly, he/she does not feel any pain while engaging in the behavior (Sandman et al., 1983). Furthermore, the release of endorphins may provide the individual with a euphoric-like feeling.

Nutritional and medical interventions can be implemented to normalize the person’s biochemistry; this, in turn, may reduce severe behavior. Although drugs are often used to increase serotonin levels or to decrease dopamine levels, the Autism Research Institute in San Diego has received reports from thousands of parents who have given their son/daughter vitamin B6, calcium and/or DMG. These parents often observed rather dramatic reductions in, and, in some cases, elimination of self-injurious behavior. Parents have also reported reductions in severe behavior problems soon after placing their child on a restricted diet, such as a gluten/casein-free diet, or removing specific foods to which their child showed signs of an allergic reaction.”

While Edelson admits that researchers and medical professionals have not reached a clear consensus on whether dietary or even pharmaceutical interventions can address autism and headbanging, he recommends exploring these options with your child’s pediatrician.

Can headbanging cause brain damage?

For parents of children with autism, brain damage is a common concern if a child starts headbanging. Children under three years old will rarely cause long-term damage by headbanging. Their heads are designed to handle impact from learning to walk, and headbanging will rarely cause more trauma than a slip and fall accident at this age. However, as children get older, they are at a higher risk of causing lasting damage.

Children who are strong enough to cause injury should receive a functional behavioral intervention to come up with a plan to replace headbanging with healthy coping and communication strategies.

“[Self-injurious] behaviors can be physically dangerous for the individual who is head-banging…; and self-injurious behavior is very concerning for their caregivers who want to keep these children safe. In order to implement a behavioral treatment plan for self-injurious behaviors, a functional behavioral assessment should be performed to help determine the environmental and/or internal factors that are maintaining the behaviors. This information is then used to inform behavioral interventions in order to preempt the causes or replace the unwanted behaviors with ones that are more acceptable,” writes Minshawi.

How can I protect my child from self-harm?

It can be terrifying to witness when a toddler hits himself or herself in the head, but protective measures can be taken to remedy autism and self-harm. Some children respond well to resistance exercises including chin-ups or lifting light weights. Tracking when your child headbangs and to what extent will help determine what level of pain he/she might experience after the episode.

Your pediatrician should be your primary source of information on how to best help a headbanging child. He/she will be able to assess the likelihood of self-harm, help you identify why your child headbangs, and offer solutions and alternatives.

The Cleveland Clinic recommends consulting a doctor immediately if your child hurts him/herself, leaves bumps or bruises, or if you think that the child is having seizures.

If you are unsure if your child is headbanging due to a diagnosis of autism or if it is developmentally normal at this point, partner with your pediatrician. He/she can refer you to other professionals who can help. This includes occupational therapists, behavior interventionists, or community support groups for parents.

Can an autism helmet protect my child?

Providing your child with a medical helmet as prescribed by the pediatrician should help prevent injury. You can also add padding to areas of your home that your child typically headbangs, especially any corners or uneven surfaces.

Self-injurious behavior treatment strategies

Treatment for self-injurious behavior in autism can take many forms and will most likely be a process of trial and error. In-home accommodations can be made to help an overstimulated child. Some examples are:

  • Noise-canceling headphones
  • Low-lit, monochromatic environment
  • Favorite piece of clothing
  • Playing with sensory toys

It is vital for a parent or caregiver to seek professional help to correctly resolve autism and headbanging. An occupational therapist (OT) can help you and your child learn alternatives for headbanging. Many children find sensory therapy with an OT to be helpful. For children with autism, headbanging strategies might also include yoga and rhythmic therapy in conjunction with routine sensory input under the guidance of an OT.

Your pediatrician or insurance company can help you identify an OT in your area.

Katherine G. Hobbs is a freelance journalist and university student studying English, with an emphasis on journalism, and psychology. She is interested in the impact of having a special needs child on the family dynamic. Katherine is dedicated to bringing awareness of resources to families and providing help to those who love their autistic children. You can find her online at katherineghobbs.com.

