PRESCHOOLERS’ HABITS: HANDLE WITH CARE

NEW YORK TIMES COLUMN: FAMILIES TODAY:
PRESCHOOLERS’ HABITS: HANDLE WITH CARE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

(NOTE:This article is updated from “Touchpoints: Three to Six,” by T. Berry Brazelton,M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

Many preschool children go through a period of various self-comforting habits such as hair-pulling, rocking, or biting their nails and the skin around them. As if they were exploring the behavior that bothers parents, they seem to run the gamut of habits.

Habit patterns have deep roots. My first child sucked her middle two fingers as a newborn to comfort herself an unusual pattern – and I found myself taking them out of her mouth. My wife said, “You’d never recommend trying to stop this to your patients. Why do you try to interfere with her sucking?” I couldn’t answer her.

A week later, my mother came up from Texas to see her new grandchild. “Isn’t that amazing? She sucks the same two fingers you used to suck! In those days, finger sucking was considered a bad habit. We tried to stop you, but we never could. You were determined.”

I realized then why I’d tried so hard to stop my daughter. Attention to a habit pattern is more likely to set it as a problem than to eradicate it. Thumb bandages, terrible-tasting ointments, or other ingenious measures have the opposite effect from that intended.

An older child can be helped to see that she resorts to self-comforting habits when she’s stressed and needs to calm down. These are signs of tension. Parents can evaluate the pressures on a child who is resorting often to such habits. The pressure isn’t always from the outside.

An over-charged, hard-driving child may need such a habit pattern to help her manage her temperamental intensity. One child, on being reprimanded for her nail-biting, pleaded, “Mummy, can you take my head off? My mouth just bites my fingers. I don’t like it and I don’t know what to do.”

This shows the depth of feeling in a child who is trying to control such a symptom. Do we want to add our own pressure to it? Why not say, “Most people bite their nails. Sooner or later you will stop. In the meanwhile, worrying about it won’t help. I’ve made you feel guilty about it, and I’m sorry.”

Better to reassure her that the habit is likely to go away. This is more likely to happen if everyone (including the child) can ignore it. The various habits common at these ages – thumb sucking, pulling out hair, nail-biting, stuttering, and the many others that parents encounter – can show a common pattern. (See below for guidelines to identify habits.)

Criticizing the child for a habit makes her feel inadequate, unable to “break” the habit. For these reasons, a parent would be best advised to ignore the behavior from the first.

Because all parents are loaded with their own past experiences, this is not easy. Nail-biting was a habit to be “broken” for the last generation. A parent today who was broken of this habit during his own childhood will find it extra hard to “ignore” such behavior today.

HABITS TO GROW OUT OF

  1. Many 3- and 4-year-old children run the gamut of habits. They last only a few weeks or months. Many of these habits may be imitative of a parent, a sibling, or a peer.
  2. Habits may serve a self-calming purpose at a peak of frustration or excitement. A child turns to this behavior as she might have to her thumb earlier. A special doll or other treasured object to hold and touch might help to redirect the child’s need for self-comfort.
  3. When a parent sets up a prohibition, this surrounds a habit with heightened interest or excitement and tends to reinforce it. Either the added attention or the use of it as a kind of rebellion makes it satisfying. All this is unconscious on the part of the child. In this way, what might have been transient behavior becomes more fixed – a habit.
  4. Much less commonly, more unusual kinds of involuntary behavior (for example, repetitive hand washing or staring spells, among others) may seem to take on a life of their own and seriously interfere with a child’s daily life. If they have a more bizarre quality, are more repetitive or disruptive throughout the range of a child’s activities, they require professional attention. A health professional is needed to determine whether these are habits or something more serious (such as obsessive compulsive disorder, Tourette’s syndrome, or certain seizure disorders) for which treatment is needed. Your pediatrician can refer you to a pediatric neurologist or child psychiatrist.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.