What is head banging and body rocking?
Head banging and body rocking -- also called rhythmic movement
disorder -- usually involve some type of repetitive stereotypical rocking,
rolling, or head banging behaviors. These behaviors are usually seen in children
around naptime and bedtime and may recur after awakenings throughout the night.
Typical movements:
- Head banging typically occurs with the child lying face down – banging
the head down into a pillow or mattress. In the upright position, the head
is banged against the wall or headboard repeatedly.
- Body rocking is typically done with the entire body while on the hands
and knees. In the upright position, the upper body can be rocked.
Body rocking and head banging may occur at the same time. Other
less common types of rhythmic movement disorders include body rolling, leg
banging, and leg rolling.
One or two movements can occur every second or two and
"episodes" often last up to 15 minutes. Sometimes this may be accompanied by
humming or other vocalizations. The movements usually stop if the child is
distracted or after sleep is established. Usually, there is no recall (amnesia)
upon awakening.
As a parent, should I be concerned about my child’s head banging
and body rocking behaviors?
If your child is normal and healthy and only shows these
behaviors during the night or at naptime, you should not be concerned -- these
are common ways for children to fall asleep. They are seen in many healthy
infants and children beginning at an average of 6-9 months of age. These
behaviors typically subside by age 2 or 3 and by age 5 are only still seen in 5
percent of normal, healthy children. These movements tend to occur at the same
rate in both girls and boys and may run in families with a history of these
movement disorders.
Note: Head banging and body rocking behaviors should only be
considered a disorder if they markedly interfere with sleep or result in bodily injury.
Parents of certain children with other health issues --
including developmental delay, neurological or psychological problems, autism
spectrum disorder, or those who are blind -- will need to be watchful of these
behaviors, as they can (though rarely) lead to injury. Of note, rhythmic
behaviors in children with health problems may occur both during the day and night.
What response or protective action should a parent take?
Simply keep in mind that head banging and body rocking are
normal activities that some children engage in to fall asleep. There is not much
you need to do and most children will grow out of this behavior by school age.
There is no real need to put extra pillows or bumpers in the crib -- they
usually don’t work. Also, don’t forget that by visiting your child while they
are doing these activities, you may be reinforcing what may be an attention
seeking behavior. So, make sure you are giving your child plenty of attention
during the day, and ignore this behavior at night. As far as your child’s safety
is concerned, do make sure the bed or crib they are in is secure -- that all the
bolts and screws are checked and tightened on a regular basis. If your child is
in a bed, put a guardrail up, so he or she does not roll out of bed. You may
want to move the bed/crib away from the wall to reduce the noise factor at night.
When should I consult a doctor?
You may wish to discuss this with your doctor if:
- There is injury associated or you fear there is potential for harm
- If there is a lot of disruption to the home environment due noisy head banging
- If you feel there may be other sleep disorders such as snoring and sleep
apnea involved
- If you are concerned about the development of your child
- If you worry your child may be have seizures
Additional Sleep Information and Suggested Readings
Mindell, JA and Owens, JA. A Clinical Guide to Pediatric
Sleep: Diagnosis and Management of Sleep Problems. Philadelphia, PA:
Lippincott Williams and Wilkins, 2003.
http://www.sleepeducation.com and other educational links on the
American Academy of Sleep Medicine website http://www.aasmnet.org.
The National Sleep Foundation at http://www.sleepfoundation.org.