2 year old self harms when angry.

[cuddlebugluv]

Long story short I watch my niece and nephews along with my daughters on a week on week off basis while my brother is at work. The youngest one is 2 and has very serious temper issues along with some serious behavioral issues. He used to bash his head into the floor or any other hard object when he became extremely angry and has a history of this, I myself am not impressed with the pediatrician he has who says this is " normal" behavior for a 2 year old, as does my brother who is seeking another pediatrician. Anyway I've been working with him on not bashing his head in and so far he hasn't, but it has evolved into other self harm mechanisms like digging into his skin to the point he bleeds, pinching himself or smacking his face. I need some advice on how to curb this, as it is the bio mom isn't friendly and is very bitter towards my brother and is looking for anything to get him in trouble, all the more reason to get him seen by a different pediatrician and some advice on how to curb this self harm behavior.

 

[DobbyForever]

I would suggest doing an MCHAT-R online. I don’t want to freak you out because head banging can be a normal part of a tantrum, but it could be ASD or something similar.

Even if your pediatrician says it’s normal, if you ask for evaluation or testing then I’m pretty sure they have medical obligations/responsibility to assess. Idk what the rules are for kids not in preschool or school, but I know in elementary if a parent requests evaluation then we have to do it and within 60 days.

You should speak to a developmental pediatrician if you can. My son is being evaluated by one on a couple of weeks. His pedi thinks he is fine but he failed two screeners/i’m Not one to be told no lol so off he goes

Idk any good advice. My pedi said not to stop him from banging but just to make it safe. I forget the logic because I asked so long ago. He has to get that frustration out somehow though so hopefully y’all can figure something out. Hugs

 

[noon_child]

They usually don't screen for ASD because normal 2yr old behaviour mimics some of the symptoms of ASD in older children. I think the reason is probably similar though and it centres around lack of ability to communicate plus lack of awareness of emotional states. The 2yr old is probably feeling very strong emotions which he can't explain and he also has no idea how long he will feel like this, that its normal to feel like this, that it will go away and there are things to do that can help. All he knows is "This feels awful. What can I do to make it go away?"

I addition to the normal 2yr old struggles he's also had his mum and dad split up (I assume) during his most formative years. He may not understand the situation but he knows how he feels and, I suggest, he doesn't feel safe (not that you and your brother aren't doing everything you can to keep him safe - just that feeling emotionally safe is all about stability in the primary care relationships). So anything you can do to make him feel safe when he gets upset will help. He has learned not to head bang to please you but it has just turned in to another behaviour to express his strong emotions. It's important to allow him to feel his emotions, let them out. Behaviour is communication so until he can communicate better he will "tell" you he is upset in all sorts of physical ways.

I'm not saying he hasn't got ASD but there is very little way of knowing at this young age. In searching for a label so that you can learn how best to care for him and get treatment, you are perhaps missing the labels you already know - he's a 2yr old whose mum and dad don't love each other.

 

[DobbyForever]

ASD is diagnosable at 18 months though most usually parents/caregivers/doctors usually see flags before 18 months. That’s why I suggest taking the MCHAT-R to discern the risk level because it will include more than just head banging in its risk assessment. I’d rather evaluate and be wrong than ignore and lose out on early, crucial intervention that could be a huge difference. But i’m biased. As a teacher, i’m pro intervention because it’s so obvious in my students who had interventions and are successful mainstreamed and whose parents were in denial and they need to be pulled out or have an aide or go to RSP. Obviously not for more severe cases because most schools only take mild/moderate cases so who knows. Rambling. Anyway.

I do agree it’s about communicating frustration, which he has a lot of. Since he doesn’t know how, he hurts himself. I just wish I could help but my son only banged for a few weeks, and now only does it when he is really mad or tired.

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https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Recommendations.
“The AAP recommends conducting developmental surveillance at every health supervision visit and conducting general developmental screening using evidence-based tools at 9, 18, and 30 months, or whenever a concern is expressed. In addition, autism-specific screening is recommended at ages 18 and 24 months, and social-emotional screening is recommended at regular intervals.“

 

[SarahBear]

I think head-banging to a degree can be normal, but if he's actually hurting himself and then when discouraged, redirecting his aggression to another form of harm, there is something wrong. Does he seem insensitive to pain when he's not angry? Or is this just an anger issue? As for the ASD comments above, how is he with social engagement?

 

[noon_child]

Agree with Dobby that the MCHAT is a good tool. No other screener would be recommended for toddlers here in the UK as they aren't all reliable.