Is head banging and rocking normal?

What the evidence says

Rocking, head-rolling and head-banging around bedtime are a normal part of development for many babies and toddlers. Body-rocking often starts around 6 months and head-banging or rolling around 9 months, usually as a way for children to comfort and settle themselves to sleep. Most children grow out of it by age 5.

This is genuinely common: studies estimate rhythmic movements occur in well over half of typically developing 9-month-olds, dropping off steadily through toddlerhood. A large Canadian study found body rocking and head banging in a small percentage of otherwise healthy 2.5 and 6 year olds. Boys are somewhat more likely to do it than girls.

It only crosses into something called sleep-related rhythmic movement disorder when it significantly disrupts sleep, causes daytime tiredness or behaviour problems, or leads to injury like bruising, skin thickening, or rarely hair loss. This affects a small minority of children. It's also seen more often, and more intensely, in children with autism or developmental delay, so it's worth mentioning at a checkup if you're also noticing other developmental differences. For most families, simple safety steps help: move the crib or bed away from walls and hard furniture, keep the sleep space free of extra padding for babies under a year, and try not to give the behaviour extra attention at bedtime since that can reinforce it. Talk to your doctor if it happens a lot during the day too, if your child snores or seems very tired despite it, if it's causing real injury, or if you have any broader concerns about development.

Some children do exhibit repetitive, seemingly purposeless movements most commonly seen when a young child is excited, stressed, frustrated, bored or engrossed in their imagination. They can happen multiple times a day for seconds to minutes at a time. The child may be aware of their movements and can be distracted from them. The movements do not change over time, and look characteristic or similar when they occur. These are broadly called Motor Stereotypies.

Up to sixty per cent of children will have stereotyped movements like these between the ages of two and five years old. They do not cause harm and do not need specific treatment.

Motor stereotypies can occur in children with developmental problems such as autism, learning, speech or coordination difficulties. They can also occur in otherwise healthy, typically developing young children (up to seven per cent). Many children enjoy some aspects of the movements, and some report it helps their imagination. Motor stereiotypies tend to remain stable over time and children do not grow out of them. The movements may lessen as children grow older and become more socially aware. Parents can gently guide and teach their young child about when it is or is not acceptable to engage with their motor stereotypies. Some older children and adolescents may continue to choose to engage with their stereotypies in socially appropriate situations, such as at home.

Motor stereotypies do not need treatment with medication or specific therapy. Behavioural strategies can be helpful if stereotypies are troubling your child or interfering with their daily activities. These strategies are most successful when the child is socially aware and motivated to stop their stereotypies. This is usually difficult in young children under the age of seven years.