Teeth grinding, also known as bruxism, is a behavior that is commonly observed in adolescents with Autism Spectrum Disorder (ASD). While it may not seem serious at first, frequent grinding during the day can lead to tooth damage, jaw pain, tension headaches, and difficulty focusing. This behavior can also cause distress for caregivers who are unsure how to help their child manage it.
One approach that has proven effective is Habit Reversal Training (HRT) — a structured, behavioral strategy that helps individuals become aware of and replace repetitive behaviors with more appropriate alternatives.
Understanding Why Teeth Grinding Happens
For many autistic adolescents, teeth grinding is not a deliberate act. It often happens unconsciously and can be triggered by:
- Sensory needs: The grinding may provide calming or stimulating input.
- Stress or anxiety: It may appear more frequently in overwhelming situations.
- Boredom or inactivity: Some teens grind during periods of low engagement.
Identifying the purpose of the behavior is key to choosing the right intervention. Occupational therapists assess these patterns and consider sensory, emotional, and environmental factors.
What Is Habit Reversal Training?
Habit Reversal Training is a behavior-based method designed to reduce unwanted repetitive behaviors. It includes the following key steps:
- Awareness Training
The first step is helping the adolescent recognize when the behavior is happening. This may involve keeping a simple log or using visual cues to identify triggers such as certain activities, emotions, or environments. - Competing Response Training
The next step involves teaching a new action that makes teeth grinding physically harder to continue. This could include:
- Lightly closing the mouth and keeping the jaw relaxed
- Using a chewable sensory tool
- Holding an object in hand or doing a calming movement
- Positive Reinforcement
When the child uses the new behavior, praise or small rewards are given. Encouragement helps make the replacement behavior more appealing and reinforces the habit change. - Generalization
The new skill is practiced in various places such as home, school, and therapy settings. Over time, the competing response becomes a part of the adolescent’s routine. Occupational Therapy and HRT
Occupational therapists are trained to look at behavior holistically. We examine how habits like teeth grinding affect the child’s daily life, including eating, social participation and other areas of participation.
HRT aligns well with occupational therapy goals because it builds:
- Self-awareness
- Emotional and behavioral regulation
- Independence in daily activities
We often combine HRT with sensory-based strategies to address the root cause of the grinding. For example, if a child is seeking oral input, we might recommend appropriate chew tools or calming sensory activities throughout the day.
In Summary
Habit Reversal Training is a supportive and structured way to help adolescents with autism reduce teeth grinding. It empowers the child to recognize their own behavior, make healthy changes, and feel more in control of their actions.