Habit disorders include repetitive behaviors like head banging, hair pulling, and nail biting that discharge tension. They become disorders when they interfere with functioning. Many habits are learned and start purposefully but become compulsive. Breath holding attacks in infants involve crying, holding breath, and losing consciousness in response to upsetting events. They peak at age 2 and usually stop by age 5. Pica is repeated ingestion of non-food items like clay, ashes, or paint, especially in children ages 1-2. It requires investigation after age 2 and is associated with lower socioeconomic status, family issues, and health risks.

1. Habit disorders
Dr. Adnan Hamawandi
Professor of Paediatrics
College of Medicine
University of Sulaimni

2. Habit disorders
 Include tension discharging phenomena such
as head banging, body rocking, hair pulling,
thumb sucking, nail biting, teeth grinding,
hitting or biting parts of owns body, repetitive
vocalization and air swallowing. Tics, which
involve the involuntary movements of various
muscle groups are also included.

3. (.Habit disorders (cont
 All children at various developmental points show
repetitive patterns of movement that can be
described as habit whether they are considered
disorders depend on the degree to which they
interfere with the child’s physical, emotional, or social
functioning. Some habit patterns may be learned by
imitation of adults. Many begin as purposeful
movement that for some reason becomes repetitive
with the habit losing its original significance and
becoming a means of discharging tension.

4. (.Habit disorders (cont
 For example, a child who has eye irritation or is
attempting not to shed tears might try close the eye
lids several times in rapid succession, this activity
may become repetitive and incorporated into the
child’s behavior as an outlet for tension. Such
symptoms are often reinforced by attention from
parents and others. As involved children become
older, they learn to inhibit some of their rhythmic
habit patterns, particularly in social situations.

5. Breath holding attacks
 A breath holding spell can be a frightening
experience for parents because the infant
become lifeless and unresponsive owing to
cerebral anoxia at the height of the attack.
Commonly the spells are of the cyanotic type
in which the spell is usually predictable and
always provoked by upsetting or scolding an
infant.

6. (.Breath holding attacks (cont
 The episode is heralded by a brief shrill cry followed
by forced expiration and apnea. There is rapid onset
of cyanosis and a loss of consciousness that may be
associated with repeated tonic clonic jerks,
opisthotonus and bradycardia. Interictal EEG is
normal.
 Breath holding spells are rare before 6 months of
age, they peak at 2 years and they abate by 5 years
of age. The management concentrates on the
support and reassurance of the parents.

7. Pica
 Means repeated or chronic ingestion of non-
nutritive substances which may include clay,
wool, ashes, paint, soap, and earth.
 The age of onset is usually 1-2 years but
may be earlier, although testing and
mouthing of objects is normal in infants and
toddlers, pica after the second year of life
needs investigation.

8. (.Pica (cont
 Pica appear to be more prevalent in the
lower socioeconomic classes, it is often a
symptom of family disorganization, poor
supervision, and lack of parental nurturing.
 Children with pica are at increased risk of
lead poisoning, iron deficiency anemia, and
parasitic infestations.