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Daycare Center and Family Home Forum>What Would You Do? - Child Who Likes to Pull Her Hair
seashell 09:06 AM 11-09-2009
I have a new child in my care who likes to pull hair. HER OWN HAIR! She's a little over a year old and she is pulling her hair out in clumps. She doesn't pull the other children's hair (yet anyway). Her mom has Trichotillomania, which is the technical term for someone who pulls their own hair out. Mom wears a hat all the time to cover her bald spots and she even appears to pull out her own eyebrows. Here's what Wikkipedia says about Trichotillomania:

"Trichotillomania, a hair-pulling disorder, is a mental disorder that involves an irresistible urge to pull out hair. This behavior occurs to the point of noticeable hair loss. The most common areas for hair pulling are the scalp, eyelashes, and eyebrows, but may involve hair anywhere on the body.

Trichotillomania is a type of impulse control disorder. Impulse control disorders are mental illnesses that involve the repeated failure to resist impulses, or urges, to act in ways that are dangerous or harmful. People with these disorders know that they can hurt themselves or others by acting on the impulses, but they cannot stop themselves.

In children, trichotillomania occurs equally in males and females. In adults, it is more common in women than in men.

What Are the Symptoms of Trichotillomania?
A person with trichotillomania cannot control or resist the urge to pull out his or her body hair. Other symptoms that might occur with this disorder include:

A sense of tension before pulling hair or when trying to resist the urge to pull hair

A feeling of relief, satisfaction, and/or pleasure after acting on the impulse to pull hair

Presence of bare patches where the hair has been pulled out

Presence of other associated behaviors such as inspecting the hair root, twirling the hair, pulling the hair between the teeth, chewing on the hair, or eating hair (called trichophagia)

Many people who have trichotillomania try to deny they have a problem and may attempt to hide their hair loss by wearing hats, scarves, and false eyelashes and eyebrows."

I have talked to mom about it and she just laughs it off and says, "like mother, like daughter". I don't know what to do. Should I try stop the behavior? Redirect the activity when she starts pulling? Should I just ignore it? What would you do? Consider, mom has offered no help in the situation.

lmdc 09:40 AM 11-09-2009
wow...that poor little girl! i would continue to do some research and see what the treatment options are...should the mother be referring her to some type of therapist or getting her some type of treatment? do you know if other drs or professionals are currently involved, or is mom just letting things go as they are, since she too has the disorder? i would probably talk to my licensor to get their opinion, just because i trust them and know they have seen it all, and could probably direct me in the right of my first thoughts, although i'm not quite convinced this is the way too go, is to get cps or somebody higher up involved, if mom truly is not doing anything to help this child do whatever she can to overcome this disorder...

good luck!!!
AmandasFCC 12:25 PM 11-09-2009
My best friend in grade school used to do this. She would pull the hair on her head and her eyebrows. She used to sleep with mittens on so she couldn't do it in her sleep, but otherwise she was constantly being reminded to stop pulling her hair. It's an unconscious thing for the most part (at least, it was with her) so once she realized she was doing it she'd stop...
kitkat 12:46 PM 11-09-2009
Wow! Obviously the mom is in denial if she's just laughing this off. If you are licensed, I would contact them to see how this should be handled. Since mom has the disorder, I'm wondering if daughter is copying the behavior she sees mom engaging in. Someone definitely needs to be contacted about this, I'm just not sure who. I'm guessing whoever you call will be able to at least direct you to the appropriate source. Will the daughter wear a hat for you? If so, you might want to put that on her to try to control/slow the behavior.

Please follow up and let us know what you decide to do and what happens.
DBug 12:06 PM 11-10-2009
I don't know if this will help at all, but my son experiences childhood transient tics that happen more frequently when he's stressed or nervous. If you mention them, they get worse. When I see him starting to tic, I don't say anything, but I'll go and rub his back or scratch his head to relax him. For him it's an unconscious compulsion, so he has a very difficult time controlling it.

Does this little one appear to have any triggers? Even tiredness, hunger, or somebody in her personal space. If so, maybe you could do something to counteract the trigger, and decrease the chances that she'll start pulling her hair.

Just my thoughts .... Keep us updated!
jen 12:32 PM 11-10-2009
I gotta be this case, I think this family needs some intervention. I would probaby call licensing or social services...
Chickenhauler 11:48 PM 11-10-2009
Is there any treatment options for this affliction besides keeping the person permanently stoned on pharmaceuticals?

Reason I ask, is a child this young will probably not be able to (nor would it be healthy) to take such medicines.
rabagley 11:00 PM 11-19-2009
Originally Posted by Chickenhauler:
Is there any treatment options for this affliction besides keeping the person permanently stoned on pharmaceuticals?
My wife has trich, though it's a minor case compared to many (she still has a full head of hair, though a sweep of the floor near the couch would reveal quite a few individually pulled hairs).

Unfortunately, there is no treatment at all. It is caused by the same kind of neurological disorder that causes Tourette's syndrome. It's very distressing to the afflicted, because they are aware that they're disfiguring themselves and feel completely unable to resist the urge to pull.

As someone who has dealt with this issue and talked with many members in a support group, I think the best thing to do in a case like this is to simply clean up after and don't let yourself get distressed (your anxiety will make her distress worse). Mom's lack of advice is a helpless but also a rational response. She feels completely helpless for herself and for her daughter and knows that for now, the best thing to do is to try to laugh it off.

Realize that the world is a strange place, and not everything that is broken can be fixed. This little girl has a few extra hurdles to deal with, but they don't have to prevent her from being a successful student/professional/wife/mother/friend/caretaker/boss/teacher/cook/etc.


I read the first and last post in the thread, but I see several misconceptions in the other posts. The girl is not copying her mom. The girl has a compulsion caused by a neurological disorder she inherited from her mom. No intervention will help, and any such event is almost guaranteed to make the situation worse. The reality check is needed here, as we are discussing very real people with a very difficult condition who need understanding and compassion, not suspicion and accusation.
jen 07:08 AM 11-20-2009
Let me clarify, when I said intervention, I didn't mean they should be "turned in" rather they need some help. There ARE treatment options such as HRT (Habit Replacement Therapy) that can be helpful, especially when teamed with medication, but also helpful on its own. I'm sure this is a very stressful situation for the family, which is exactly why they need some help in not only addressing the situation themselves, but so that they can effectively communicate to the childs caregivers so that they can adequately respond to the needs of this child.
Unregistered 08:00 AM 11-23-2009
I am not sure what you should do. I think if you just keep deterring the little one when you notice it happening and take note of stressors in her life it might help.

My sister-in-law suffers from Trich. She's had it since she was a little girl as well. It sounds exactly like her. It gets worse with stress. It's extremely difficult to treat. In my state there is one therapist that is really good and specializes in this treatment and even their success rate is not 100%. It's so sad and so hard to be the one with this illness. My sister-in-law has gone through two wigs due to hair loss---she even pulls out the hair from the wigs. It's very embarrassing for her and she secludes herself because of it.
Tags:cps, disorder, drs, eyebrows, hair, impulse control disorder, mental illness, pulls hair, social services, therapist, treatment, trichotillomania
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