Head-Banging in Autism : Behaviour Management

This article is based on the presentation that talks about head-banging, one of the common behaviours in Autism. It is crucial to understand the root cause of this behaviour and identify ways to handle a similar situation. This article has been created by Parul Gupta, an expert advisor who has shared her input with Nayi Disha.

Consider the following situation:

Varun is 8 years old and recently started having trouble going to bed. He has recently started banging his head and being self-injurious and does it several times a day. Mom and dad try to read him books and calm him down, but nothing is working.

How should a parent handle this situation?

To address this issue, it is important to first understand the probable underlying cause.

This can be done by analysing the situation, and by careful observation:

1. When does this behaviour occur?
2. Does it happen at a specified time?
3. How many times does it occur and how long does it last?
4. Is the child aware of his doing?
5. How does it usually end?

It is important to observe the behaviour to understand the root cause of the problem and what it is that the child wants to communicate through the behaviour.

Possible reasons for the head-banging behaviours

Scenario 1:

Sensory Nature of Self-Inflicting Behaviour

Observe if the child has a preference for the kind of surface he chooses while head banging. If the surface is hard, then it might be because the child is seeking a sensory- proprioceptive input.

What can we do ?

Once you have identified the probable reason for the self-inflicting behaviour to e sensory i nature:

1. Meet a psychologist to assess if the child indeed has sensory sensitivities and if this is the cause of the behaviour
2. Consult an Occupational therapist to help understand how to address this behaviour by fulfilling the sensory needs of the child
3. Practice at home: Use alternatives to provide the sensory input the child is seeking. Use a soft, elastic head band. Make sure you take safety precautions to minimise injury.
4. Work with an Occupational therapist to ensure the child gets the required sensory input:
   • Help the child be aware of his sensory needs
   • Teach the child to ask for help
   • Provide him with alternatives to achieve his sensory needs, instead of self-inflicting behaviour

Scenario 2:

Observe if the child is completely aware of his behaviour and looks for reaction from his parents. 

This might be a case of the child using self-inflicting behaviour to get what he wants. For example, an outing or a toy or attention.

The behaviour in this case may be stemming from difficulty in communication,where the child uses this behaviour instead of expressing his needs.

What can we do?

Short term:

• Consult a speech therapist for guidance on what steps can be taken.
• Help the child understand that his desires or displeasure can be communicated through verbal expression or through the use of picture communication boards

Long Term:

• Work with the child on modes of communication to express themselves. This can be through verbal expression, use of pictures or alternate means of communication such as AVAZ (an AAC tool)
• It is also important to work on the emotional regulation of the child.

Scenario 3:

The child has a meltdown as he gets angry and has trouble controlling his emotions. This may be an attempt to seek attention, but at the same time the child finds it difficult to regulate his emotions and gets overwhelmed and frustrated. Instead they express their emotional discomfort through self-harm, in this case – head banging.

What can we do?

Once, the cause for the behaviour has been identified as difficulty in emotional regulation, the following approaches can be adopted:

Short term:

• Approach a psychologist for further guidance
• Bridge the gap in communication by encouraging communication.
• Effective communication need not necessarily be only through speech. It can be through gestures, pictures or alternative means of communication.

Long term:

• Work closely on the child’s communication skills, helping them to express their emotions. This will help them feel less frustrated.
• Identify and teach the child alternate means of expressing his emotions. (chk if examples can be added)

Scenario 4

The child seems frustrated but helpless. He resorts to head banging but no apparent reason can be observed.

In such cases, there can be an underlying medical reason causing bodily discomfort.

What can we do?

It is extremely important to identify and address any medical concern that is compounded by the lack of communication. Medical conditions may be allergies, tooth aches or ear aches, sinus or stomach issues. This physical discomfort might be making the child restless that is being expressed through self-harming behaviour.

Short term:

Consult your pediatrician and address any concerns.

Teach the child to express any physical discomfort. This can be through gestures or using pictures.

Long term:

Working on communication skills will help the child to express any discomfort without resorting to self-harming behaviour.

If your child also shows differences with handling his/her behaviours which can manifest as undressing his/her clothes often, please refer to this resource.

If you have questions about Autism, Down Syndrome, ADHD, or other intellectual disabilities, or have concerns about developmental delays in a child, the Nayi Disha team is here to help. For any questions or queries, please contact our FREE Helpline at 844-844-8996. You can call or what’s app us. Our counselors speak different languages including English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.

DISCLAIMER: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management