HABIT DISORDERS
INTRODUCTION-
HABIT DISORDERS is the term used to describe several related disorders linked by the
presence of repetitive and relatively stable behaviors that seem to occur beyond the
awareness of the person performing the behavior.
It may be associated with anger, anxiety or sleepiness.
DEFINITION-
Habit disorder, also known as stereotypic movement disorder, is a childhood onset
neurodevelopment disorder that causes various types on nonproductive motor behavior that
causes interference with normal activities and has the potential for self-harm.
COMMON HABIT DISORDERS-
THUMB SUCKING
NAIL BITING
TICS
ENURESIS
ENCOPRESIS
STEALING
TELLING LIE
THUMB SUCKING
It is the non nutritive thumb sucking behavior.
Repeated forceful sucking of thumb associated with strong buccal and lip contraction
If thumb sucking continues up to 5 years or above indicates emotional problems.
ETIOLOGY
- Working mothers
- Age of child
- Parents occupation
- Order of birth of child
- No. of sibling
- Feeding practices
- Social adjustment & stress
ADVERSE EFFECTS –
- Anterior open bite
- Maligned teeth
- Malformation of upper palate
- Speech disorder
- Lisping & thrusting
MANAGEMENT-
Role of parent (PHYSIOLOGIC)
DReminder therapy
Chemical therapy
Mechanical therapy
NAIL BITING
Also known as onychophagia.
It is a common compulsive habit in children and adult.
It can be seen in the children around 5 years of age.
ETIOLOGY
- Out of curiosity
- Stress
- Successor of Thumb sucking
- Feeling of insecurity
ADVERSE EFFECTS
- Rotation
- Alteration of incisal edge of incisor
- Inflammation of nail bed
MANAGEMENT
ASSESSMENT OF PSYCHOLOGICAL ENVIRONMENT: stress, emotional problems
NO PUNISHMENT
BITTER SUBSTANCE USE: such as nail polish
USE OF LOTION AND WARM OIL: to prevent injury.
ASEPSIS: parents should take care of child hand cleanliness.
TICS
Tic is an abnormal involuntary movement which occurs suddenly, repetitively, rapidly and is
purposeless in nature.
ONSET: 2-15 years.
75%cases of Tourette's disorder: age 11 year
TYPES
SIMPLE
COMPLEX
ETIOLOGY
- BIOLOGICAL FACTORS Genetics (autosomal dominant)
Dopamine dysregulation
Autoimmunity
- SOCAIL AND PSYCHOLOGICAL FACTORS
Some life event
Low birth weight child
Exposure to high level of caffeine
MANAGEMENT
GENERAL MEASURES
- Psychoeducation
- Collaboration with school
PHARMACOLOGICAL MANAGEMEN
- ALPHA adrenergic receptor agonist: clonidine, guanfacine
- Typical antipsychotics: haloperidol, pimozide
- Atypical antipsychtics: resperidone, clozapine
PSYCHOLOGICAL TREATMENT
- Cognitive behavioral therapy
- Relaxation therapy
- Habit reversal training
ENURESIS
Also known as bed wetting.
It is a disorder of involuntary micturition in children who are beyond the normal bladder
control should have been acquired.
Commonly during 4-12 years
TYPES
1. PRIMARY
2. SECONDARY
1.PRIMARY- Refers to the condition where no successful training to control urination is
given to child.
2. SECONDARY- Successfully trained but revert bed wetting in response to stress.
ETIOLOGY
- Inappropriate toilet training
- Neurological developmental delay toilet training
- Genetics
- Emotional factors
- Organic causes
CLINICAL FEATURES
- Incontinence
- Dysuria
- Continous dampness
- Straining on urination
MANAGEMENT
PHARMACOLOGIC:
- Tricyclic antidepressants- Amitriptyline., imipramine
- Desmopressin (ADH) - reduce urine production during sleep.
NON PHARMACOLOGIC-
- Behavioral modification
- Parental counseling
- Bladder exercise
- Alarm device
ENCOPRESIS
Also known as paradoxical diarrhea.
It is an involuntary fecal soiling in children who are past the age of toilet training.
ETIOLOGY
- Inefficient intestinal motility
- Aggressive & prolonged medical treatment
- Stress
- Dietary manipulation
MANAGEMENT
- Eating a diet high in fiber ( fruits, vegetables)
- Drinking plenty of water
- Scheduled toilet sitting
STEALING
When a child take something that belong to somebody else without permission is called
stealing.
ETIOLOGY
- Poor impulse control
- To be cool & impress others
- stress
MANAGEMENT
- Use disapproval
- Talk with child
- Talk about ethics & value
- Restitution
- Behavior watching
TELLING LIE
To make an untrue statement with intent to deceive.
Occur in 4-6 years of age.
ETIOLOGY
- To cover something
- Experiment
- Attention
- To get something they want
- Avoid to hurt someone’s feelings
MANAGEMENT
- Make conversation about lying or telling.
- Help your child to avoid situation where they need to lie.
- Praise your child or owning up to doing wrong.
- Be a role model for telling truth.
BRUXISM
It is characterized by non functional repeated grinding of teeth with high pitched sound,
usually during sleep.
Begins in first 5 years of age.
ETIOLOGY
- Abnormal sleep activity
- Familial behavior pattern
- Neurological disease
MANAGEMENT
- Behavioral modification
- Parental counseling
- Psychotherapy
- Pharmacotherapy (DIAZEPАМ?)
NURSING RESPONSIBILITIES
THE FOLLOWING ARE THE NURSING RESPONSIBILITIES WHILE CARING
CHILDREN WITH HABIT DISORDERS:
Comprehensive assessment
Educate child and family about the course of disorder.
Completion of necessary diagnostic tests.
Psychotherapy and behavioral therapies.
Parental counselling.
Provide medication to the child.
Encourage for dietary modificati
CONCLUSION
In conclusion, habit disorders in pediatrics are common repetitive behaviors that can
significantly impact a child's well-being, often manifesting as thumb sucking, nail biting, hair
pulling, or bruxism early detection and intervention are crucial, with treatment strategies
focusing on behavioral therapies, parental education, and addressing underlying stressors, as
many childhood habits are transient and can resolve without specific intervention, but
persistent or severe cases may require professional support to manage the behavior and
minimize negative impacts on the child's life.
BIBLIOGRAPHY
Datta Parul, A Textbook of Pediatric Nursing, Jaypee Publication, Fourth Edition, Page no:
584
Gupta Ghai O.P, Ghai Piyush V.K., Essential Pediatrics, 6th Edition CBS Publishers and
Distributors, Page No: 1001-1002
Kurian Somya, A Textbook of Pediatric Nursing, EMMESS Publication Second Edition,
Page no.: 448
Sharma Rimple, Essentials Of Pediatric Nursing, Jaypee Publication, Third Edition, Page no:
530
Yadav Manoj, A Textbook of Child Health Nursing, S. Vikas & Company (Medical
Publishers), Revised Edition 2014, Page no.: 774
ONLINE REFRENCES
https://www.slideshare.net/slideshow/habit disorder of children/33353221
https://www.slideshare.net/slideshow/habit disorder of children-247200687-247200687
