Monday, August 2, 2010

Self-Harm or Communication?


FROM CAROLINA: Many of you have experienced one of these moments - when you're watching your child do something that looks harmful to his or her body: your son bangs his head on the wall - over and over and over so that he has a little bump or bruise on his forehead; your daughter bites her hand so hard she leaves teeth-marks; your son balls up his sweet little fist and punches his head when you don't give him something he asked for.  It's a moment when most parents tell me that they feel fear and concern - wondering how to keep their beautiful children safe. It's a moment that most parents use to blame themselves - "If I only knew how to care for my child better, he wouldn't do this."

Of course, we want to keep our children safe - that is of number one importance. If I'm with a child in the playroom (big or small, young or old), and he or she is doing one of these behaviors, I'm going to first offer that child a way to be safe.
For example, if a child has just smacked his head on the wall, I'm going to get down a pillow or blanket to hold up on the wall in front of him, to soften the surface he's using.  Or if a child is biting intensely on his or her hand, I'm going to offer other options for that child to chew on - like a chewy tube or a washcloth - so the child has a way to bite something other than his/her hand. Or if a child has a hard toy and is using that toy to hit himself, I'm going to calmly remove that toy from the child and put the toy out of reach on the shelf.

However - here's what's amazing: most of the time, when we offer alternatives to our children - they don't want the alternative. They simply find another place on the wall, seemingly ignoring our offer. It brings up the question: why would our children continue doing something if it hurts so much?

So perhaps it's time to see "self-injurious behaviors" differently - what if these behaviors are not injurious at all? In 99% of the children we work with, our children have simply found a way to look like they're hurting themselves, when they've actually found something that doesn't hurt at all. Just for fun - go try it - go and smack your forehead against the wall. You'll find that your child usually hits the front of his forehead - the hardest part of his skull - or you'll see that your child bites his hand on the big soft part - to the left of the palm, just below the thumb. Try it - bite that part of your hand really hard. You'll probably leave teethmarks but you'll find that it actually doesn't hurt. Our children are incredibly intelligent - and they've simply found ways to try to move the world and get what they want.

Plus, we have to keep in mind that our children have bodies and sensory systems that are different from ours. Many of the children we've worked with are hypo-sensitive - meaning that they don't feel sensations as easily as we do - and so they crave intensely deep pressure on their hands, feet and head.  They can handle (and repeatedly ask for) levels of pressure that often doesn't feel good to many of us - which indicates that their bodies feel things differently than we do.  I know children who have talked about their extremities (hands, feet and head) feeling numb - so it makes sense that they're craving input, because otherwise they can't feel their feet or their hands.

So - if we keep in mind that our children are incredibly smart, and that our children have different sensory systems than we do, then we can create an entirely new perspective. A child demonstrating "self-injurious" behaviors may be doing so simply to communicate with us - to insistently remind us to listen.  So, let's listen.  Let's figure out what our children are really telling us - so we can offer them what they're really asking for. Let's stay calm and easy, turning our perspective to one of curiosity and a desire to help. By doing so, we can help our children no longer engage in these behaviors.

Through "self-injurious" behaviors, our children are telling us:
1) I want more control. The world around me is often overwhelming and beyond my control and I want more control in my life. I bang my head when you take me outside because there is too much stimulus there. I bang my head when my brother is making too much noise because it overloads my brain. I want less stimulation and more control in my life.
2) My body needs physical input - sometimes it doesn't feel good to me so I bang my head to relieve pressure or to help me feel my body. It changes every day - I can't control the feelings I'm getting in my body - so I'm just biting my hand or banging my head to try to help my body feel better.

How we help:
1) If you already have a playroom, offer your child time to be in the playroom - because this is the best place for your child to feel less overwhelmed. Many children who hit their heads, bite their hands, etc. immediately reduce or eliminate these behaviors once they're spending time each day in the playroom. If you don't have a playroom yet, create a quiet space in your house where your child can be to relax and not feel overwhelmed. You can be there together or you can offer your child time alone in the playroom or in this quiet space.

