18 month old boy `head butting' and trying to break things.

[LittleRuss]

My wife cares for a daughters 18 month old boy whom we dearly love. We are concerned about his `head butting' tendencies. We don't know if it's because he wants attention or if it's a communication problem.  Development otherwise seems to be on target.

[kidcare]

Is your grandson talking at all?  You did state you wondered if it could be a communication issue.  If he is not talking at all and only babbling, he probably needs to have his hearing and speech evaluated.  Was he late with any of his development or was he on time with everything?  You mentioned he throws his bottle when he gets mad..he should be drinking from a sippee cup instead of a bottle.  Does he only eat certain types of food...soft with very little chewing involved or does he have difficulty chewing or swallowing food?  If his language is behind and he is only eating certain types of food..he would benefit from speech to help develope the muscles or movements used in talking and eating.  Does your grandson have difficuly going from one activity to another, does he dislike wearing clothes-shoes/socks or touching/feeling certain things?  If so, he may need sensory intergration therapy to help him bring all of his senses..hearing..touching..smelling..etc together.  A pediatric occupational therapists can evaluate these areas and explain the tx.  I work with young children and sometimes we see behavioral issues because of language delays or sensory intergration dysfunction.  On the internet go on NECTAS and find your state and the contact for the Infant and Toddler Part C program.  Have your daughter call since she will have to sign the consents, and tell her to ask to have her child evaluated.  The evaluations will not cost and if he is eligible for the program they can possibly help with cost of tx.  The doctor will need to be aware of these concerns since he will have to write an order for the evals/therapy.  He sure is lucky to have such caring grandparents..best of luck as you address these issues.

[Kevin Kennedy, Ph.D.]

To address a minor point first, don't worry about the lack of interest in building. It's normal for an 18-month-old to do what he does. The head banging, when it's not done in frustration, can be worrisome. It sometimes is a means of self-stimulation in children with various neurointegrative conditions. It's worth having this checked out with the pediatrician, though I noted you did mention he seems to be developing OK in general. When he head butts you, I'd put him in time out (you can use a playpen or crib for this). Tell him "No", and immediately put him in time out. Otherwise (i.e., when the head butting does not hurt anyone) I wouldn't intervene other than to be sure he (a) is on a fairly soft surface (e.g., carpet) and (b) has things to occupy him.

[LittleRuss]

To elaborate, the youngster will bump his head firmly on almost anything at anytime while holding him or while he's playing. As yet, he hasn't brought blood, but has caused himself to cry. He butted me so hard, while I was holding him, I thought he had broken my jaw. He also will put his head down on the floor and push, like plowing a garden. When he's through eating he throws what's left onto the floor, whether it's his bottle or table food. When we try to get him interested in playing with building blocks all he wants to do is knock them down and shows little interest in building. He's very curious about things, but I think that's an attribute. His older sister (by 10 years) has ADHD and his father is tightly wound also. His mother (our daughter) has an attention disorder as well. Makes me think there's a gene problem. We haven't been able to pinpoint what sets him off. How do we keep him from hurting himself or others.

[Kevin Kennedy, Ph.D.]

Would you elaborate a little? I can't offer you guidance without knowing a bit more about the beahvior.