Head banging

Head banging is the rhythmic movement of the head against a solid object and is marked by an almost compulsive repetitiveness. The reported incidence in childhood varies from 5 to 15%. The male to female ratio is approximately 3 or 4 males to each female. While the exact etiology is unknown, the suggested etiologies include: an integral part of normal development, a kinesthetic drive, a tension releasing maneuver, an attention-seeking device, a response to restricted activity, a consequence of emotional deprivation, and a response to various acute illnesses. The onset is usually in the latter half of the first year of life and generally ends spontaneously by four years of age. Head banging generally occurs before normal sleep. The duration may vary from a few minutes to an hour. The frontal-parietal region of the head is the most frequently struck. Although head banging appears alarming, the child seldom inflicts significant damage to the head. The physical examination in children who are head bangers is usually normal. Laboratory investigations are generally not indicated. The appropriate treatment of head banging is to offer the parents a supportive and reassuring explanation that brain damage is unlikely and that the child will outgrow the problem.