Why Head Banging Doesn’t Mean Your Toddler Is Autistic


I have worked with so many toddlers who terrify their parents with a tendency to bang their heads on the floor when frustrated.  Their parent’s first question is almost always  “Do you think he could be autistic?”.  Sometimes the answer is yes, but it isn’t because of the head banging.  It turns out that head banging is a behavior seen frequently in autism, but it can be a sign of unrelated problems or just a developmental phase.  No one likes to see their child walk around with welts on his forehead. Head banging can be stopped or at least diminished when you know why it is happening and how to turn around the cause(s).

Here are some suggestions to deal with this behavior whether or not your child is on the spectrum:

  • Watch the timing and the pattern of behavior/experiences prior to head banging. Sometimes hours before the head banging.  Tornadoes do not appear without clouds, and head banging doesn’t emerge without a trigger either.  Even the children who bang their heads to “stim” (increase specific sensory stimulation in any mode of sensory input) have an actual reason.  Usually their reasons are to exchange one sensory input for another more irritating one, or seeking input to raise their overall sensory alertness. It is hard for many parents to understand, but strong, even painful sensation can actually be calming to a person who is experiencing internal turmoil.  This appears to be the basis for another troubling symptom seen in teens and adults: cutting.  That is why head banging could be an attempt to deal with frustration or rage a child cannot control and cannot express.  Work hard on those communication, sensory and behavioral concerns.  Sometimes it can be as easy as dimming the lights or snipping the tags on shirts.  Sometimes you need a complex behavioral program as well as a sensory diet.
  • There are toddlers that bang their heads a few times and then slip a quick look to see if they are getting their way.  Is she running for the cookie, not the sandwich?  Is he turning on the DVD now?  Fewer sobs, less intense desire to bang his head, and no visible relief from the few hits he takes. That sidelong look tells you what you need to know.  He is hoping to scare you into caving in.  Don’t fall for it.  In fact, that might be the time to use the Fast Food Rule (below) and a consequence/loss of privilege.  You are being played.
  • If sleep schedules are erratic or if sleep is insufficient, that can contribute to a very short fuse and  support this behavior when frustrated or overwhelmed.  So many childhood behaviors have been linked to sleeping issues, and this is one of them.  Get help if you need to for sleep problems, and then see where you are with this issue.
  • The inability to communicate frustration and desires/needs is a huge reason for head banging in toddlers of all stripes.  And not just the kids on the spectrum or kids that struggle with sensory processing.  Build his language skills and use The Fast Food Rule from Happiest Toddler on the Block.   See my post in March 2015 ” Taming Toddler Tantrums Using Empathetic Reframing” so that your child feels that you really, really hear what is bothering him!  After that, use Dr. Karp’s Happiest Toddler technique “patience stretching” after your child is 12 months old, or with a  child who is at a 1-4 year cognitive and communication level.
  • Finally, make sure kids are safe and have alternatives that work and that they can use.  This takes practice for both of you.  Not yelling, being firm and supportive isn’t easy when your child is determined to head bang.  Some kids will be willing to bang their heads into bean bag chairs, sparing their skulls.  Some will let you massage their scalp for stimulation, also kinder and gentler. Some need to know that choosing head banging consciously instead of speaking, seeking a quiet space, a therapy toy or a hug will result in the loss of privileges.  But always equipt your child with some alternatives that work and help them make a good choice before they risk a loss of a privilege.


By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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