
![]()
Nail
Biting, Finger sucking, Thumb sucking
Nail biting is a common habit. It is usually not a
serious problem for children. It becomes most common in adolescence when almost
half of all children bite their nails to some degree.
Most children that bite their nails have no problems. In
some cases, nail biting may cause:
Some of the reasons children bite their nails include:
Treatment
It should address the reason why the child is biting his
nails. If the child is under a lot of stress, try to reduce the stress.
For example, try to figure out what stressful situations
seem to cause your child to bite his nails (such as being bored, watching a
suspenseful TV show, or getting frustrated with homework) and try to avoid
those situations.
Cutting long nails helps some children. Nails can also be
smoothed so that they do not bother the child. Direct the child's attention
away from nail biting and try to help the child feel good about himself.
Punishing or shaming a child for nail biting is not
helpful.
If you have an older child that wants to stop nail
biting, you can help the child make a plan to break the habit. You can help the
child find something to put on his fingers to remind him to stop nail biting.
If the child's
habit is making you develop some of your own, you think she is too old for it,
or if it is annoying to others, you may want to try the following steps to
discourage the habit:
Calmly
point out what you don't like about the behavior and why. This approach can be
used with children as young as 3. Say something like
·
I
don't like it when you bite your nails. It doesn't look nice. Could you try to
stop doing that?" Most important, the next time you see your daughter
biting her nails or twirling her hair, do not scold or lecture her. Punishment,
ridicule, or criticism could cause the behavior to escalate.
·
Involve
the child in the process of breaking the habit. Ask your child what she thinks
she could do to stop the habit or if she wants to stop the habit. If your
5-year-old comes home crying from kindergarten because the other kids made fun
of her thumb sucking, it is her way of asking you for help.
·
Clearly
and positively state the alternative behavior you desire. Instead of saying,
"Don't bite your nails," try saying, "Let's try to let your
nails grow." Sometimes, foul-tasting substances applied to the fingers may
help to discourage nail biting or thumb sucking, but continual use diminishes
their effectiveness.
·
Reward
and praise your child when she displays self-control.
For example, allow a little girl to use nail polish if she lets her nails grow.
Every time your son refrains from sucking his thumb, reinforce the positive
behavior by allowing him to watch television or reading him a bedtime story.
For example, the child may want to try wearing a pair of
gloves, putting Band-Aids on the fingers, or applying a bitter-tasting
preparation to the fingers.
One should not require your child to use any of these
strategies. It should be the child's decision to work on breaking the habit.
Most nail biters eventually stop the habit. It is
difficult to say when children will stop biting their nails. More than 75% of
those who bite their nails as adolescents will stop by the time they are 35
years of age.
Nail
biting, thumb sucking, and finger sucking are common, everyday symptoms.
Psychiatrists should be aware however, that the thumb sucking and finger
sucking may do considerable damage to dentition.
Epidemiology
Nail
biting may begin as early as 1 year of age. From that point on, it shows a
steady increased incidence until age 12. Even so, at age of 17 to 18 in select
population of patients, as many as 1 of four persisted on the habit.
Finger
sucking is still present in about 31 percent of children around 12 years of
age. The habit is more common in girls than boys. There seems to be some
coincidence of finger sucking and nail biting.
Causes
In
psychoanalytical theory nail biting is thought to be caused by intense or
competitive impulses toward a parent. If such impulses were actualized, the
child would destroy his source of dependency gratification. To resolve the conflict, the child may bite
his nails, thus denying his hostility, injuring himself, and demonstrating his
punishment.
At the
same time, he is able to express aggression but spare the object of his
aggression. Finger sucking and Thumb sucking are thought to be the result of
regression to oral satisfactions when the person is placed under the duress of
tension or fatigue.
Learning
theorists have satisfied themselves that the symptoms are the result of simple
learned habits. Most investigators agree that no particular personality
features characterize a person who is troubled with nail biting or thumb
sucking.
There is
a spirited debate as to the relationship of inadequate or unsatisfactory breast-feeding
and the later development of thumb-sucking. However the general surroundings
and social conditionings that are present when an infant goes to sleep may
exert an influence. Rocking, lullabies or story telling by an adult or a parent
seem to be positive factors.
Some of
these habits are simply copied from friends, and disappear on their own accord
after 1 or 2 gentle reminders.
These
habits are a sign of tension. The body is geared up through emotional energy,
to do something physical(shouting, fighting, running away) to deal with the
cause of its anxiety, but since it may not know the cause and since physical
activity may be forbidden, it releases the pent up energy, by nail biting or
nose-picking or thumb sucking or whatever.
The more
tense the child becomes, the stronger the habit. And trying to put the habits
to an end by threats or punishments, only makes matters worse, not only because
it adds yet another anxiety but because the highly charged emotional energy
will only seek another restless outlet.
Clinical Features
Nail
biting is an active process. Finger-sucking and thumb-sucking are more passive
processes.
Although
nail-biting may be an oral–aggressive, tension reducing, impulse that is most
likely to occur when the patient is bored or anxious, the habit is often
present in persons in whom there is no obvious emotional disturbance.
Finger-sucking
and thumb-sucking are present in nearly all babies in the first year of life.
Such sucking should cause no concern. By age 2-5, children may resort to
finger-sucking when under emotional stress.
The
persistence of the habit may be associated with general immaturity
characterized by such habits as baby-talk and bed-wetting.
Treatment
With
children who do not bite their nails severely, treatment techniques relying on
suggestibility and self-reliance have been successful.
The
child recognizes that the family members are interested in him and that they
have confidence he can master a large problem. The physician should help the
family reduce tension on the child by being more tolerant and consistent. The
child may participate in the treatment by means of placebo task, such as taking
the responsibility of soaking his nails daily in olive oil.
