Breaking the Thumb-Sucking Habit<
By scott chandler
Reviewed By Brunilda Nazario
My 8-year-old, Michael, had me concerned. He was finishing up third grade and still sucked his thumb.
"What can I do to make him stop?" I asked my pediatrician. His grandmother had been successful the previous summer at getting him to quit during a week-long stay at her house. Her remedy: Give him undivided grandma love and reward his efforts daily. Once home, the habit returned.
"Is finger-sucking normal at this age?" I wanted to know. I found out it was not. Fortunately, the problem wasn't serious, but the solution would require patience and determination -- on my part and his.
Most Infants Self-Pacify
Most experts agree that a thumb-sucker younger than 5 shouldn't be pressured to stop. Most children will give up the habit on their own before they enter kindergarten.
"Thumb-sucking is an appropriate and useful behavior for very young children," says Linda Goldstein, MD, a Washington pediatrician. "It allows them to comfort and entertain themselves."
In fact, more than three-quarters of infants suck their thumbs or fingers through the first year of life. A child usually turns to the thumb when bored, tired, or upset. It is not uncommon to see a thumb-sucker simultaneously engage in other behaviors, such as twirling a strand of hair, holding onto an ear, or rubbing a blankie.
"Even when the habit lingers past infancy, thumb-sucking is rarely something to be concerned about. It doesn't indicate that a child has emotional problems or that he will still be sucking his finger when he's a teenager," says Sabine Hack, MD, assistant professor of psychiatry at New York University School of Medicine.
Reaching a Merciless Age
As children move past toddlerhood and into the preschool years, the thumb-sucking crowd begins to dwindle. Nevertheless, one in five children will still be sucking his thumb or finger past his 5th birthday. "This is the merciless age, the time when teasing begins. Parents begin to worry because the thumb-sucking is causing social difficulties for the child," Goldstein says. "By kindergarten you'll find that kids don't want to play or sit next to a child who's a thumb-sucker."
Thumb-sucking also can lead to dental problems. A child who is still thumb-sucking by age 5, when permanent teeth start coming in, may develop an abnormal bite. Beyond a simple overbite, some children develop speech problems: troubles with the "S" sound and other "tongue-tip" sounds, according to Forrest Umberger, PhD, a professor of special education and communications disorders at Valdosta State University in Georgia.
"Many of our clients are referred to us by orthodontists," says Umberger, who has studied the role of thumb-sucking in muscle and facial pathology. "The idea is not just to do a cosmetic fix but to help children correct the speech difficulties once the sucking habit is gone."
Prolonged finger-sucking also can cause minor physical problems like chapped skin, calluses, and fingernail infections. In Michael's case, the second finger on his right hand became shriveled up, and the nail barely grew. During winter the skin on that finger would become dry and cracked, which only seemed to make him want to suck it more.
Support, Guidance Key
"If a child who is older than 5 or 6 is still sucking his thumb and having difficulty stopping, parents ought to think about what they can do to help him," Hack says. Before insisting that a child go "cold turkey," it's important to observe how deeply entrenched your child's behavior is, she says. How often does your child suck and in front of whom? If it happens only at bedtime or in front of family members, it's a less serious problem than if it happens at school or in social situations.
Attempts to steer a child away from thumb-sucking can backfire if they are not tempered with support and guidance. Don't nag or reprimand your child, and don't pull a child's finger out of his mouth. These kinds of actions can result in a power struggle, experts say. "The truth is most kids over 6 really do want to stop, but they need some extra help," Goldstein says.
Simple Treatment Plan
Breaking a habit is a much easier feat when the child is a willing participant. Many parents have success with a simple behavioral approach that engages the child in the process. Here's how it works:
First, says Hack, call a one-month moratorium on discussion. "If finger-sucking is part of a power struggle, not mentioning it may help extinguish the behavior," she says. Next, buy poster board and stickers and make a "progress chart." Offer a prize at the end of each week for no sucking -- and a larger reward at the end of the month. Make sure that your child has an active role in the plan; for example, decide together how many slip-ups he's allowed each week and have him choose the stickers and place them on the chart.
It may also be helpful to place a bitter-tasting liquid on the nail (not directly on the finger), especially at night, as a reminder not to suck. Products for this purpose are sold over the counter, but home remedies can be just as effective. What worked for Michael was perfume. Each night for two weeks, I asked him to choose a bottle of perfume from my collection. He would sniff them all, pick one, and I would place a dab at the tip of his finger. "Yuck," he'd always say, but he clearly welcomed the crutch. Mittens, gloves, or a finger-splint may also be worn at night. It may take six weeks or more to successfully break the habit.
Dentists Can Help, Too
While your child is trying to change his or her behavior, it's essential to give lots of praise and support: an extra cuddle, a special outing, playing a new game together. Be aware of situations that might promote thumb-sucking, like TV or riding in the car. "Use your imagination to guide your child to other means of solace that are more age-appropriate," Hack says.
If this program doesn't work, don't despair. Breaking a longstanding habit is difficult and some children may need additional help. Talk to your child's dentist, who may recommend inserting a device in the child's mouth that prevents sucking. These oral appliances go by names like "palatal bar" and "crib" and come in fixed and removable versions.
If the problem seems particularly resistant to treatment, this may be a signal that your child is troubled about a deeper problem, Goldstein says. In this case, you may want to seek the advice of a mental health professional.
Published Oct. 14, 2002.
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