5 year old hits himself when angry

This post is part of a series where our team of child mental health professionals answer real questions submitted by readers like you. This post deals with topics related to self-harm. Please take care when reading.

One parent wrote in with a worry about their daughter, who hurts herself when she becomes frustrated. Below is the question, and a response from one of our child mental health experts:

I am sorry to hear that your daughter is hurting herself when she becomes upset or frustrated.

Oftentimes children who hurt themselves are experiencing “big feelings,” and rather than take them out on others, they hurt themselves.

Some children will also hurt themselves if they feel they need to punish themselves, or because they don't see themselves as “good” or “worthy.” For example, if your daughter accidentally makes a mistake on her schoolwork, this could provoke frustration. Instead of seeing it as a little thing she can fix, she starts to think, “I made a mistake, I must be a bad student” or worse, “I must be a bad kid.”

When children have such an internal dialogue with themselves, they can self-punish as a way to cope with these thoughts. For example, “I will pinch my arm to teach myself a lesson because I am a bad student.”

Depending on the frequency, severity, and type of self-punishment your daughter is inflicting, you may want to speak with a child specialist. It will be important to help her first identify other ways of coping with her negative emotions (e.g., taking a break, distraction, working on more positive self talk, and learning to identify her feelings).

The goal would be to help your daughter by increasing the time between her feeling of frustration and anger, and her behavior.

If you are at a stage where you feel your daughter could benefit from additional support, you could consider Little Otter. We offer parent coaching, and child therapeutic services as needed. You could also consider speaking to your pediatrician, who may have additional recommendations for child specialists in your area.

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It’s always hard to see toddlers upset, but it’s even worse when they are so frustrated or angry that they start hitting themselves. Usually, toddlers will hit someone else when they are angry, but sometimes they turn their frustration on themselves.

Although this type of outburst isn’t a common occurrence in children, when it does happen, it can be scary. However, that doesn’t mean it’s something to be overly concerned about.

Instead, pay close attention to when it occurs and how the situation plays out to determine if you need to mention it to your pediatrician. Most of the time though, as children grow up, they will stop this self-harming behavior. Keep an eye out for the habit to return, though, as some children use the behavior has an unhealthy outlet.

A KidsHealth poll asking older children about their stressors and what they do when they’re upset. Approximately 25% responded that when they are upset, they take it out on themselves through hitting, biting, or banging their heads on something.

As children grow from infants into toddlers, they will start exploring their surroundings and communicating their wants and needs. However, their capabilities don't quite match their desire to do both of those things.

As a result, their inability to verbalize their wants or needs, combined with their struggle to navigate their environment successfully, can be a recipe for a temper tantrum. If they have a low tolerance for frustration, they may hit themselves as a way of expressing their exasperation.

If you notice this happening, take note of any triggers that led to the tantrum. Perhaps you said no to something your child really wanted to do. Or maybe, they were simply over-tired or hungry.

Once you recognize a pattern or a trigger that leads to the self-harming behavior, you may be able to prevent problems before they start. Just be sure to intervene before the fists start flying.

When parents are unable to prevent their kids from hitting themselves, there are effective ways to handle the temper tantrums. Here are several things you might try doing to keep your child safe.

When kids find multiple ways to hurt themselves—such as banging their heads against the wall—move them or the objects out of reach.

For instance, taking your arms and preventing them from hitting themselves by blocking their fists is an option. This action can be comforting and might be enough to calm your toddler down and stop the self-injury. The goal is to create a safe, loving environment for kids to soften the pain or frustration that they're feeling.

Telling kids that they are safe and that you are there for them can be comforting, too. You also can give them something to hold, such as a teddy bear to squeeze or a sippy cup full of water to drink.

Although it is tempting to try to reason with toddlers or lecture them on their behavior, now’s not the time. It’s more important to focus on calming them and reducing their risk of being harmed.

Once the moment has passed, then you can start working on teaching your toddler healthy ways to express frustration.

You might start by talking about how to identify and verbalize feelings by saying, “I can see that you’re feeling really mad.”

When kids know you recognize their frustration or anger, they may be less likely to show you how upset they are and stop hitting themselves. Teaching "feeling words" also sets the stage for your child to begin learning healthy anger management skills throughout the preschool years.

Another explanation for toddlers suddenly hitting themselves, is that they may be in physical pain. For instance, toddlers that hit themselves on the side of the head may have an ear infection.

Meanwhile, babies who are teething may also hit themselves at times to cope with the pain in their gums. Sometimes, hitting can be self-soothing. Be on the lookout for signs your child may be in physical pain.

Pay attention to where they are hitting themselves. Sometimes kids are trying to communicate where it hurts. And, depending on the source of the pain, you may be able to treat your child at home.

If you are uncertain what is causing the pain, however, a trip to your child's pediatrician may be in order.

When kids are hitting themselves on a regular basis and it’s not connected to a temper tantrum or acute pain, the habit can be especially concerning. Sometimes, self-injury may be associated with autism.

In addition to hitting themselves, children with autism may scratch, pinch, or bite themselves or bang their heads. Children with developmental disabilities may find self-injury to be self-soothing. Rhythmic head-banging, for example, provides vestibular stimulation.

It's also concerning when children are causing physical damage to themselves. If they are hitting themselves so hard they are leaving bruises or marks or they are causing other injuries to themselves, see a pediatrician.

For toddlers who are a little bit older, the extreme frustration of not being able to express themselves might be a result of a speech delay. Therefore, the pediatrician may want to provide a referral to a speech therapist for an evaluation.

When in doubt, it’s always best to get your toddler evaluated by the pediatrician to rule out any potential medical conditions or developmental delays.

If you think your child's behavior is a symptom of a larger issue, write down when you notice it occurring and bring your notes to your child’s doctor to ask for advice.

The physician might recommend additional screening to determine what’s going on. Talking to a physician about your child's behavior also may give you peace of mind, strategies to use when your toddler self-harms, or a referral to a specialist for further evaluation and treatment.

Usually, when toddlers hit themselves or bang their heads, it is nothing to worry about. However, it never hurts to observe when the behavior is happening and how frequently.

Then, talk to your pediatrician about what you are seeing. In the meantime, just focus on trying to keep the hitting to a minimum and helping your child find other ways to communicate frustration.