What is head banging and body rocking?

Head banging and body rocking are types of rhythmic movement disorder that usually involve some type of repetitive stereotypical whole body or limb rocking, rolling, or head banging behaviors. These behaviors are usually seen in children around naptime and bedtime and may recur after awakenings throughout the night.

Typical movements:

• Head banging typically occurs with the child lying face down – banging the head down into a pillow or mattress. In the upright position, the head is banged against the wall or headboard repeatedly.
• Body rocking is typically done with the entire body while on the hands and knees. In the upright position, the upper body may be rocked.

Body rocking and head banging may occur at the same time. Other less common types of rhythmic movement disorders include body rolling, leg banging, and leg rolling. One or two movements can occur every second or two and "episodes" often last up to 15 minutes. Sometimes this may be accompanied by humming or other vocalizations. The movements usually stop if the child is distracted or after sleep is established. Usually, there is no recall (amnesia) upon awakening.

Should I be concerned about my child's head banging and body rocking behaviors?

If your child is normal and healthy and only shows these behaviors during the night or at naptime, you should not be concerned – these are common ways for children to fall asleep. They are seen in many healthy infants and children beginning at an average of 6-9 months of age. These behaviors typically subside by age 2 or 3 and by age 5 are only still seen in 5% of normal, healthy children. These movements tend to occur at the same rate in both girls and boys and may run in families with a history of these movement disorders. Note: Head banging and body rocking behaviors should only be considered a disorder if they markedly interfere with sleep or result in bodily injury.

Parents of certain children with other health issues – including developmental delay, neurological or psychological problems, autism spectrum disorder, or those who are blind – will need to be watchful of these behaviors, as they can (though rarely) lead to injury. Of note, rhythmic behaviors in children with health problems may occur both during the day and night.

What response or protective action should a parent take?

Simply keep in mind that head banging and body rocking are normal activities that some children engage in to help with sleep onset. There is not much you need to do, and most children will grow out of this behavior by school age.

There is no real need to put extra pillows or bumpers in the crib – they usually don't work. Also, don't forget that by visiting your child while they are doing these activities, you may be reinforcing what may be an attention-seeking behavior. So make sure you are giving your child plenty of attention during the day, and ignore this behavior at night.

As far as your child's safety is concerned, do make sure the bed or crib they are in is secure – that all the bolts and screws are checked and tightened on a regular basis. If your child is in a bed, put a guardrail up, so he or she does not roll out of bed. You may want to move the bed/crib away from the wall to reduce the noise factor at night.

When should I consult a doctor about head banging and body rocking behaviors?

You may wish to discuss this with your doctor if:

• There is injury associated or you fear there is potential for harm.
• There is a lot of disruption to the home environment due to noisy head banging.
• You feel your child may have other sleep disorders such as snoring and sleep apnea.
• You are concerned about the development of your child.
• You worry your child may be having seizures.

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