Sunny Days Blog

Baby Head Banging & Autism

Head banging in Children

Head banging is a common calming or self-soothing rhythmic habit of babies and toddlers. While head banging can be a normal behavior for infants, when combined with developmental delays it can be a sign that a child should be screened for Autism Spectrum Disorder.  Head butting, head rolling, body rocking, and thumb sucking are related self-soothing behaviors. 

In this post, we discuss when and why head banging occurs, preventative measures, and when to speak with a medical professional about the behavior.


Kinesthetic Drive: Why Children Engage in Repetitive Motions

To understand why young children engage in repetitive motions, like head banging and head butting, we first need to understand what actions they are replicating. 

All infants are rocked by their mothers while in utero, which progresses to enjoying being held and rocked in a parent’s arms. As children grow, rocking toys, exersaucers, tricycles, slides, amusement park rides, bumper cars, and bike riding are manifestations of this kinesthetic drive—joy in movement—because these activities engage the vestibular system of the brain. The intensity, duration, and type of movement that provides pleasure varies from child to child.


Baby and Toddler Head Banging: Why it Occurs 

There are several possible reasons why young children engage in head banging behavior. Here are some common examples:

  • Baby head banging is a common self-soothing technique at naptime or bedtime. Infants are used to being rocked to sleep, so many infants and toddlers find ways to create a repetitive motion themselves—often with head butting or banging their heads against a surface.
  • Children who are under-stimulated because of sensory deficits, such as those who are blind or deaf, often engage in head banging for stimulation.
  • Likewise, children whose environment offers little distraction may become bored or lonely and thus bang their heads for stimulation.
  • Children who are overwhelmed by a busy, loud, restless environment are also soothed by rhythmic movements such as head banging.
  • Some children head-bang for relief when they are teething or have an ear infection.
  • A baby may bang his head out of frustration or anger, as in a temper tantrum, is also common.
  • Some children engage in head banging as an effective attention-seeking activity. The more reaction children get from parents or other adults, the more likely they are to continue this habit.

In general, children do not head-bang in order to injure themselves.


How Common is Baby Head Banging?

Up to 20 percent of healthy babies and toddlers have a head-banging phase. This is not a concern if your child is healthy and only head bangs when going to sleep. 

That said, head banging, head rolling, and body rocking activities are far more common in children with developmental delays, children with an autism diagnosis, and children who may have suffered abuse or neglect.

Boys are three times more likely to be head bangers than girls.


How Long Does Infant Head Banging Last?

Rhythmic motor activities are typical behaviors in healthy infants and young children. Head banging typically appears after six months old and generally ends spontaneously by age four. An episode can last up to 15 minutes

However, head banging behavior is atypical if it persists beyond the early years or if it results in serious injuries.

In typical childhood development and behavior, a child who is still head banging beyond age three should be medically evaluated.


Head Banging and Autism

How do you know if head banging is a sign of autism?

Five key behaviors distinguish kids with autism-associated head banging/head butting and those with normal head banging:

  1. Lack of Pointing: By 14 months old, most children will point at objects in order to get another person to look at/secure the object.
  2. Lack of Gaze-Following, aka Joint Attention: By 14 months, infants will often turn to look in the same direction an adult is looking or pointing.
  3. Lack of Pretend Play: By 14 months, children will begin to play using object substitution, e.g. pretending to comb the hair with a block.
  4. Lack of Eye Contact/Fleeting Eye Contact: By three months, children make sustained eye contact as a means of social communication and interaction.
  5. Lack of Response to Name: By 12 months, children either look at or turn to the person who calls their name or the nickname that they hear most often.

These five behaviors are typically absent in children who may be diagnosed with Autistic Spectrum Disorder. If you are concerned, reach out to your pediatrician no matter your baby’s age.


How Can I Prevent My Child’s Head Banging?

If you’ve seen your child head banging, you likely want to prevent the behavior—and understandably so. Here are some ways you can help deter a head-banging habit:

  • When you notice head banging, try introducing a distraction. By decreasing the amount of time spent on the activity, it will be outgrown faster.
  • You can reduce your baby's head banging intensity by remaining calm and moving the child to a different area where there is no access to a hard surface.
  • If head banging is part of a tantrum, calmly distract your child but do not give him the object/activity he threw the tantrum to get. If you give him/her the desired object/activity, you are teaching your child that throwing a tantrum is a sure way to get whatever he/she wants.

**Please note that extra padding, pillows, blankets, or bumpers in a crib or bed should only be used with older children to prevent SIDS in infants.


How Can I Prevent Injury if My Baby is Head Banging?

Typically, healthy toddlers don’t seriously injure themselves with the head banging habit, because pain prevents them from banging too hard. However, some children have very high tolerance to pain and head banging could put them at risk for head injury.


If you are worried, talk to your pediatrician. You can record a video of your child during the episode and show it to the doctor to discuss possible solutions. For some children, pediatricians will recommend a helmet if head banging is severe enough to risk injury by contact with a hard object. In most cases, this action can be controlled or modified with a good behavioral approach.


Carola d'Emery, PT, PhD

Carola, a native of Chile, is responsible for the supervision of all trainings created by the Sunny Days’ Clinical Education Team, as well as for the creation of new trainings focused on refining the clinical skills of the Sunny Days’ practitioners in New Jersey, New York, Pennsylvania, Delaware and California. She also trains Early Interventionists via live webinars that are announced on our site. A bilingual English/Spanish Physical Therapist with more than 30 years of experience in the clinical field, Ms. d’Emery is also a former member of the New Jersey State Interagency Coordinating Council. Dr. d’Emery joined Sunny Days in 2007 as Targeted Clinical Educator, and became the Director of Training and Clinical Quality Assurance in 2019. She has a PhD in Movement Sciences from Columbia University and a MPT in Kinesiology from the School of Medicine of the University of Chile. She is a member of the International Society of Early Intervention and of the New Jersey Chapter of the American Physical Therapist Association.