Prevent Head Banging in Autism: Sensory Strategies & Addressing Demands, Frustration, Pain or Attention Seeking
Autistic kids and children with disabilities may show a wide range of challenging behaviors such as property destruction, physical aggression towards others, and, quite often too, self-injurious behavior. One of the most distressing self-injurious behaviors (SIB) is head banging.
This post proposes 25 tips and advice to prevent or minimize head banging. The strategies are designed to adapt to the various functions that self-injurious behavior may serve: sensory processing issues (sensory overload and under-stimulation), attention seeking, escaping demands, frustration, and pain.
Head banging, hitting the head with a fist, or banging the head on the wall or floor are all different manifestations of the same behavior. For us parents, it is an extremely overwhelming situation:
- fears of brain damage and for their general health and safety
- frustration over our inability at times to understand what is going on or what our child is trying to communicate
- helplessness over our failed attempts to help them
- doubts about whether our actions help fix the problem or make it worse.
Today, I will try to put together a comprehensive document to help parents or caregivers facing this type of situation. Hopefully, by the end of this read, you will know a bit more about the following topics:
- most common reasons why kids engage in headbanging behavior
- tips and ideas to prevent it or mitigate the consequences
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What is Head Banging?
We can find two very different head-banging definitions when we look at this behavior in kids:
- “Behavior that appears in up to 20% of normal children in the latter half of the first year of life and ends spontaneously by about 4 years of age; more common in boys.”
Source: Medical Dictionary for the Health Professions and Nursing. © Farlex 2012
- A type of stereotyped self-injurious behavior, often present in those with ASD, intellectual disability, or other developmental disabilities that may be described as:
- highly repetitive behavior
- episodic under highly specific stimulus contexts, or
- in bursts after long periods without problematic behavior
Source: Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input.)
In this post, I’m going to focus on the latter.
The first head-banging behavior that I’ve mentioned does not typically result in physical injury. It is still a worrying situation for a parent, and you will need to consult your doctor. But it doesn’t mean there is a developmental problem behind it.
Head Banging and Autism
Self-injurious behavior is frequent in autistic kids and adults(up to 50% occurrence). And head banging is its most common form.
Why do Kids Engage in Head Banging Behavior or Other Self-Injurious Behaviors
There are lots of theories about the origins of SIB (developmental, biological, environmental), but most research shows that SIB is a learned behavior maintained by its consequences.
Dr. B. Iwata, who conducted extensive research to assess the functions of self-injury in individuals, suggested the following reasons for engaging in these types of behaviors:
- social positive reinforcement (either attention or access to food and materials)
- social negative reinforcement (escape from demands or sources of aversive stimulation)
- automatic positive reinforcement (sensory reinforcement )
- automatic negative reinforcement (the SIB assists to stop an aversive stimulation-like pain)
Source: Functions of Self-Injurious Behavior: An Experimental Epidemiological Analysis (Iwata, B)
As parents, we don’t usually use these academic/behavioral labels when we talk about the causes of head banging. The most common reasons for head banging that I will address below are:
- Sensory processing issues: Overwhelmed response to sensory stimuli triggers (sounds, lights, textures)
- Attention-seeking: Trying to get people to notice and pay attention to them.
- Escaping from demands: Trying to avoid or get out of something they’re asked or expected to do because it feels difficult or unpleasant.
- Communication Issues / Frustration: Difficulty expressing their feelings or needs that leads to frustration.
- Pain: Trying to mask or mitigate a feeling of pain or discomfort.
It soon becomes obvious that there cannot be a one-size-fits-all solution. Understanding the function of this behavior is key to ensuring that the strategies you implement will be successful.
What can we do to Prevent Head Banging
General Tips, Ideas and Recommendations
Some tips could apply to SIB in general and specifically to head banging, no matter what the function of this behavior is:
1. Always look for advice from your health professionals.
2. A Functional Analysis by a behavior therapist will help produce a good behavior intervention plan.
3. Watch out for precursor behaviors (things that may be happening even before the actual behavior is present):
- mood changes
- verbal escalation
- anxiety
If you can act on those behaviors, you may be able to avoid the SIB situation altogether.
A tip for those situations may be to redirect them into another task or distract them with a question (Response interruption and redirection): What was your favorite toy? What was your favorite food?
4. Track behaviors to understand their function (you can read my post on how to track behaviors)
5. Understand triggers
6. Act upon those triggers
7. Medication may be required for severe or long-lasting cases.
Tips to Minimize Physical Harm:
8. Get a protective helmet.
9. Secure problematic areas with some padding (e.g. padding on the walls around the bed)
10. Learn how to do safe holds to prevent harm / Block attempts to bang the head.
Sensory Processing: Sensory Strategies for Head Banging
Senses are often acutely affected in autistic people.
Autistic kids may have increased or decreased sensory sensitivity (over-responsiveness or under-responsiveness). An individual can even present both reactions to a different range of stimuli.
Tips to Prevent Self-Harm Due to Sensory Overload:
11. Remove stimuli that are causing the sensory discomfort:
- Ensure they wears comfortable clothes
- Remove a smell that may be overpowering
- Remove noise with noise-cancelling headphones.
- Take the child to a quieter room
Tips to Prevent Self-Harm Due to Under-Stimulation
12. Provide sensory alternatives that provide a similar experience to head banging:
- Jumping on a trampoline.
