head banging becoming a (painful!) problem

[theDudesmummy]

Hi, I would be really grateful for any advice. My DS is 2.7 and although not yet formally diagnosed I am pretty sure he is ASD. He has very few words, is highly demand avoidant and has a number of behavioural issues. Up until recently it was the chewing of everything within reach that was causing the most concern in terms of day to day life. This has however improved quite a lot (and we use chew noodles to help when he needs to chew).

A new and more difficult problem has now become the main issue: headbanging. He does it only when either he is told to do something and does not want to do it, or (the main issue) when anyone leaves. That could mean someone just walking out of the room, or leaving the house, me leaving him at nursery, or even the postman or delivery man coming in for a few seconds and then going away again. It can even mean a toy saying "goodbye" (he has a toy computer that says this when it switches off) or someone on the TV saying bye (In Justin Fletcher's Bee Bright the damned ants and bees keep saying bye!)

All these result in an immediate head banging response. He just gets down onto his hands and knees on the floor in a determined manner, and bangs his head, really HARD, about three times. If you hold him to prevent him doing it, he bangs his head on you, either backwards or forwards, with equal force. This morning when his dad left the house he smashed my nose so hard with his forehad that I cried . The nanny has also had her face bashed on many occasions. The nursery teachers told me that all know that that have to be very careful as they have all been bashed in the face too.

I am going through the first steps of planning to set up an ABA programme and am doing a lot of reading about it etc, but in the meanwhile, does anyone have any tips or success stories in this area? Thanks so much.

PS his nanny has just brought him back from a soft play/Gymboree session nearly in tears because he was head banging really hard there after being asked to stop opening and closing a door. We are getting rather desperate. It looks so painful and it is getting more and more frequent. Any advice would really be ratefully received.

If you are in London I know a parenting training organisation that may be able to help. That's not a suggestion that you are a bad parent - it's just real help with behaviour. They will do private sessions as well as group programmes. You must be beside yourself.

can you get a helmet for him?

Well, I don't want to go down the route of a helmet just yet, I suppose it is such an obvious thing for people to see, and he would have to wear it literally all the time as the head banging can occur at any moment...even in the bath...

Yes I am in London jif, I am looking into training in ABA and starting an ABA programme at the moment, but would be happy to hear about any other training resources, thanks

Here it is. I haven't tried them but they have been running for quite a few years and are very much about treating kids as kids (and adults as adults) rather than little programmeable robots IYSWIM.

www.calmerparenting.com/

I had the same problem with ds, I haven't really got any advice tbh as I found it really difficult to deal with.

The advice I was given by HV was to ignore he wouldn't hurt himself, but I deffo don't recommend that!!!!! This was before we realised he had ASD. I used to just pick him up to stop him but then he would attack me.

He did grow out of it by the time he was three, he headbanged from about one year old.....I feel for you it is very stressfull, if there is an org as suggested above go for it.

Thnaks ver much for the helpful feedback. We are having some success with distraction. We also NEVER say bye (even on the phone!) but just a closing door or someone leaving the room is enough to set him off. If he is the one who is leaving it is not nearly as bad (as long as no-one says bye)!

I had tried the ignoring thing but he was banging so hard that I could not do it. I don't know if he would really harm himself or not but standing by and watching the full-force thumping, or leaving him to it just is not possible. He does stop after a few thumps, doesn't go on for very long, but it is just so forceful.

What we are trying now is: not shouting "no! (just seems to make it worse! but hard not to do as a reflex!) grabbing him and hugging him tight (with the knowledge that he will thump you if you let his head move in any direction), pressing hard on his forehad with your hand then encouraging him to pat his forehead with his own hand. Then after about a minute distracting him with one of his favourite songs (he loves songs and music so this gets his attention). I have had some success with this today! It's really hard though!

It is encouraging to hear that other children have moved on from this behaviour...

Have you tried blocking the impact of the head bang with a cushion/ mat, etc.? Oftentimes, if input is dulled/blocked the behavior will diminish.

You will need to determine an alternative behavior to teach him that allows him to express his needs/wants related to these antecedent events in a more appropriate and less harmful manner (i.e., handing the person leaving a stop, hug & kiss me first card).

