Self-Injurious Behavior, Post-Hemi

Aiden has been hitting himself on the head since about 3 months after his hemispherectomy in August. Over time, the behavior has worsened.At first we thought he was doing it for attention because when we'd tell him "no", he'd smile as if he got the reaction he wanted and then stopped the behavior. Then it progressed to him doing it when we'd try to get him to do something he didn't want to do. Now he does it even when no one is bothering him. We've tried ignoring the behavior but he continues to hit himself even when he's doing something he enjoys. We've tried firmly holding his arm and telling him "no" but that just makes it worse. If we hold his arm, he begins head-butting.

At a recent eye exam, Aiden exhibited this behavior and his doctor suggested an elbow restraint called a "pedi wrap" and I Googled that as soon as I got home. In my search, I read that there are many possible reasons why a person with disabilities may engage in self-injurious behavior including: pain, frustration, sensory, biochemical or communication. Another article I came across on the internet suggests using restraints as a means of behavior modification. So, I asked Aiden's PT if we could borrow one to try at home. She explained that it shouldn't be placed on his arm unless he begins hitting himself. So, we are putting it on and taking it off 15-20 times a day. It's ridiculous. And when it's on him, he finds other ways to hit his head, like on the floor or wall.

Now, I am concerned that this isn't a behavior or sensory issue at all but a sign of pain or hydrocephalus. So, I emailed Dr. Sankar at UCLA and he called me right away. He's pretty sure it's a purposeful behavior but he suggested I schedule an appt. with Aiden's pediatrician to rule out ear infection or teething. He also scheduled a CT scan to rule out hydrocephalus. Then if those are negative, he suggested we try Tylenol or Advil as it might be due to post-craniotomy migraine and then see if the behavior stops. If above do not pan out and if initial tantrums evolve into an obsessive behavior pattern, he will elect to treat Aiden with Celexa.

Please pray for my little boy; that this is just a phase and that there isn't a serious underlying issue. I am fairly confident after speaking with Dr. Sankar that it is an issue of behavior brought on by his inability to communicate his wants, needs and frustrations with words.

Thank you,
Rachel