Hair-pulling 3-year-old wants attention, not pain


January 22, 1995|By BEVERLY MILLS

Q: My 3-year-old has recently starting pulling out his hair in hanks big enough to put in the baby album. Before he would just twirl it around his finger. What should I do?

-- Bonnie Borderson,

Victoria, British Columbia

A: The best thing you can do is completely ignore the hair-pulling while giving your child lots of positive attention. If you do that, the problem should go away by itself in time.

Trichotillomania is the complicated medical term for hair-pulling, something that's usually quite uncomplicated in young children.

"Even though hair-pulling has a name, for young children it's a syndrome that's similar to any other repetitive behavioral problem, like nose picking or nail biting," says Trevor Valentine, a behavioral pediatrician and pediatrics professor at Boston University.

"It's very hard to stop, but the No. 1 way to deal with it is to ignore it. Parents usually create more problems by intervening."

Parents get particularly anxious about hair-pulling because they can't understand why a child would hurt himself or herself and because the behavior is so destructive.

"Is there any crying, bleeding or scarring?" Dr. Valentine asks. "If the child isn't showing signs of pain, then he's OK."

Young children usually do the pulling in public, which Dr. Valentine says is a tip-off to its main, underlying cause.

"It's the big A," Dr. Valentine says. "A certain amount of pain is accepted as the necessary means to get attention."

There are exceptions. Children who pull out enough hair to create large bald patches, scarring or bleeding need professional attention. Children who continue the habit for longer than six months may also require treatment.

When Dr. Valentine treats trichotillomania in preschoolers, he recommends what he calls competing hand exercises. As soon as parents and other care-givers notice the hair-pulling, which is almost always done with the same hand, engage the child in an activity he enjoys with the other hand.

Many parents who called Child Life recommend shaving the head or cutting the child's hair very short so that pulling becomes impossible. Dr. Valentine says this isn't a good idea. "This way, the parent is mimicking the child's behavior, only you're getting to the hair before the child does," he says. "This focuses too much attention on the behavior, and I think it can lead to unhealthy relationships."

For more information, write the Trichotillomania Learning Center, 1215 Mission St., Suite 2, Santa Cruz, Calif. 95060 or call (408) 457-1004. The nonprofit group offers a complete information package for $7.

While a reporter at the Miami Herald, Beverly Mills developed this column after the birth of her son, now 5. Ms. Mills and her husband currently live in Raleigh, N.C., and also have a 3-year-old daughter.


Here's a new question from a parent who needs your help. If you have tips, or if you have questions of your own, call our toll-free hot line any time at (800) 827-1092. Or write to Child Life, 2212 The Circle, Raleigh, N.C. 27608.

* No hitting: "My 21-month-old son is quite violent," says K.T. of Miami, Fla. "He hits me and other people with anything he can get his hands on. He doesn't have a set bedtime, and I have to try and hang in there since I am a single parent. I don't believe in spanking. How can I stop him from hitting?"

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