You need to figure out the function (medical, escape/avoidance, attention, tangible or sensory) of the head banging. Planned ignoring is a common strategy suggested for SIBs (self injurious behaviors) that indiividuals engage in to gain attention. But you mentioned that he likes to open and close doors too. Could his head banging be related to others opening and closing doors? Just a thought...

Hope some of this helps! Good luck!

Thanks for that. I am pretty sure the banging is his way of saying "I am not happy about something that has just happened", and he can't say that because he does not have the language for it.

Well, I eventually got hold of the special needs health vistor yesterday afternoon and she spoke to me for ages onthe phone, was very sympathetic and gave me a plan: basically to stop reinforcing the behaviour, so when he headbangs we must pick him up with NO talking or eye contact at all, place him in a business-like fashion (no cuddles, no anger etc) on a soft surface like a cushion or couch, and not interact until he stops the banging. When he stops then distract him with a song etc (he does love a song!) I have tried this a few times now and it does seem to work (although you have to (a) be very careful when you pick him uo because of the sudden backward head fling! and (b) be prepared to reposition him on the cushion or whatever more than once ALL WITHOUT SAYING ANYTHING (easier said than done!)

Everyone who looks after him including nursery is going to be doing the same thing now. Hope we can beat this!

I'm glad you have a solution. Regarding what you say about him having no language - is there any work being done on that such as signing or SALT? Also mine once had an analysis from a physiotherapist saying that she had a 'need' to exercise her 'vestibular system'. In other words she needs to swing. It is possible that in very young children there is a link between pacifying the vestibular need and pacifying emotional needs. I hope that makes sense, it's just my theory really - does he like swinging?

Hi thedudesmummy, i have a 3.5yo who headbangs. Although thankfully not as much as she used to. It is pure frustration because she doesn't have the words to express her pov.
After advice from portage, we ignore it completely at home, she gets no response from us at all. And very rarely does it at home anymore.
Until recently she was doing it at nursery, I discovered they were reacting to it and so she was doing it more. When she got a new ta, the ta stuck a small cushion under her head and walked off, couple of times doing this and dd doesn't do it very often there anymore.

From experience if dd is restrained or prevented from doing it then she goes into complete meltdown and lashes out at everyone nearby. Hitting, head butting, biting, kicking, screaming.

I would recommend watching ds very carefully when he does it. Is he doing it to hurt himself or for the reaction?
In watching my dd, she swings for the floor with force, but just before she hits it she holds herself back so she doesn't actually butt the floor with much force. She then screams, but it's not a pain scream, (there is a difference), it is a pure frustration scream, (a tantrum scream).
It is easier to ignore when you see that they're not doing it to actually hurt themselves.

If you go down the ignoring route it does get worse before it gets better.

I'd also recommend using picture boards eg now and next, as visual reassurance of what is happening. Pre-warning/counting down to an event that you know will trigger it. And huge Praise/reward if ds doesnt head bang in a situation where he usually does.

And like you said in your last post, make sure everyone is reacting in the same way.

And big hugs because it is easier said than done. (especially in the middle of adsa when everyone turns to stare,)

Thanks for that, all very helpful. There does appear to have been an improvement already (including a decrease in the force of the bangs), although he has been sick with a cough and fever the last two days so maybe he is just feeling too sick to bother!

In answer to the question about the lanuage etc, yes he has been having SALT weekly (privately) for six months now, but with limited results as far as any lanuage is concerned. His attention and concentration, and his interactivity have however impoved quite a lot. We have been trying to get him into signing (Makaton) but no real luck with that so far).

I just Pmed you with a couple of ideas Thedudesmummy

Hi again Thedudesmummy,
My dd likes "sing it in sign with scarlet" (should be able to find in Internet search) she sings and signs nursery rhymes in BSL. Great for beginners, dd signs twinkle twinkle from it.
When we started signing it generally took about 2-6 weeks between us introducing a sign and dd using it. But now she understands quite a few, but is selective with who she signs to and which signs she uses. (she doesn't waste words, if she can say it in 1 sign she won't use any more.)
You say theres been no real progress with salt, we are the same. Have you had ds's hearing tested recently? (about 5% of HI children pass the newborn screening)

Thanks for that. Yes he has had hearing tests and had grommets last July for glue ear. The last hearing test he woudl not co-operate with so we have to go back again. I am pretty sure he hears fine now though.