Can Head Banging in Children Cause Brain Injury?

Question: 

I am a school nurse and have a second grader who has started banging his head on the concrete walls, table, and other surfaces enough to leave red marks. We are wondering what he could possibly be doing to himself over the long term. He is emotionally disturbed and autistic. Should he be checked for possible traumatic brain injury? How can we help him?

Answer: 

There is no easy answer to your question. First, I would have him seen by his pediatrician for a thorough check-up and review his medical history to see if has had any previous falls or concussions. The next step would be to try to figure out what has precipitated this new head banging behavior. Typically developing children usually do not intentionally bang their heads hard enough to cause injury — but it's an effective behavior to get an adult's attention. For this child though, we can’t count on his ability to regulate himself even when a significant level of pain is involved.

The first priority is to keep him safe. That means not allowing him to hurt himself. A thorough assessment of his behavior should lead to a plan to reduce the head banging. In the meantime, he may need other interventions that might include protective headgear or medication. If a neuropsychologist or a behavioral psychologist is not involved in his care, you might consider a referral to help you figure out how best to manage this difficult and concerning situation.

 

Posted on BrainLine December 16, 2009.

Comments (8)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I'm desperate for some insight.

My daughter, as a toddler, banged her head regularly and throughout the day. She did it hard and we tried to stop her, but 2 pediatricians assured us she wouldn't be able to do it hard enough to cause injury and to allow it to some extent.

Additionally, when as a 4-5 yo she started sneaking her albuterol inhaler, going off and taking many hits. I really don't know how many times, but probably as many as 10 before I caught her and secured the inhaler.

Lastly, she was put on Concerta for ADHD for 3-4 years during adolescence.

Now she's a junior in college and has ALWAYS struggled with mood, outbursts, learning difficulties and attention. I worry headbanging, albuterol abuse, and Concerta have caused her brain injury. I've tried researching online about all three issues and haven't come up with much. If you could tell me what you know about any of this I would greatly appreciate it.

I've let her down as her mom, the person who should've protected her, and I'm feeling devastated that all this may have impacted her permanently. I feel I should not have blindly trusted her doctors about the banging and safety of Concerta (which is now known not to be so safe after all). Thank you for any insight you might provide.

Hi! I just happened by this site and saw your plea for help. I’m certainly not an expert in brain injury! But I do know one thing for certain...you were and are an excellent mother. You have always done the very best you could with the information you were given at the time, with your daughter’s needs at heart.

I am blessed to have a mother like you. Like you, she did not always make the correct decisions. I (like all children ever born) live with the results of my parents’ choices, both good and bad. However I know that every move they made was done from love and deep concern for my wellbeing, and so I blame them for nothing.

We all have to feel our way blindly through our lives, racking up successes and failures. In my opinion, the only guidepost we are given is love. If what we do and say is based on love, we can genuinely say that we did the best we could, and leave the rest to fate.

May God bless you and your daughter and give you peace. You Did The Best You Could.

I wonder if (as a child) did (lifelong damage) from head banging?? My behaviour was ignored yet I was told I would, hit my forehead so hard, it would leave large lumps. Hmmm

Hello Doctor, my son is 12 years now but when he was around 2 years old had fallen in the bathroom hitting the back of his head on the bathroom tiles. He cried but acted normal. I am worried whether the accident will have an effect in future.

Hello Dr Gioia I'm the mother of a 15 year old who hits himself in the head when he's stressed out. He does see a neurologist and takes Lexapro. How can I help my son stop this before he seriously injures himself......I'm afraid he will do this while I'm at work and I won't be there to step in

What about a one year old that frequently bangs his head hard enough to leave bruises? At 2 he is exhibiting very low speaking ability and prefers signing to speaking sounds or words.

Recommend that the child have a genetic blood test done. Autism is just a label, not an etiology behind the behaviors. Multiple genetic syndromes result in self injurious behaviors including head banging.

Children-and adults- with autism will headbang, flap arms, and do a lot of quote "weird" behavior, especially when stressed or overwhelmed. Requiring the behavior to stop can be even more stressful. Finding out what might be driving the intensified head-banging is the first step. If the source cannot be directly reduced, then providing an alternative or a safe time and place to de-stress might also work. For example: a set time, place, and duration where the kid can hit their head on/against a thick pad or pillow. Yes, autistic people are different. So is everyone on the planet. Look for the reason behind what you do not understand.