Q: Our 9-year-old is driving us all crazy by cracking his knuckles. How can we get him to stop?
A: Many school-age children have patterned motor habits that they repeat when under stress or during certain activities, such as watching TV.
If the habit is well-established, repeated reminders to stop often draw the child's attention to the habit and make it even more compulsive. Yell- ing or pleading will not make this habit 'N disappear.
If your son really wants to stop, ask him to come up with a plan. He might start a chart on which he can make an "X" when he gets the knuckle urge -- and then substitute some other behavior. Or consider giving him a small prize for each half-hour without cracking.
If certain activities bring the cracking on, he should avoid those activities or keep his hands busy with something else. One word of caution -- when one motor habit goes, another often takes its place. The new one may be even more obnoxious.
Dr. Wilson is director of pediatric primary care of the Johns
Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.