2) Give your child more control and remind your child how much control he/she has. In the playroom, we can offer our children more control - we can be quiet when they ask us to - we can join their repetitive behaviors - we can get them the toys they want - we can only play the games they want us to play.  The more control we give our children, the more our children will feel in control and will need to bang their head less.  And when you give your child control, show him what you've done - "Look how fast that  happened! When you said no, I jumped across the room to put it away - isn't it cool how much you're in charge here?".

3) Give your child physical input. If your child is banging his head, offer him squeezes on his head, jaw and neck. Your child might want really light squeezes, or really light scratches - or your child might want really deep pressure. Or your child might say no to head squeezes but allow feet squeezes. Only do what your child allows - remember, giving control is first. If your child bangs his head frequently, you can also look into craniosacral therapy - a form of massage that helps the skull move into better alignment and therefore be more comfortable for our children.

4) Look at your child's diet. If your child regularly bangs his head or bites himself, perhaps it's a reaction to something he's eating.  VERY often, our children are banging their heads because of sugar intake - too much processed sugar or too much fruit sugars. Our children have more sensitive bodies than we do, and often a food allergy or sensitivity to sugar can create these types of behaviors.

Sending you all love and looking forward to hearing how you all do with these suggestions!

Love, Carolina

5 comments:

  1. It was nice to read this to be reminded of these ideas. Jacob has started hitting himself in the head since school started again. He also wants to control us all evening long by turning off all of the lights in the house.
    I know he works so hard to hold it together all day and all week that he just needs to de-stress when he comes home.

    He also will not go anywhere when he comes home from school- not even to a fun place.

    Jacob is hugely controlling. He is 16 now and doing well- still has communication issues- although he can say everything.

    Last FRiday night, he was invited to a classmates birthday party. HE was excited about it. However, come Thursday- he started to stress over it, saying "no Paul's party, stay home." Finally that night he said "Mom, I do not want to go to Paul's party." A full sentence- a nice sentence, and I responded by letting him stay home. He has a high anxiety level being involved in the world all week long in school. He simply cannot handle the stimulation of doing anything else.
    Other people think I was wrong to let him stay home, but what I did was to remind my son that his words have power. The full sentence was rewarded by letting him have the thing that he needed- no more social stress.

    I can't let him stay home from school when he asks- but this I could let him do.

    We still make lots of mistakes. Each thing we do right- it deepens the bond and makes him more able to communicate.

    I was disappointed- and am disappointed when he doesn't want to do things. Then I must ask myself- who is that for- me or Jacob?

    Laurie Howard

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  2. Thank you for sharing this information. I found it very helpful. It has stimulated ain interesting thought process. As I ponder on these concepts you brought up in this article, I am sure I will find a way to help my AS teenage daughter transition into this new stage of her life. Yes, this article was most helpful. I would love to correspond with you more in the future. A "teenage" playroom sounds like something I should construct in the near future. Her savant characterists include music, computers & 'the rules' in specific sports of her fixation. Thank you.

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  3. robertaross@comcast.netNovember 11, 2010 at 1:27 PM

    My oldest is a self-biter. Thank you for your contribution Carolina!

    Roberta
    Mother of Hanna & Megan

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  4. Brandon likes to bite his lip or the inside of his cheek until it's bleeding and infected. He seems to be doing this more lately and chewing everything he can get his hands on. He is getting new teeth and they are crowded (he's 9) - could it just be teething??

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  5. Hello,

    Thankyou for your great question! If his teeth are crowded then it's likely that they could be chaffing on his gums or cheek. Seeing a dentist will be the most effective way of finding out if that's the case.

    When we see our children bleeding or in need of medical attention, we can often feel worried or scared. The most effective resourse you can be for Brandon is to be the calm in his storm, having a loving, supportive and comfortable attitude

    Our children pick up on how we feel so quickly and if you or other family members are concerned and worried about this then it could be a way for Brandon to make the world move.

    Offer him a wash cloth/flannel to bit onto as an alternative and know that the tissue in the inside of our mouths have a way of healing really quickly.

    love Becky

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