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.
Abstract

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