Hair-pulling in autism can be a surprising, often distressing behavior experienced by some babies and children on the spectrum. According to researchers, self-injurious behavior, including hair-pulling, is common in people with autism, occurring more often in females. In fact, a study of 112 children suggested that hair-pulling in those with autism occurs at a rate almost twice that of the general population.
While hair-pulling can be a challenging behavior for parents to address, learning more about its possible causes and behavior management strategies can empower you to support your child.
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Autism Behavior Interventions
Understanding hair-pulling in babies and toddlers
Hair-pulling is a common self-stimulating or self-soothing behavior in people with autism and Sensory Processing Disorder (SPD). Twirling hair is also sometimes associated with conditions like anxiety, ADHD, and OCD, though this symptom alone does not constitute a diagnosis.
This body-focused repetitive behavior can ultimately cause pain and damage to the scalp, as well as increased emotional distress. In seeking sensory stimulation or soothing, it is common to target areas of the body where there are many nerve endings, including the scalp.
When experiencing anxiety or boredom, a child might pull their hair to calm their nervous system or provide sensory stimulation. While baby hair pulling can be associated with autism, it isn’t necessarily a sign of autism in your baby.
Many typically developing babies might pull their own hair, but this is often mild and resolves on its own over time. Some young children pull their hair when they feel flooded with emotion and cannot get their needs met in socially appropriate ways.
Between the ages of 10 and 13, a small percentage of youth will begin to struggle with trichotillomania, a mental health disorder marked by compulsive hair pulling. While the cause is unknown, genetic, environmental, and other mental health factors could be at play.
Consulting with a professional can help you to rule out other causes of hair-pulling.
What causes hair-pulling in autism?
When trying to understand any behavioral pattern better, it is helpful to consider its function. Some of the most common reasons for challenging behaviors include:
- attention-seeking (positive or negative),
- escape or avoidance (of a stressful situation, discomfort, or an unwanted task),
- sensory needs, or
- wanting to get something.
Carefully observing your child to identify what might be triggering the hair-pulling behavior and ways it could be being reinforced by your response can shed light on possible causes.
Common hair-pulling triggers for children with autism include:
- stress,
- anxiety,
- boredom, and
- sensory sensitivities.
For many children with SPD, hair-pulling can offer the sensory input that they’re seeking. Other children might have difficulty communicating their feelings and needs, and hair-pulling can result from their frustration at being unable to express themselves with words.
How to help your toddler with hair-pulling
There are several things you can do to help your toddler with hair-pulling. First, it is important to cultivate a safe, supportive environment in your home so that your child feels secure and receptive to your feedback.
You also will likely want to find ways to keep your child safe while you continue working with them to reduce hair-pulling behavior. This might look like encouraging your child to wear a bandana or hat to reduce access to their hair and cover sensitive bald spots.
Here are a few strategies that can help your toddler with hair-pulling:
- Redirect your little one to another sensory activity that keeps their hands busy, like a basket of fidget toys.
- Prepare a visual schedule for your child to offer security, reduce stress, and let them know what to expect throughout the day.
- Reinforce moments when your child is not engaging in hair-pulling. Offer words of encouragement (e.g., “Nice gentle hands!”), hugs, or even a small reward that will be meaningful to your child.
- Avoid reacting in a harsh, animated manner when your child engages in hair-pulling. Remain calm and gently redirect, limiting the attention given to the hair-pulling behavior.
- Encourage healthy coping strategies, including meditation, deep breathing, or walking away to do something they love, like build with Legos. These healthy habits will reduce stress, and when you practice them with your child, you will strengthen your bond and help yourself to be a more relaxed, present parent.
As you begin to identify your child’s triggers, you’ll be better able to mitigate them. If your child is driven by anxiety, finding ways to reduce stressful situations and preparing them for unavoidable anxiety-inducing circumstances can target your child’s hair-pulling motivation at the source.
Additionally, offering extra support during those times can be beneficial. Early intervention is important, as is individualized support based on your unique child’s needs.
Hair-pulling behavior can be managed
While hair-pulling can feel distressing for parents and children, it can be managed through careful observation and trigger identification, stress-reduction, as well as redirection to a more appropriate sensory activity.
If you notice signs of hair-pulling in your child, seek support and consult healthcare professionals for personalized guidance.
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FAQs
Q: Is hair-pulling in babies a symptom of autism?
A: While hair-pulling is a behavior often exhibited by children on the spectrum, if your baby is pulling hair, it does not mean that your child has autism. Many typically developing babies pull hair out of frustration or a lack of communication skills and eventually outgrow the behavior.
Q: Is hair-twirling connected to autism?
A: Hair-twirling is a common self-stimulating behavior in the general population and not necessarily a stim that is associated with autism. It can also occur in people struggling with anxiety, ADHD, or OCD. If your child engages in hair-twirling behavior, it does not necessarily indicate that they have autism; however, seeking an evaluation from a professional can help answer any questions you might have about your child’s development.
Q: Is hair-pulling sensory seeking?
A: Hair-pulling can be a sensory-seeking behavior for some children, including those with autism and/or SPD. Because the scalp has many nerve endings, it offers ample sensory input for seekers. Observing your child carefully and taking note of what seems to trigger the behavior can offer valuable information about the reason behind the hair-pulling behavior of your unique child.
Q: At what age is autism first noticed?
A: Autism usually shows signs by 12-18 months of age or earlier, including problems with eye contact, communication, and play. Early detection and intervention are important in offering your child the support they need as they grow and develop.
References:
Grant, J. E., & Chamberlain, S. R. (2022). Autistic traits in trichotillomania. Brain and Behavior, 12, e2663. https://doi.org/10.1002/brb3.2663
Houghton, D. C., Tommerdahl, M., & Woods, D. W. (2019). Increased tactile sensitivity and deficient feed-forward inhibition in pathological hair pulling and skin picking. Behaviour Research and Therapy, 120, 103433. https://doi.org/10.1016/j.brat.2019.103433
Johnson, C. P., & Myers, S. M.; American Academy of Pediatrics Council on Children with Disabilities. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5), 1183–1215.
Laverty, C., Oliver, C., Moss, J. et al. Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study. Molecular Autism 11, 8 (2020). https://doi.org/10.1186/s13229-019-0307-z
Mayo Clinic. (2016). Trichotillomania (hair-pulling disorder) – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20355188
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. https://doi.org/10.1097/CHI.0b013e318179964f
Steenfeldt-Kristensen, C., Jones, C.A. & Richards, C. The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study. J Autism Dev Disord 50, 3857–3873 (2020). https://doi.org/10.1007/s10803-020-04443-1