In case
of adults or children who have obvious emotional illness, the therapist must
attend to the urgent and pressing life stresses.
Behavior
therapy is largely used to treat the symptoms of finger sucking and nail
biting.
Positive
rewards for eliminating the habit have been successful with children and
adults.
·
When
sucking becomes a problem to the environment and the patient, psychotherapy is
indicated. Besides securing task oriented help by the patient, the physician
directs major efforts towards the patient’s general emotional problems. In many
instances, an uncontrolled assist comes from the patient’s regard for his peer
status.
·
Many
children stop sucking on their thumb or pacifiers around their third birthday.
After this age, if he still uses a pacifier or sucks his thumb, one should
consider taking action to stop this habit if he is sucking on his
thumb/pacifier for most of the day, if it is affecting his communication or
social skills, if he is having trouble with his pronunciation of words, or if
it is causing problems with his oral development.
Some treatment
tips to help the child give up thumb sucking or pacifier use include offering a
reward or special treat, begin to limit thumb/pacifier use (first limit use to
inside the house, and then put the kitchen off-limits, etc.), taking the air
out of the pacifier by poking a hole in it or cutting off the end, replace the
comfort of sucking with other comforts (for example, holding his hand when he
upset), supply a substitute and keep his mouth busy by singing a song, playing
a musical instrument or having a snack, and most importantly, ask the child
about giving up sucking his thumb or pacifier and how he would like to go about
doing it.
Avoid
putting the child down or describing him as being ‘babyish.' Also avoid nagging
the child or turning this into a power struggle.
Most
children have a comforter (an object that makes them feel secure when they are
tired or unhappy) at some stage in the pre-school years. It could be an old
teddy that brings them tranquility, or a tattered cot blanket. One may be amazed
at the importance the child places on such a sruffy object- but it’s the
familiar smell of the comforter, its familiar appearance, and its familiar
texture, which matter to him.
A child
may have a comfort habit, for instance, ‘thumb sucking’ rather than a comfort
object. Adults often become annoyed with pre-school children who thumb-suck,
because they regard it as babyish. And dentists are aware that continuation of
the habit beyond the age of 5 may result in the child’s set of teeth being
pushed out of the line.
When this
happens, dental treatment to correct the defect is necessary.
To stop
the child from thumb-sucking:
·
Decrease
the habit gradually: Just as an adult who wants to give up smoking often finds
it easier to do it gradually, so too does a child who needs to stop
thumb-sucking. Set a time scale of, say 8 weeks, during which time we may hope
to eliminate a habit.
·
Explain
to the child why he should stop the habit: Use language he can understand- for
instance, tell him that his best friend dosen’t suck his thumb, or that his
teeth will be damaged. A child aged three and upwards will understand this sort
of explanation.
·
Select
one short occasion, during which he usually sucks his thumb, and use this as
the starting point: It may be when he is watching television, or perhaps when
the parent is reading a story to him.
·
Slowly
increase the number of occasions the child has to do without thumb-sucking:
Build up gradually from, say, once every two days, to once every day, and so
on. Decide on a clear plan of action and stick to it.
·
Give
him lots of praise when progress is being made: Each day when one sees thumb
sucking decreasing in frequency, let the child know that he has done good. Make
a big fuss of his achievements.
·
Don’t
use techniques based on avoidance principles: Strategies such as painting the
child’s finger with a nasty tasting solution, or covering the offending thumb
in sticking plaster, rarely work. This usually makes a child more determined to
persist with the habit. It may show an instant success, but if one takes an
aversive approach it runs the risk of heated confrontation.
Children who bite their fingernails may be damaging their IQ, a
study suggests
Researchers in
Russia say children who chew their nails are at greater risk of lead poisoning.
This is
because lead can gather under their nails simply by playing in dusty
conditions, both indoors and outdoors.
It has long
been known that exposure to lead may contribute to developmental problems in
some children. Previous studies have suggested it may also damage the nervous
system.
Lead is found
naturally in soil and dust. As a result, it is sometimes consumed via fruit or
vegetables that have not been washed properly. Many men, such as plumbers,
painters and printers, are exposed to lead at work.
But scientists
at the Ural Regional Centre for Environmental Epidemiology in Ekaterinburg,
believe that biting finger nails may explain why some children also show high
levels of the chemical.
Worrying
levels:
They assessed
children living in a number of cities in the Urals. They found that as many as
two out of three children in some areas had worryingly high levels of lead.
Levels varied
depending on whether the children lived in homes that overlooked busy roads or
if they had a habit of eating soil, snow or paint.
But they also
found a link between high levels of lead and children who regularly bit their
nails.
They found
more than 69% of girls and 62% of boys involved in the study bit their nails or
other objects like pencils.
All of the
children involved in the study lived in highly industrialised cities with high
levels of lead.
However,
children living in the UK and other western countries may also be at risk.
Paint:
Dr Erik
Millstone, a senior lecturer at the University of Sussex, said: "The
government stopped collecting figures on blood lead levels a number of years
ago.”
"However,
I wouldn't be surprised if something in the order of 6% to 10% of children
under the age of six had blood lead levels at which there is evidence of adverse
effects."
Lead levels in
soil across Britain are quite low. However, old paintwork is often a source of
this potentially damaging chemical.
"Many
homes built before the mid 1960s have old leaded paint," Dr Millstone
said.
"When
this is sanded down it can create contaminated lead dust.
"For that
reason we should not be trying to stop children putting their fingers or other
objects into their mouth, but rather focus on the importance of handling old
leaded paint with care."
DR. SUMIT GOEL M.D. (Hom)
DR. AMITA AGARWAL BHMS