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Bad Habits

Parents get really shook up when their child develops a “bad” habit like nose-picking or hair-twisting.

Here is an unusual one from a recent email: “My 3-1/2 year old granddaughter has been chewing the inside of her lips/cheeks for over a year, even using her finger to poke her cheek in from the outside and occasionally drawing blood.. We can’t get her to stop. Some adults in the family also chew the inside of their mouths in the same manner. She is a very bright, articulate and mostly happy child although she is somewhat lacking in sociability outside of her immediate circle. Her parents were divorced when she was a little over one year old and she shares days and nights with each in two to three day increments. She has a loving parent and grandparents on each side. What is the best way to deal with this chewing issue…should it be totally ignored or should we continue to point it out to her?”

This letter describes one of the so-called “tensional outlets.” This term helped change our previous thinking that nail-biting and other such behaviors were bad habits. There is nothing “bad” about a child who repetitively chews her cheek.

Tensional outlets like thumb-sucking, or nail-biting are common in young preschoolers. The hand-to-face tensional outlets like nail-biting and nose-picking become very common in kindergarten, along with fidgeting behaviors.

All of us have bad moments when we feel tense and out-of-sorts. Indeed tension is universal. Adults have a repertoire of ways to relieve tension from “bad” things like smoking, to healthy things like taking a brisk walk. Children are more limited in their choices but have as much need to relieve tension as adults do.

Some parents think it strange that a child should feel tension. Isn’t childhood an idyllic time with no worries? If a child has tension isn’t it the parents’ fault for not making the child’s life smooth? The answer to both questions is “No.” Childhood has its share of tensions; growing up is a hard job. Parents cannot, and should not, eliminate tension from their child’s life. Every child has to learn ways of reducing tension that are socially and personally acceptable. Your granddaughter has loving parents and grandparents which is great but she does not have an intact family which means she must move every few days.

If a child chews her cheek does this mean the child has an abnormal degree of tension? The answer again is “No.” Years ago psychoanalytically-trained therapists would have called this a form of self-mutilation. Very rarely we see severely disturbed children who bite to hurt themselves. But most children who chew cheeks or nails do NOT hurt themselves.

Some children chew away only when they are under special stress like seeing a scary movie or taking a test at school. But in my experience most kids just chew. This act of chewing is a pretty unconscious one which is why it is a hard habit to break.

A tensional outlet like this can be pretty disturbing to parents and grandparents especially if blood is drawn. Some kids do bite or tear at their nails until they bleed and I have actually seen a little girl very much like your granddaughter in my practice.

However parents and grandparents can observe the child to see whether there is a pattern to the chewing or if there is a particular time the child seems under stress. Parents can model ways of reducing stress by including the kids in exercise or “stress-breaks” when the whole family lies on the floor and does deep-breathing or images themselves in a peaceful place.

If there is bleeding her mouth will be sore and that could give her a hint to stop. Limit her TV and other “mindless” times, give her plenty of loving attention, reassure her that when she gets bigger she will have so many things to do she will stop. However if she complains her cheek hurts or she wants to stop, try the rubber band on the wrist technique. Whenever she feels like chewing tell her to snap the band instead.

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