Advice from the Child Psychologist: Thumbsucking and Angry 7 Year-Old

Dear Cheri,

I am concerned about my 4 year old daughter. From the time she was about 4 months old, she has sucked her thumb and played in her hair, particularly while sleeping. I had become accustomed to her waking up every morning with her hair completely undone, whether there were ponytails or braids; she could undo any hairstyle.

About 2 months ago, I noticed that she had begun to twist her hair so tightly that it would be in almost dread-like knots. I talked to her about it and tried to explain that playing with her hair was the reason behind all the trauma of combing it in the morning. But it only seemed to get worse as I noticed small balls of hair around her room; I then noticed that she had a bald spot in her head from pulling out her hair.

I have talked to her Montessori teachers to see if they noticed any changes in her behavior or trouble with classmates, but they insist that she is doing well with her work and makes and keeps friends well at school.

I don't know what I should do next.

Dear Janell,



I can understand your concern about your daughter's current behavior, especially if you have actually noticed a bald spot. It is apparent from your letter that this is something that you have been struggling with for some time.

There are some questions I have that would indicate what direction to go with this situation. The first thing we need to determine is whether your daughter's behavior is simply a habit that has gone to an extreme, or if your she has some emotional issues that are bothering her and causing her to be so anxious that she is pulling her hair. You did not mention whether she is pulling her hair in the daytime, or if you have noticed any tendencies she has to be stressed, anxious, or angry. While you did exactly the right thing to ask her Montessori teachers if they noticed anything unusual at school, it is equally important to specify if there is anything going on at home. You are the best judge of your child's emotional state.

Therefore, my next question would be whether there have been any changes in the past couple of months that may be causing your daughter to feel stress or anxiety. You mentioned that your daughter is four years-old. Did she start Montessori at age three, which is the standard, or did she only recently start school? What is the situation at home? Have there been any changes with members of the family--marital issues, illness, or new experiences? Remember, that positive experiences can oftentimes be as stressful and negativee ones.

Once it is determined whether your daughter's hair pulling is, in fact, a bad habit, or if she is pulling her hair due to an emotional issue, we will have a better idea of which direction to go to help alleviate the problem. If it is due to an emotional response to something that is going on in her life, discovering what is bothering her by speaking with her directly and carefully observing how she interacts in her environment can help determine which road to take to help her build her coping skills. Pay special attention to her behavior to identify specific times she becomes stressed, anxious, or angry. Write these incidents down and search for patterns. Ask her school teachers to do the same. If it becomes apparent that she is emotionally distraught about something and simply speaking with her and trying to help her cope with the situations yourself is not effective, you may need to consider speaking with a therapist specializing in working with young children.

If it becomes clear that the hair pulling is simply a habit gone to extremes--much like the child who bites his or her nails until they bleed--it is important to interfere with her habitual behavior so it is no longer automatic. Simple things that you may or may not have tried include: have her wear a clean scarf to bed each night, making sure that it is pulled down low on her forehead to make it more difficult to pull it off; consider having her sleep in mittens for a time period so it becomes impossible for her to undo her hair; let her pick out the mittens and scarf so that wearing them will be fun; and check on her several times a night to determine that her scarf and mittens remain on. Also, make sure that her hair remains as healthy as possible. Dry hair breaks very easily. If your daughter's hair is well-conditioned and moisturized it will be less likely to pull out. You may even want to consider taking your daughter to the hair dresser and having it professionally deep conditioned.

And please remember that therapists specializing in work with young children are available in almost any community if you feel you need additional support.

Dear Cheri,

I hope that you can help me find a program to help my daughter and grandson. Here is the situation.

My grandson is 7 years old & he is a very angry boy. Right now he is refusing to go to school and giving his mother, as well as the staff at school a hard way to go. He is fighting with other students, disrupting the class room any way that he can. The other day, he was brought to his classroom and ran out, of course the teacher told my daughter to take him home.

I talked to her this morning, she is at her wit's end. She was even considering finding a Christian boarding school for him to attend. With the money situation, it seems to be out of the question on her part as well as mine. Besides, there seems to be a location problem. We live in Tucson, AZ

He has no father in his life and/or male influence. She is a single mother, just lost her job & and has just started taking medication for depression. The depression problem seems to run in our family.

I know that you can't give me a miracle cure, but I was wondering if you could suggest some resource that we can take to get this boy on the right track again. Any input from you will be of great help in getting things going on the right path.

Thank you in advance

Dear Jean,

I am happy to offer some suggestions that may help the situation with your grandson.

