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Body-focused repetitive behaviors (BFRBs) are common among children due to a combination of developmental, psychological, and environmental factors. Some of the common causes for adoption of BFRBs in children include sensory exploration, habit formation, and environmental stressors. Therefore, understanding such causal factors helps parents identify the signs of BFRBs and create an effective management plan. Let’s review some of the common signs of BFRBs in children and how to support their recovery.
How to Recognize BFRB Signs in Children
Identifying body-focused repetitive behaviors in children often involves constantly observing their emotional responses, behavioral patterns, and physical appearance. Taking note of such elements will help you understand their triggers and how to help in the management. The general signs to look out for are usually if there are any repetitive habits and if these habits affect their appearance and how they spend their time. Depending on the self-soothing habit the child adopts, you can pick it out by observing their appearance and behavior.
For instance, in children dealing with trichotillomania, you can easily pick it up by checking for noticeable hair loss or finding pulled hair around the child's play, sleeping, or study area. Also, for BFRBs such as cheek biting, nail, and skin picking, you have to look out for any injuries around these areas. Additionally, the child may avoid a lot of contact due to soreness, for example, they may avoid eating if they bite their lips or cheeks. Some of the behavioral changes you should take note of include social withdrawal, emotional distress, and even changes in routine to accommodate the acquired habits.
How to Support Children with BFRBs
Supporting children with BFRBs takes a multifaceted approach that involves neutralizing the factors that exacerbate this condition, such as promoting environmental modifications and behavioral interventions. Furthermore, it involves empathizing with them and understanding the underlying triggers of their condition. Here are some ways to help children manage BFRBs.
Create a Supportive and Non-judgmental Environment
The best way to create a supportive environment is by first making the child comfortable enough to speak about their challenges with BFRBs. You can encourage the child to talk more about their experiences with the habit they are struggling with without the fear of punishment. Being empathetic validates their emotions instead of feeling like they are being dismissed. Showing such care and support helps them build a positive attitude toward healing and adopting healthier behaviors. Creating a no-judgmental environment also involves promoting positive reinforcements by giving rewards for any minimal effort made towards containing the BFRB.
Most importantly, you have to be on the same side as your child by having continuous conversations with them on what makes them feel motivated and supported. Listening to them and respecting their wishes helps them open up to you more, and you can get more insights into their experience with the compulsive habit they are struggling with. Moreover, you have to understand that the BFRB healing process is gradual, and thus, there is a need for patience and consistency in supporting positive behavioral interventions.
Utilize Support Groups and Resources
There is a wide range of informative resources available, from websites to books on BFRBs and their management. Therefore, you need to educate yourself on these conditions to help you make informed decisions when dealing with your child. Understanding how BFRBs occur, their impact, and management makes it easier for a parent or guardian to create a supportive environment for their child. On the other hand, operating without knowledge may lead to impatience and poor handling of the situation.
Furthermore, you can join support groups for children and families with BFRBs. These groups can help you share your experiences and strategies with others who are also going through a similar situation. These support systems are instrumental in helping you gain more knowledge on how to deal with your child's condition. Watching children struggle with BFRBs can be draining, and thus, joining a community of people dealing with similar challenges can be a source of motivation to keep going. Also, you can enroll your child in therapy to help them develop strategies for coping with these repetitive habits.
Do Not Micromanage
The instinct when your child is biting their nail or picking their skin is usually to call them out. However, children, just like adults, do not like to be micromanaged, which includes giving them a side eye or shouting at them whenever you spot them engaging in these repetitive habits. Calling them out all the time can be frustrating; thus, you need to find alternative ways to deter the habit without policing them.
As an example, some of the ways you can deter bad behavior include creating physical barriers, or including visual aids to make them more aware of their behavior. For instance, if the child is biting their nails, you can use adhesive bandages to cover their fingers or provide fidget toys to keep their hands busy. Alternatively, you can agree on a subtle code that you can use to make them aware that they are biting their nails or pulling their hair.
Reduce the Focus on The Injuries Incurred from Engaging in BFRBs
It is always tempting to comment on your child’s change in appearance. However, this should not be the case since children dealing with BFRBs are often sensitive about their appearance, and any comment may lower their confidence and even increase their anxiety. Therefore, you should avoid calling attention to their appearance or injuries. Your child will likely feel pressured over intense observation. The pressure may result in depression and anxiety, and they may engage more in BFRBs to get instant relief, thus creating an unending cycle. So, you need to focus more on solving the problem instead of the outcomes of the habit.
As an illustration, month-long progress can be undone within hours if your child is unable to manage triggers such as stress and anxiety that may come from calling out their appearance. Additionally, you can educate those around your child on how to care for them and what they should not do around them. For example, you can let their teacher in on the condition and let them know how to respond in case they spot your child biting their nails, pulling their hair, or picking their skin.
Talk to Your Child About How to Take Unsolicited Comments
While parents may strive to create a safe space for their children, it cannot be entirely achievable since sometimes kids are out of sight, especially when they are in school and outside. Therefore, you need to help your child build their confidence by helping them understand how to take unsolicited comments about their appearance or condition without relapsing. You should help them understand that their condition is temporary and that taking unsolicited comments seriously may hinder their recovery.
Additionally, be sure to help them focus more on taking positive comments and brushing off the negative ones. Children dealing with BFRBs often struggle with self-esteem issues, and thus, such comments may cause anxiety and even depression.
Summing Up
BFRBs are not an individual struggle, their impact is often felt within the family. Therefore, there is a need to create a strong support system to help one recover from it. While it is normal to worry about your child’s wellness and hold unanswered questions, you will still have to approach the situation with more compassion and positivity to help your child achieve a positive outcome from their healing process.
To sum up, the first step when building an effective support system is identifying the symptoms of various BFRBs that your child might be struggling with. Recognizing the signs helps you create a significant management plan, from modifying your child's triggers to seeking help from a professional therapist.