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Common Behaviour Problems

 

What is normal behaviour?

The norms with which society reacts to day-to-day situations are considered normal behaviour. Children, at times behave in a different manner which causes worry in parents and may need remedial measures. Some of the commonest problems faced are :

Thumb & Finger Sucking Temper tantrums
Self Stimulation Stammering
Breath holding Aggression
Tics Anxiety
Head banging Jealousy
Nail biting

 

Thumb & Finger Sucking

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Sucking is an instinctual behavioral pattern. Most young infants suck on their fingers for varying periods of time. This behaviour should be considered normal.

Constant thumb sucking is strongly related to the emotional satisfaction of the infant or young child. Finger sucking will not have any detrimental effect on the position of the permanent teeth, as long as the habit is discontinued before the secondary teeth have erupted.

Management:
Majority of children give up the habit of finger sucking, by the time they reach school age, except in moments of severe stress. In most cases, thumb sucking represents a greater problem to the parents than to the child. The history usually reveals that the child does not do an unusual amount of thumb sucking; it is the parent who is made anxious by the behaviour. The child may benefit from the use of positive reinforcements for not sucking the thumb rather than negative statements regarding the behaviour.

 

Self Stimulation

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It usually consists of the normal self-soothing habits of children and arise in early infancy. Such behaviors appear in two forms:
  1. Rhythmic habits – include rocking, head
  2. rolling, head banging. Appearing in the second half of the first year, these behaviors usually occur at the time of fatigue, sleepiness, or frustration and serve as comfort to the child.
  3. Genital exploration or manipulation – The extent of this behaviour is directly correlated with age. In an infant or young child, genital manipulation is a manifestation of wholesome curiosity, while in the 3-6 year old, it is an expression of a normal interest in sex. This should not arouse concern if the child is outgoing, sociable and not preoccupied with the activity. Excessive stimulation usually indicates underlying high-level anxiety or family conflict, or may be a sign of emotional disturbance. In later stages, from 6 years to puberty such behaviour is naturally suppressed.

Management:

  1. Management of concerns regarding rhythmic behaviour is directed towards averting injury and reducing noise. Don’t attempt to discipline or restrain the young child once the behaviour has started.
  2. Management of concerns regarding masturbation is directed toward reassuring parents that masturbation is part of normal development. Gentle inhibition or distracting the child is more appropriate than calling attention to the activity. Attempts to suppress the activity, may produce potentially damaging psychological sequelae.

 

Breath holding attacks

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These are alarming to parents and are seen mainly in toddlers.

Features

Child is usually intelligent and easily frustrated and reacts in a dramatic way to gain attention.

  • Rarely occur when the child is alone, as he needs an audience for the show.
  • An attack often starts with the child taking a very deep breath in as if he were going to scream, but instead he holds his breath and his face goes redder and redder and eventually turns blue.
  • The attacks aren’t usually dangerous, although occasionally a very long attack can end with a convulsion or a short period of unconsciousness because the child’s brain does not get the required oxygen.

What you can do:

  • Simple measures like slapping the child are usually ineffective but a good trick is to hook your finger over the back of his tongue and pull it forwards. This makes it impossible for him to hold his breath and the attack is cut short. However this should be done early in the attack before he clenches his teeth.
  • If the attacks are controlled early, they seem to disappear.
  • A combination of preventing frustrating situations and sensitive handling of each attack will control the problem.
  • Most children grow out of these attacks by school age.

 

Tics or habit spasms

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These are irritating nervous habits often affecting the head and shoulders. For e.g.: tossing the hair back, rocking, sniffing, shrugging shoulders, pursing of lips and what not.

Remember:

  • Tics are not the child’s fault but can be infuriating to those around him.
  • Try to ignore them as much as possible and find out if there’s anything that might be worrying him. Being tough with the child does more harm than good.
  • None of the tics do any harm to the child, so there is no need to be anxious.
  • Tics are a type of movement disorder which is only partly under voluntary control. They can be part of a wider syndrome- Tourette disorder. There is an uncontrollable urge to move which is often interpreted as pain or discomfort by the child and this precedes the movement. The urge can be controlled for only a while. The cause of tics is not psychological though emotional stresses can increase the tics. They should be treated if and when they start embarrasing the child and make others ridicule him eg vocal tics like grunts or shouts or when they are responsible for damage to other organs (happens rarely)
  • Try not to leave your child alone when he is awake or involve him in whatever you are doing, even if only as an observer.

 

Head banging

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It usually is seen between 6 months to 1 year. More commonly it occurs in:
  • Bored kids
  • Children left unamused for long periods
  • Mental retardation

Head banging can cause:

  • Bruising
  • Callus formation
  • Bald patch

Parents should:

  • not leave the child alone when he is awake for a long time
  • make sure that whatever he bangs his head against is soft and unlikely to hurt him

 

Nail biting

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This is a habit occurring in school going children, but may last even in late adulthood.

