Treatment of Typically Developing Toddlers with Hair-Pulling Behavior and Concurrent Poor Sleep Hygiene: A Case Series

Abstract

Hair-pulling disorder is a rare condition with onset most commonly in adolescence and a well-documented association with comorbid psychiatric disorders. Minimal literature currently exists detailing the occurrence and treatment of this condition in young children, particularly less than 5 years old. Method: This case report describes 2 cases of children (<24 months old) with hair-pulling disorder and concurrent highly disrupted sleep. Treatment aimed at addressing sleep hygiene through parental psychoeducation and training, competing items, and faded naptime/bedtime. Results: In both children, sleep hygiene intervention yielded significant improvement in sleep disruption patterns and hair-pulling behavior across approximately a 3-month period that maintained at 1-and 3-month follow-ups. Conclusion: Identifying factors that may be related or concurrent to hair pulling in young children is vital in ensuring that treatment is individualized and effective.