Childhood Habit Behaviors and Stereotypic Movement Disorder Treatment & Management

  • Author: Cynthia R Ellis, MD; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Jan 26, 2010
 

Medical Care

Treating childhood habits that do not interfere with everyday functioning is often unnecessary because many habits remit spontaneously over time. However, if the habit is causing the child and/or family members distress, social isolation, or physical injury, a therapeutic intervention may be required.

If the physical examination reveals bodily damage from a habit behavior, focus on treating the specific injury and reducing or eliminating the immediate physical harm the child may be inflicting on himself or herself. At this time, consultation with a developmental-behavioral pediatrician, child psychologist, and/or child psychiatrist may be indicated.

Dental occlusal splints are occasionally used in the treatment of oral destructive habits. Splints do not eliminate but do help reduce the frequency of bruxism.

Helmets may be required for children with severe and persistent head banging, particularly those with clinically significant developmental disabilities.

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Consultations

Consultation with a developmental-behavioral pediatrician, child psychologist, and/or child psychiatrist may be indicated.

Behavior therapy is the mainstay in the treatment for children with habit behaviors. Effective behavioral therapies for habits include the following:

  • Habit reversal: This is the most consistently effective way to treat presenting habits in children because of its brevity, immediacy, efficacy, durability, flexibility, and consistency.
  • Relaxation training
  • Self-monitoring
  • Reinforcement
  • Nocturnal biofeedback (bruxism)
  • Competing responses
  • Use of bitter-tasting substances (nail biting)
  • Negative practice
  • Use of aversive-tasting substance (thumb sucking)
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Activity

Although no specific activity limitations are needed when treating a child with a habit disorder, some situations and contexts may perpetuate habitlike behaviors. Therefore, a functional behavioral assessment by a psychologist can help determine the types of activities that may co-occur with or exacerbate habitlike behaviors.

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Contributor Information and Disclosures
Author

Cynthia R Ellis, MD  Director of Developmental Medicine, Associate Professor, Department of Pediatrics and Psychiatry, Munroe Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center

Cynthia R Ellis, MD is a member of the following medical societies: Nebraska Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Connie J Schnoes, MA, PhD  Psychologist, Director of Training, Supervising Practitioner, Father Flanagan's Boys' Home, Boys Town

Disclosure: Nothing to disclose.

Holly Jean Roberts, PhD  Assistant Professor, Pediatrics, Munroe-Meyer Institute, University of Nebraska Medical Center

Holly Jean Roberts, PhD is a member of the following medical societies: Autism Society of America, National Association of School Psychologists, and Psi Chi

Disclosure: Nothing to disclose.

Specialty Editor Board

Chet Johnson, MD  Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH  Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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