Causes:

  1. If a child’s nails are too long, this can start off the habit because he finds long nails unpleasant.
  2. Generally, it’s a habit copied from other children or practiced because the child gets enjoyment or comfort from doing it.
  3. Boredom, excitement, worry or embarrassment.
  4. Fear, insecurity or apprehension

Ways of handling:

  1. Ignore it.
  2. Older children are most easily motivated to stop biting (especially girls) because they realize it’s unattractive.
  3. Older girls may give up the habit if allowed to use nail varnish.

 

Temper tantrums

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These are sudden displays of uncontrolled rage and are seen under the age of four years. The behaviour takes the form of screaming, crying or lying on the floor with head banging and heels drumming. It may last from a few seconds to minutes depending upon how the child is handled.

Causes:

  1. Children of this age are not able to control their emotions and so release their anger and frustration in the only way they know how.
  2. They are unable to tell their parents what is bothering them because of lack of fluency of speech.
  3. They cannot get their own way.

How to cope:

  1. Keep calm.
  2. Find out why your child is behaving this way and if it’s something you can put right, do so. However if it’s because of something you won’t let him do, don’t give in. Quietly tell him why he can’t do whatever it is, then if he’s still upset, give him a cuddle and try to divert his attention to something he likes doing.
  3. Never physically punish the child, as this will enrage him more.

 

Stammering

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Hesitant, repetitive speech causing an interruption in the normal rhythm of speech, severe enough to attract attention, interfere with communication and cause distress to the child. In some cases sounds are repeated, with a stutter, even before the word is eventually spoken, whereas in others the child may stammer at the first word and can normally complete the sentence once the initial hurdle is overcome.

Your child knows precisely what he wants to say, but at that time he is unable to say it easily because of an involuntary repetition of sound.

Stammering is most common between 2-6 yrs of age. It is 3 times more common in boys than in girls. Most children stop stammering by 4 yrs of age.

Causes:

If you want your child to stop stammering, you must understand that NOTHING is wrong with him. Stammering occurs because your child's mind is running ahead of his ability to get the words out. This should be considered normal as speech development is occurring at this age. You will notice that your child is speaking normally when alone, singing, talking to animals or people whom he knows well. Problem begins when his answer is expected or keenly awaited. This should convince you that, stammering is more emotional than physical.

A study has shown that children who stammer, generally have a great degree of domination, discipline, over-protection & perfectionism at home. Watch out! You may be responsible for your child's stammer.

Dos and Don'ts:

  1. Never try to discipline your child to make him speak properly. It is believed that that excessive fussing over early transient stammering leads to more permanent stammering.
  2. Don't show signs of impatience or laugh when he struggles to get the words out. Give him time to speak.
  3. Never mention your child's stammer to him. Mild cases recover on their own. If you are extremely worried see your doctor and he may refer you to a speech therapist.
  4. If your child continues to stammer by the 4th birthday, he definitely needs to see a therapist, as he must talk normally by the time he goes to school.

A very small percentage of children may have problems like tongue-tie, as the cause of stammering which needs surgical correction. If your child started talking normally and started stammering later on, it is definitely emotional.

 

Aggression

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Aggressive/attacking behaviour is a protective mechanism, necessary for survival instinct. It enables us to cope with problems we face. It is present from birth onwards and you have to train your child to control it.

Babies if not fed and hungry, scream and wave their arms and legs about, as this is the only way they can convey their needs. If you meet your babies need right away they are less likely to react in this manner to every frustrating situation, as they grow older. A baby who is made to wait generally quietens down but his anger and aggression are then directed elsewhere or contained and expressed internally and manifest as failure to thrive etc.

In older children, aggression takes various forms and may present as anyone of the following:

In later years this aggressive urge is exercised to meet the challenge of competition from other children. Whatever age a child is this sort of behaviour should be handled with love. More often than not the underlying cause is emotional deprivation. If you can't solve the problem, seek help from your doctor.

 

Anxiety

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Like adults, children also do get anxious and experience nausea, dizziness, weakness and palpitations. If this happens as a response to something, which can normally cause anxiety, then only reassuring your child is enough. But if it arises in simple situations like going to school, travelling etc. then medical help may be required. In some children this may produce physical symptoms such as- limb pains, headache, abdominal pain.

 

Jealousy

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Jealousy especially between brothers and sisters is absolutely normal. You may first notice it when your new baby arrives. This can be in the form of aggressiveness towards the new arrival or even you. He may become sad, quiet, start wetting his clothes, demanding a bottle or cuddle at awkward times. The youngest child in the family is generally the most affected. You should make sure that all your children get a fair share of your time daily. Give them plenty of love and affection to make them feel secure of your affection as jealousy basically arises out of a feeling of insecurity.