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It's unsanitary and ugly to look at: Nail biting is indeed a habit that most parents want their children to outgrow and live without as early as possible. What causes this nasty habit to develop in children? How can it be stopped?
Nail Biting Defined
Nail biting, medically called "Onychophagia", is an oral compulsive habit that affects both males and females of all ages. It is a common mannerism that a person does when he is feeling anxious - like when being nervous about performing on stage, stressed about beating a certain deadline, worried about looking stupid in front of friends, or excited about an upcoming party. Even in uneventful occasions like just being hungry or bored, some still resort to nail biting to relieve them of the anxiety.
According to Baltimore County psychiatrist, Dr. Carol Watkins, nail biting occurs slightly more in males than in females and is a behaviour that transcends any culture and geographic location. It is seen in 28% to 33% of kids aged 7 to 10 years old and in almost half - about 44% - of adolescents and teenagers. Nail biting is also reported in 19% to 29% of young adults and in about 10 to 20% of adult men and women.
The Cause of Nail Biting
Medical experts have long been curious about the reason behind nail biting. According to Dr. Watkins, one of the earliest theories that have been believed to be the cause of nail biting is the Freudian view - a psychological view that means it had something to do with an oral fixation. This theory is no longer a popular opinion and is replaced by other behavioural and biological views.
Today, experts are exploring the possibilities that nail biting is a learned habit or it is caused by a relative of obsessive-compulsive disorder. Other followers of genetics think that nail biting may be an inherited characteristic, since it has been observed to run in families. Another theory is that it is an exaggerated grooming behaviour, like what has been observed in some animal species (like chimps).
Until today, there is no single accepted cause of nail biting behaviour. Whatever the reason behind it, one thing is for sure: there is a comfort-stress-relief aspect for a lot of people who bite their nails. According to Dr. Watkins, the cause of nail biting may be different for each individual. Although for many it's associated with anxiety, other studies report that not all people nibble their fingernails because they are anxious about something.
The Perils of Nail Biting
The act of biting one's fingernails is usually harmless and kids can outgrow the habit by themselves when they reach adulthood. If you see your child biting his nails once in a while during times when he is feeling shy or nervous, there is really nothing to be alarmed about. As long as you ensure that your child's hands are clean most of the time, he'll be fine.
According to Dr. Ella Toombs, a dermatologist at Dupont Circle, nail biting can cause no serious or long-term medical problems, but it can be unattractive. She said that prolonged nail biting can lead to cosmetically unacceptable fingernail beds due to swelling and scarring of tissue. Broken and swollen skin, Dr. Toombs explains, is more susceptible to skin infection.
Deformed and infected fingers are not just painful, it can also be embarrassing. The embarrassment of unsightly fingers can cause your child to grow up with low self esteem and insecurities later in life.
Nail biting may also be a sign of other emotional or mental disorders like OCD (obsessive compulsive disorder). People with extreme cases of nail biting can gnaw their nails up to a point of reaching their own flesh, without them even noticing it...Ouch!
In many reported cases, the act of nibbling one's fingernail is only one of the many ticks they develop to reinforce their anxiety levels. Other ticks include thumb-sucking, nose-picking and hair-twisting. Some extreme cases even report nail biting while sleeping as a subconscious attempt to address their anxiety.
Helping your toddler stop
In a nutshell, nail biting is most likely something that naturally goes away in time, but if your child won't be able to wean off the habit, it may lead to unpleasant results as enumerated above. As a parent, you can help your child get rid of the biting for good by trying out a few suggestions below:
Address your child's anxiety. Don't nag
Did you know that by shouting "NO!" to a child who is biting a nail may just be reinforcing the habit? Many first time parents may not know this, but instead of helping your child deal with his stress, shouting "no" at him could only worsen it.
According to parenting educator Janis Keyser, co-author of "Becoming the Parent You Want to Be", the usual response when a child is doing something that worries the parents is that they try to stop the behaviour. Keyser explains that it is essential that parents deal with the underlying cause of the behaviour that worries them and address the cause.
To address whatever is causing your child's anxiety, talk to him. Ask why he is biting his nails. What makes him uncomfortable? What worries him? After finding out whatever causes the stress, reassure him that everything will be okay. By reassuring a child, you are helping his anxiety levels go down and hopefully, the nail biting episodes will follow.
Replace the habit with other distractions.
If your child is too little to understand what frightens or worries him, you can still help stop the habit by replacing it with another distraction - like a toy, for example, or having him watch an educational show on TV. You can bring him to start talking or singing, as this would make his mouth too busy to bite.
