I wanted to write this blog because I know that while those with trichotillomania have many questions about treating their disorder, I know that parents do, too. In fact, they may have even more because all they want to do is help, but they don’t know what to do or even where to start.
This past week, I attended a Trichotillomania Learning Center webinar (online seminar) called “When Young Children Pull: Treating Baby Trich,” which was presented by Litsa R. Tanner, MS., MFT. Her webinar dealt with guiding parents who have children five-years-old and younger who pull (thus “baby trich”), but I feel like there was a lot of good advice that can be translated across the years of youth.
While the common onset of trich is said to be around puberty, for many it does begin younger than that. For some, even in infancy; although, according to Tanner, a lot of times those who develop it in infancy will simply grow out of it, much like children outgrow sucking their thumb because it comes from the same self-soothing need. However, that doesn’t mean the hair pulling behaviour should just be ignored hoping that your child will outgrow it. At the same time, you shouldn’t start carting your child around from doctor-to-doctor unless the behaviour is really severe. It is also recommended to consult a doctor with your child if your child has trichophagia (or eats the hair) because there is risk of intestinal blockages.
From a psychological standpoint though, Tanner says she deals primarily with the parents of young pullers to determine a strategy to work with their child, then it is from there up to the parent to stick to and implement those strategies that they collectively came up with.
To being with, be attentive of when your child is and isn’t pulling. Through observing your child, you will be able to determine if it’s maybe a certain time of day, such as in the mornings or before school or before bed at night or before daycare or whenever it may be. Also pay attention to what other behaviours accompany the pulling, and then with all this information gathered you can work with the doctor or therapist to determine what to do to help your child.
One of the strategies is finding replacement behaviours. It could be a matter of finding a doll with hair or a fuzzy blanket that provide the same sorts of sensations for their fingers. Or find a fidget toy that works for your child to keep their hands busy while they go about their daily activities (Tanner recommended therapyshoppe.com for some good options). One of the keys is implementing these alternative behaviours before the pulling begins. That’s why observing your child is so important. For instance, if your child pulls while watching television, give them the fidget before even sitting to watch television or just as you’re about to.
Another important detail is to not admonish the “bad” behaviour. Tanner put it nicely when she said instead of scolding your child for their pulling, say something like, “Oh, you forgot your fidget toy” or “your hands must be bored.” She recommends this method because “correcting” the behaviour may be unintentionally reinforcing it. Rather, ignore the behaviour and encourage and praise the use of strategies. Praise your child for remembering their fidget, or even a simple smile is a good tool to let them know you noticed their efforts. Reward with simples things, like stickers, and for really young children, it is better that the reward be more immediate because they’re not old enough to understand cumulative measures or why they should have to wait until later for their reward. Luckily, for really young children, too, the reward doesn’t have to be substantial in order to have a great impact on them.
For especially young children, or babies, you as a parent will probably have to constantly monitor their behaviour and be observant and aware of what they are doing (more so than usual!) for the simple reason that they don’t have the capability to make the changes yet themselves. And if you’re worried about pre-school or daycare with regards to monitoring, don’t be shy about talking with the caregiver about the behaviours and your strategies. You may be surprised to find how willing they are to help and what creative methods they can come up with for the classroom setting. They may even come up with ideas that can translate into the home environment as well.
Ultimately it is about finding what works best for your child, but I think these are great tips to take with you along the way, especially if you are having trouble finding a doctor. In my opinion, what’s most important though is showing your child love and support, no matter what. It’s tough for the both of you, and your child needs to know that you’re there as a positive influence and guide every step of the way.