Some of the common habit behavioral disorder
What are Habit disorders ?
They are repetitive,non-functional behaviors that do notresult in injury or interfere with normal activities, occur in the contextof normal development and typically resolve without specific treatment. They are mostly tension discharging phenomenon.
Some commonly observed habit disorders are :
Thumb sucking,
Nail biting,
Breath holding,
Headbanging and body rocking.
Hair pulling (Trichotillomania),
Teeth grinding ( bruxism),
Air swallowing (Aerophagia ).
What is the extent of the problem ?
Most people will develop habit behaviors at somepoint in their lifetime.
Prevalence are as low as 4-5% for breath holding to a high of about 80% for
thumb sucking.
Overall, about 15-20% of children under the age of 3years will exhibit some kind of habit behavior.
What is the cause ?
The cause may vary depending upon the habit it may be associated with painor anger (breath holding), sensory seeking (thumb sucking), anxiety(nail biting) or sleepiness (head banging,body rocking).
Interventions for Selected Habit Behaviors:
Thumb sucking:
Reassurance for parents
May Ignore in children under 4 years –will usually remit by 6 years withoutintervention.
Praise and rewards for not sucking thumb.
Use a bandage on the thumb to remind them not to suck.
May refer children over 5 years to an orthodontist for a thumb crib.
Nail biting:
Ignore
Keep nails short
Must rule out underlying emotional disorder.
Habit Reversal Therapy can be applied for school aged children consists of three
components:
1. Increase awareness of habit – e.g. have them look in the mirrorwhile biting their nails
2. Teach a competing response – e.g. chewing gum, blowing airthrough pursed lips, etc.3. Teach relaxation techniques – visualization, deep breathing,progressive muscle relaxation (see anxiety module appendices)
May refer children over 5 years to an orthodontist for a bite plate
Breath Holding:
Reassurance for parents if able to diagnose by history alone – episodesgenerally remit by age 5 years
Video of event shall help in diagnose
EEG and EKG if nature of episode still remains unclear
Parents should remain calm and not give attention to the behavior
Consider supplemental iron if anemic
Head Banging/Head Rolling/Body Rocking:
May occur separately or together in otherwise healthy children aroundsleep time
Reassurance – rarely results in injury and will usually remit by 4years of age withoutintervention
Parents should remain calm and not give attention to the behavior
If still concerned:
– Line crib with bumper pad
– Move crib away from wall
If behavior persists beyond 4 years of age may need furtherevaluation.