About a month ago, Jackson started hitting his head again. He hasn’t done that since his “catatonic stage” when he first showed signs of withdrawing and regression, pre-GFCF diet. The bumper of the van, the corner of the dresser, every doorpost in the house planted their mark in the middle of his forehead, and before long, the school was sending notes home asking about the giant purple bruise on his head. We, of course, were disturbed by this self-injurious behavior and interrupted the head-banging as soon as possible, but after one or two hits, Jackson looked like the loser in a boxing match.
My first questions were “Why is he doing that?” and “How do we make him stop?” We tried redirecting Jackson to a different activity and/or room to disrupt his focus on hitting his head. That worked some of the time. I tried watching and mentally recording where he was and what he was doing to see if I could figure why he would engage in such self-injurious behavior. Everything I had read so far suggested that children engage in head-banging for three reasons: 1. to get attention 2. to “ground themselves” when sensory input becomes too overwhelming 3. to get an endorphin rush.
It didn’t appear that Jackson was trying to get our attention, since he mostly attempted to hit his head when in another room by himself. Jackson tends to be under-sensitive to stimuli rather than overwhelmed by it, so it didn’t appear he was hitting his head for the second reason. The last one was a possibility, but how could we know for sure if he was hitting his head for the endorphin rush? It didn’t seem like he had been allowed to head-bang for long enough to experience any kind of rush, and I began wondering if something else was going on.
Was there some other pain or sensory confusion he was trying to drown out by hitting his head? Was he role playing something from a movie? Single head-banging attempts often happened during a movie when the character fell over or was getting hurt.
Soon I suspected headaches because when I moved toward him to disrupt head-banging, I put my hand on his head. He would grab my hand and put it back on his head, echoing my question, “Head hurt?” He started doing the same thing at school, pulling the teachers’ hand to his head, wanting them to press down firmly. One teacher wrote, “Jackson was taking my finger and poking it at his head.” I thought, “Do you really want pressure on your head, or are you just trying to point to your head?”
When I mentioned this to the pediatrician and neurologist before, the behavior was dismissed as “typical behavior for children with autism.” So frustrating since if any of my “non-autistic” children started banging their heads, they’d be undergoing a panel of lab tests to look of potential mercury poisoning or some other issue.
Now armed with new observations, and more determination to find answers and relief for Jackson, the neurologist prescribed Nadolol 20 mg for headaches. He’s been on it for almost 2 weeks, and the only time we’ve seen head-banging is when it’s time to take then next dose.
I still wonder if it’s something he’s eating that we’ve missed, but I can’t seem to track it down. Maybe some newly developed sensitivity? We saw so much head-banging while Jackson was still eating dairy and gluten. Head-banging completely disappeared once those offenders were removed from his diet.
The school recommended using a helmet to protect his head when he does try to head-bang. We use a bike helmet, but it has become more of a deterrent. He does not like wearing it. Immediately after hitting his head one time, the helmet goes on for 15-30 seconds. Jackson will ask to take it off, and repeat, “no more hitting head.” Off it goes, and he usually does not attempt to hit his head again that day.
I still feel like we may be missing something, but at least Jackson is trying to tell us something. I wish I could hop inside his head for a bit just to find out what’s going on. Just want him to know, “I’m listening, honey…Just trying to figure out your lingo. Thanks for being patient until I learn.”