- Swinging
13. Provide other sensory inputs that they may find stimulating (examples in the links below)
- A vibrating pillow
- A soft floor rocker
- A weighted blanket (I have a post on weighted blankets for kids and how to use them. I share a mistake that may affect how this works for you)
Tips for Attention-Seeking Head Banging
As a parent, you may feel that you are giving your full attention to your kid, but triggers may be as subtle as:
- Mom and Dad talking to each other for more than one minute
- Leaving your child alone watching TV. (even a favorite cartoon) and not making enough interaction for a certain period of time
- Talking to another sibling
14. “Non-Contingent Attention” Program
There will always be situations in which we know we are going to be busy or we need to engage in a discussion with other people. If aggressive behaviors are triggered by attention-seeking, you may need to start a “non-contingent attention” program.
Non-contingent means you give attention for no special reason (“just because”). Your kid or student will get the attention they crave without the need to engage in self-injurious behavior. This approach will need to be implemented over a period of time:
- Acknowledging your kid before you start an interaction with another person
- Providing attention at very high rates of attention (every 1-2 minutes) while engaging with another person
- Slowly extending the amount of time that elapses between attention moments (e.g., 2 minutes – 3 minutes- 5 minutes).
The final objective is for your child or student to learn to regulate themselves. During the weeks that you implement this non-contingent attention program, you will need to teach the child to ask for attention in appropriate ways.
Tips to Prevent Head Banging to Escape from Demands
Some autistic kids or children with disabilities have learned that they can escape from activities that they find too difficult (or just boring) with disruptive behavior.
If we have identified escape as a trigger, these are some tips that may be useful:
15. Redirect into the task so that your kid does not associate engaging in that behavior with escaping from that demand, BUT
16. Assess the task difficulty to ensure that it is achievable
17. Assess if it can be made more fun /easier
18. Try using a token economy so that there is an extra motivation
A token economy is like a reward system. When your child or student completes the task or activity (or whatever behavior objective you set), they earn tokens (like points or stickers). Later, they can exchange these tokens for something they like, such as extra playtime or a small treat.
Head Banging as a Result of Frustration or Communication Issues
Behavior is a form of communication.
In the context of autistic children or children with disabilities, where communication challenges may be present, behaviors such as head banging may serve as expressions of frustration, anxiety, or discomfort.
19. Use visual support to help your kid or student communicate their needs.
20. Prompt your kid to demonstrate what they want “show me what you want”
21. When giving instructions, ensure that they are clear and concise.
22. Explain rules and ask your kid or student to repeat them back (if they are speaking)
Example: If you throw a toy, it goes away. When you throw a toy, what happens? (Expect them to fill in the blank). Repeat this 3-4 times before they get an item or do an activity.
23. If you identify transitions as a problem, there are different ways to address it, depending of your specific situation. You can check “Helping Children with Autism Spectrum Conditions through Everyday Transitions. Small Changes- Big Challenges”
Head Banging to Mitigate Pain
It is important to rule out any medical condition that may be causing pain.
A kid may use head banging (or other SIB) as a way to mitigate or mask pain and discomfort. So, the tips here may be a bit obvious:
24. Get your doctor to rule out a medical condition that may be causing pain or discomfort
25. Provide alternative pain relief solutions
I really hope you have found these strategies to prevent head banging useful. Let me know if there are other suggestions that we could add to this list.
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Other Autism-Related Posts:
- AUTISM GPS TRACKER: How to Choose the Best GPS Tracker for your Kid
- Autism & Elopement: 30 Tips to Help Prevent Autism Wandering
- Autism & Anxiety: 24 Triggers and 25 Coping Strategies
Autism & Head Banging: How to Prevent it / Minimize Harm
As a educator it is very hard to reduce head-banging for my student. The function of behaviour is attention seeking but using extinction does not seem to be working. Any tips will be much appreciated.
Hi Margie, it is really a difficult situation. For us, in a case of attention-seeking, what has worked better in the past was a combination of making the environment safe (padded), learning how to block the attempts safely and very importantly ? working on a “Non-Contingent Attention” program (like the example I mentioned in the post).
Your document is well-written and the recommendations/suggestions are really great. My son engages in head banging, and now that he is more verbal I have identified that he engages in this behavior due to frustration if something goes wrong with his computer or if he has difficulty communicating, and I recommended that he should try snapping a rubber band on his wrist instead of banging his head in the hope that the pain is less dangerous and he still has control of his own behavior but with a far less detrimental outcome, and I also told him to practice mindfulness activities by deliberately redirecting his focus on things around him and using his senses to focus on other things that were happening around him, outside of the problem, at the time he was feeling frustrated. I also told him to verbalize how he is feeling; for example, “this is so frustrating” or ” I am so frustrated with this computer”. He has agreed that he will be using the rubberband and also mindfulness techniques instead of banging his head. I am praying that he will be able to manage his own behaviors in a positive way.
My daughter is 35 years old . She gained a University degree and we communicate well but her night time head banging can be for a variety of reasons. She says sometimes she doesn’t know why she does it.
We’ve tried padding the headboard behind it and all sorts.
I do worry that long term she might cause some internal harm to herself.
It is preventing her from getting a flat of her own because of the impact on surrounding residents.
Hi Judith, I’m sorry to hear about your daughter’s struggle with head banging. I strongly recommend consulting a health professional for tailored advice. I can relate to how stressful this phase can be, as it was a particularly challenging time for us as well. While we implemented many of the strategies discussed in our post, our situation also required supporting our child with medication, which I mention in the general tips section. Each person is different, so I hope you and your daughter can find an effective solution that works specifically for her.