You describe a very unhappy little boy. My first concern is how he must be feeling about himself in relation to all the problems he is experiencing at home and school. A problem with difficult children is that teachers and parents tend to get into a cycle where they only interact with them in a negative way. This not only lowers the child's self-esteem, but teaches them to seek negative attention because it is what they are used to. Therefore, it is important that you, your daughter, and school personnel immediately focus on catching him being good whenever possible and immediately reinforcing him for it. Doing so can improve your grandson's self-esteem, teach him what behavior is desirable, as well as help his teachers, yourself, and your daughter view him in a more positive light. Children are extremely aware of what the grown-ups in their lives think of them, and they will behave in a manner that fits how they believe they are viewed. In other words, if a child constantly hears that he is bad from the important adults at home and school, and he believes those adults think he is "bad --he will act that way.

I would also strongly suggest that, if your grandson attends a public school, that your daughter Advice from the School Psychologist for help. You can also request a team meeting at school, which will allow your daughter an opportunity to meet with his teachers, the school psychologist, social worker, and any other school personnel that may interact with your son, and brainstorm some ideas that may work to help improve his behavior at school. If your grandson does not attend public school, you may want to consider moving him from the private school environment so he can obtain special education services. Or, if it is financially possible, consider obtaining private consultation services from a school psychologist or child therapist.

It is most important to stop your grandson's dangerous behavior at school. He needs to speak with someone he respects and has a positive relationship with about why it is not safe to run around school hallways and why we should not hurt others. I am assuming this has already been done, but if not, it should be. While he may not change his behavior right away, he will not forget the information.

My next suggestion would be to develop a behavior modification plan. This is generally the best way to change a child's problem behaviors and teach them how they should behave instead. There are several things to consider when developing such a plan.

1. Your grandson should be observed in both the home and school environments. It is important to note what happens when he misbehaves, what happened before the incident occurred, and what the adult response to the behavior was. This is necessary to determine which behaviors should be targeted for change.

2. A behavior report can then be developed that specifies problem areas. However, the focus on the form needs to be on positive behaviors rather than what he is doing wrong. For example, instead of listing, "hits others , use, "plays appropriately with peers instead. Behaviors you may want to consider include, listening to the teacher, playing well with others, willingly going to school, participating in class, and turning his behavior around after an incident and acting appropriately. Each item should be on a five point scale. Your grandson should be rewarded as long as he obtains half the possible points on the form at first. It is important that rewards be accessible to him when the program begins so he does not get frustrated. As his behavior improves, the number of points necessary for reinforcement can increase.

3. Before the program begins, it will be necessary to come up with rewards for appropriate behavior. It is essential that your grandson chooses what he wants to earn. Many behavioral interventions are designed and doomed to failure before they even begin because some adult decides what a child will find rewarding and the reinforcements are not something the child actually wants. It is important to designate daily reinforcements as well as larger, weekly ones. Oftentimes parents will offer young children large rewards, such as going to the zoo, on a weekly or monthly basis when children in general are not able to wait that long for a reward, so they forget about it, or find it is taking too long, and so the child gives up. Small daily rewards help keep them focused.

A daily reward that is extremely effective is "Mom and Me time. In this case, if a child behaves appropriately during the day he or she gets to spend a half hour with their mother or another adult doing anything they want to do that is reasonable. Generally, it is best to sit down with your child and come up with several things that he would like for a reward. This can include things like reading a book, coloring, playing with clay, etc. The idea is for the child and parent to engage in an activity both find pleasurable.

4. Once the program begins, the behavior sheet should be discussed every day. When a problem occurs, it is important to discuss with your grandson what he should have done instead of misbehaving. It is very common for adults to tell a child, " don't do that! without telling them how you want them to behave. This can be both confusing and frustrating to the child.

A couple of other possible interventions come to mind when reading your letter. You mention that your grandson does not have a consistent male influence in his life. Big Brothers and Big Sisters of America is an organization that usually has a chapter in almost every large city in the U.S. If you and your daughter were to sign your grandson up for the program he would be matched with an appropriate male adult who would spend time with him and give him the attention that he needs. The program is free and tremendously helpful. Also, you mentioned that your family is Christian. I have found that Sunday school and family Bible studies not only teach a child how they should act, but provide an opportunity for discussion to apply what the child is learning to daily life.

Hopefully, these suggestions will give you somewhere to start. Keep in mind that school psychologists are available in public schools and that others might be found on a consultation basis in your area.

I wish you the best.

About Cheri King-Guler, M.S.

Cheri King-Guler received her Master's in Educational Psychology from the University of Wisconsin-Milwaukee. She has worked with students of all ages and specializes in parent interventions. Cheri was published in the Communique, the monthly newspaper for the National Association of School Psychologists. Cheri has a unique perspective on special needs children, as she has experienced the special education system as a parent as well as a psychologist. She is presently pursuing her second Master's degree in counseling psychology. In addition, Cheri writes both fiction and non-fiction for children.