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Treatment of Typically Developing Toddlers with Hair-Pulling Behavior and Concurrent Poor Sleep Hygiene: A Case
Jill C Fodstad1,2, Katherynne T Greve3, Michelle J Curtin1,2
1Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN.
Insights
This study highlights that improving sleep hygiene in toddlers with hair-pulling disorder significantly reduces symptoms. Early intervention focusing on sleep patterns is key for young children experiencing this condition.
Area of Science:
- Pediatrics
- Child Psychology
- Sleep Medicine
Background:
- Hair-pulling disorder (trichotillomania) typically emerges in adolescence.
- Limited research exists on early childhood presentation and treatment of hair-pulling disorder, especially in children under five.
- Comorbid psychiatric conditions are common in adolescents with hair-pulling disorder.
Observation:
- This case report details two toddlers (under 24 months) diagnosed with hair-pulling disorder.
- Both children experienced significant sleep disruption concurrently with hair-pulling behaviors.
- Interventions focused on enhancing sleep hygiene via parental education, behavioral strategies, and schedule adjustments.
Findings:
- Sleep hygiene interventions led to marked improvements in sleep disruption for both children.
- Hair-pulling behaviors decreased significantly following the sleep hygiene interventions.
- Positive outcomes were sustained at 1- and 3-month follow-ups, indicating lasting effects.
Implications:
- Early identification of factors associated with hair-pulling disorder in young children is crucial.
- Tailored treatment approaches addressing sleep issues can be effective for very young children with hair-pulling disorder.
- This approach may prevent the escalation of hair-pulling behaviors and associated distress.
Objective:
Hair-pulling disorder is a rare condition with onset most commonly in adolescence and a well-documented association with comorbid psychiatric disorders. Minimal literature currently exists detailing the occurrence and treatment of this condition in young children, particularly less than 5 years old.
Method:
This case report describes 2 cases of children (<24 months old) with hair-pulling disorder and concurrent highly disrupted sleep. Treatment aimed at addressing sleep hygiene through parental psychoeducation and training, competing items, and faded naptime/bedtime.
Results:
In both children, sleep hygiene intervention yielded significant improvement in sleep disruption patterns and hair-pulling behavior across approximately a 3-month period that maintained at 1- and 3-month follow-ups.
Conclusion:
Identifying factors that may be related or concurrent to hair pulling in young children is vital in ensuring that treatment is individualized and effective.
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