To keep his hands busy while still performing other activities, you can give him a stress ball, a non-toxic putty toy, or a smooth rock that he can play with while reading or watching TV. Place his achievement stickers on his fingernails instead of other parts of his body to make him conscious not to put his hand on his mouth, at least for the day.
Set a good example
As the popular saying goes, "Kung ano ang ginagawa ng nakatatanda, ay syang nagiging tama sa mata ng bata" (Actions of adults are all presumed correct in the eyes of a child). If you constantly remind your child of how beautiful your fingers are because you don't bite them and keep them clean or kept, it could convince him or her to emulate your example. Just make sure that you offer positive reinforcement and that you don't make him or her feel bad about himself/herself as this could bring an adverse effect.
Keep them short and clean
Keep your child's fingernails short so there is less to bite. Monitor your child's behaviour after this - if he continues to bite his flesh to a point that it bleeds, you may need to consider other options.
It is also important that you wash your child's hands constantly, like before meals and after play time. Nail biting facilitates germ transfer from the hands to the mouth and this can be a cause of a myriad of bacterial and viral diseases to develop.
If he asks for help, support him
If your child approaches you and tells you he needs your help to stop the habit, like after being teased at school for ugly fingernails, then this is a good sign. This means that he is ready to make an effort and you can help by reminding him that he is biting his fingernails again during times when he forgets. Keeping your child aware of the act is important in this exercise.
Give him options that will serve as your secret reminder - like a password or a hand signal - that only the two of you understand so he doesn't get embarrassed in front of his friends. Make sure that he chooses the reminder himself, so that he will be more receptive to your efforts.
If your child is older, perhaps its time you consider other forms of treatment for nail biting. Check out some of the popular modes of treatment used to kick the habit below. Consult your family paediatrician to determine which treatment is best for your child.
Nail Biting Treatments for older children
There are many effective treatments recommended by both medical experts and former gnawers themselves, but of course the results depend per individual. Some may respond to treatment and some won't, so you have to be patient in helping your child overcome this. Here are some of the most popular treatments to end nail biting in older children (even adults).
Nurture the will to stop - let your child realize that his nail biting habit can only end if he or she wills it. It is actually not as effective as other treatments since nail biting is usually a subconscious act, but it is the least pervasive of them all and least expensive.
According to Dr. Watkins, what's key here is for the nail biter to become aware of the exact time and place where the nibbling begins. According to experts, you can help your child will his habit away by encouraging him to start a journal. This journal should keep track of the moments that trigger his nail biting episodes - is it while watching TV? Listening to a teacher lecture in class? Once the instances have been identified, tell your child to set reminders to stop biting during these crucial moments. You can do this by writing some words of encouragement on sticky notes and place it on his notebook, or save a reminder on his mobile phone calendar or computer, etc.
If your child is a female, give her a charm bracelet that jingles so that every time her hand gets to her mouth, the sound can catch her attention.
Nail polish or cream - you can encourage your teenage daughter to wear nail polish to prevent her from biting her nails again. Nail polish doesn't have to be coloured, you may start your teen with colourless nail polish if her school won't allow coloured ones.
There are also special nail polishes developed specifically to address nail biting. These special nail polishes leave a bitter or spicy aftertaste even after drying up so that the one who wears it won't be too happy tasting it from her nails. There are also special creams that have serve the same purpose - leave a bad aftertaste to discourage hand & mouth contact - while giving your poor nails extra nutrients that help keep it strong and healthy.
Medications - In cases where nail biting is merely a symptom of severe stress or depression, doctors can prescribe anti-depressants such as setraline, clomipramine, or fluoxetine for nail biting. To augment the anti-depressants, a patient may also be prescribed with a small dose of anti-psychotics like olazapine, ziprasidone, or quetiapine.
Behavioural Therapy - Habit-reversal behavioural training is available to help patients "unlearn" their bad habits like nail biting. Usually, the training involves replacing your bad habit with a positive one. Behavioural therapy can be combined with medication to achieve better results in patients.
Hypnotherapy - Okay, this may sound scary, but many nail biters have had great success with hypnosis. Since nail biting is most of the time a subconscious act, then accepting treatment from the subconscious level makes sense. In the US, parents are given the option to either bring their child to a hypnotherapist or order a "stop nail biting" hypnotherapy tape.
Different strokes for different folks
Different kids prefer different techniques to stop their nail biting habits. Since there is no way to know which treatment will work for your child unless your try it, you may have to perform a "trial-and-error" approach if one doesn't work.
What is important here is that you allow your child to feel he is a partner in this endeavour. The more he feels like you're punishing him for his habit, the less likely you'll succeed in putting an end to it. Ensure that even if the treatment fails, you still provide positive reinforcement and reassurance at all times.