Q. "If my 18-month-old daughter is frustrated or mad, like when she doesn't get what she wants, she cries and bangs her head on the sofa, bed and even the floor. I need some advice on what to do," says a mother from El Paso, Texas.
A. A toddler who is hammering away with her head is both painful to watch and tough to ignore. Readers who can turn their backs on the behavior often find it disappears, but experts say parents also need to explore what's behind the head banging.
"I raised two little head bangers," says one mother from Tacoma, Wash., named Pamara. "We discovered that the less attention paid to the behavior, the sooner it goes away."
She says her 22-month-old son recently stopped banging his head after finding out that it doesn't give him the attention he wanted in the first place.
Patti Gorry of Coventry, R.I., says her 2-year-old son also tried head banging to get attention.
"I made sure he was in a safe place and let him bang away," Ms. Gorry says. "It was hard not to intervene, but soon he realized this was not an effective way to get what he wanted, and he stopped."
As long as a child is progressing normally in his developmental milestones, head banging probably is a temper tantrum to ease frustration and not a sign of serious problems, says W. Michael Nelson, who heads the psychology department at Xavier University in Cincinnati.
"You can usually tell what's attention-getting behavior," Nelson says. "Is this happening when the child has just been told no?"
Giving in to a toddler's demands simply increases the head banging, Nelson says.
Many readers find this phase works itself out.
"I had a similar thing happen with my oldest daughter," says Julia Taylor of Colonial Beach, Va. "I figured that any attention given this matter was a reward even if it were a negative reward."
She made sure her daughter's bedroom was safe, then walked out. "After a few times of leaving my daughter in a room by herself with no one to pay any attention to that behavior, she stopped doing this," Ms. Taylor says.
Toddlers will go after attention any way they can, says a father of three boys, Gerald Rowe of Marino Valley, Calif.
"Walk away when the child does that and don't make a big fuss over it," Rowe suggests. "When she does do something good, make sure that's when she gets all the attention."
The causes could be linked to anxiety or the child could be seeking stimulation to fill a void, says Anita Landau Hurtig, a pediatric psychologist at the University of Illinois at Chicago.
"Look at what's happening at home," Dr. Hurtig suggests.
Some children need a soothing motion at bedtime to help them fall asleep, and head banging releases tension in the same way body rocking does. If the child is developmentally and socially on track, head banging to wind down tends to be normal, Nelson says.
In some cases, ear infections, headache pain or sinus congestion turns out to be the culprit. Head banging also can be part of a general syndrome such as autism, Mott says.
"Overall a pediatrician (or the family's primary health care professional) should be able to determine which avenues to follow," Mott says.
When a healthy child is not angry, his parents can help him learn to ask for what he wants and to accept no for an answer, Nelson says.
Can you help?
DENTIST FEAR: "When my daughter was 2 1/2 , she threw a fit during the exam at a pediatric dentist's office and they tied down her arms and legs without my consent or knowledge," says Linda Mahon of Cleveland. "I found out about it from my 4 1/2 -year-old son on the ride home in the car. Now, at age 4, my daughter is terrified of going to the dentist. What can I do?"
Child Life is a forum for parents to ask child-rearing questions and share tips with other parents. If you have advice, or if you have questions of your own, please call our toll-free hot line any time at (800) 827-1092. Or write to Child Life, 2322 Hales Road, Raleigh, N.C. 27608, or send e-mail to email@example.com