Autism Parenting Magazine tries to deliver honest, unbiased reviews, resources, and advice, but please note that due to the variety of capabilities of people on the spectrum, information cannot be guaranteed by the magazine or its writers. Medical content, including but not limited to, text, graphics, images and other material contained within is never intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician with any questions you may have regarding a medical condition and never disregard professional medical advice or delay in seeking it because of something you have read within.

Katherine G. Hobbs

Katherine G. Hobbs is a researcher and journalist for Autism Parenting Magazine dedicated to bringing awareness of resources to families affected by autism spectrum disorder. She lives in Florida where she teaches preschool and elementary-aged children of all abilities. Her passion for autism awareness began as a child in grade school with a dear friend. . You can find her online at katherineghobbs.com.

Click Here to Leave a Comment Below
Avatar
Vinss - August 10, 2017 Reply

Hi,

My son used to bang head earlier and he has stopped it. From past 2 months, he is pushing and biting children in the class room for no reason. At home, he is trying to bite us when he gets angry for not getting what he wants. Please tell me why he is behaving like that with children for no particular reason.Thanks

Amy KD Tobik
Amy KD Tobik - August 16, 2017 Reply

Sorry to hear your child is biting now. Please know this is a common concern. I will ask one of our experts to tackle this subject in the next few months with some fresh information. In the meantime, please take a look at one of our older articles on biting:

https://www.autismparentingmagazine.com/qa-mouthing-toe-walking-biting/

Have a great day!

    Avatar
    Stephanie Granic - September 27, 2017 Reply

    Hi,

    My son is turning 3 and he just started with striking himself in the head. He does it very hard and I truly hate watching him do this to himself. I cannot really pinpoint as to why he’s started this but my question is, does the same information apply to him printed above? Even though it’s not ‘head banging’ per se?

      Avatar
      Aspiegirl - November 25, 2017 Reply

      I don’t think the mom wants to wait a year for your story to come out before she gets some help. What the heck? What her son is doing is self-injurious, head punching or hitting. Not head banging. It’s very destructive and requires extra support. A helmet will not prevent injury because each time he hits his head he jars his brain. Take him to doctor. Get CT scan head. Mri Head. Take to dentist to rule out cavities. Get ABA therapy. Ask doc to rule out pain, for instance from chronic headaches or allergic reactions that cause elevated histamine.

Amy KD Tobik
Amy KD Tobik - October 20, 2017 Reply

Hello – we had a specialist respond to the original question regarding self harm which will be published early next year. Please keep an eye out for it.

As far as striking himself in the head, I believe your child is trying to achieve the same result as head banging.

Here is another APM article that may help you in the meantime: https://www.autismparentingmagazine.com/a-head-banging-solution/

Hope this helps.

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Annishka - October 26, 2017 Reply

hello My daughter is 7 and she is hitting herself on her legs and in her head. Please help..

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Sandra - December 17, 2017 Reply

What can we do with our grandson who is 9 non verbal that just runs whereever we go i thought of a dog leash but it might appear cruel. Any suggestions

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Jamine Dettmering - September 15, 2018 Reply

Applied Behavior Analysis is an evidence-based treatment that is commonly used to treat head-banging. It’s a bummer that Sensory Integration Therapy was mentioned by the author, but ABA wasn’t mentioned when the research for ABA is more robust than SIT. According to the Association for Science in Autism Treatment, there isn’t sufficient research to support SIT. Hopefully there will be more of a research presence in future pieces.

Avatar
Edna - September 20, 2018 Reply

Hello Jamine, Applied behavioral analysis is a wonderful evidence-based treatment for self-injurious behaviors. Each child with respond differently to each therapy and it is important to always do what works best for your child. The treatments mentioned in this article were intended to be a jumping off point, not a definitive list.

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