It can be associated with temper tantrums, tension, or stress. Head banging can also develop as a sleep ritual if the head banging occurs as the child falls asleep. Treating childhood habits that do not interfere with everyday functioning is often unnecessary because many habits remit spontaneously over time. However, if the habit is causing the child and/or family members distress, social isolation, or physical injury, a therapeutic intervention may be required. Behavior therapy is the mainstay in the treatment for children with habit behaviors. Effective behavioral therapies for habits include the following: Habit reversal: This is the most consistently effective way to treat presenting habits in children because of its brevity, immediacy, efficacy, durability, flexibility, and consistency. Relaxation training Self-monitoring Reinforcement Nocturnal biofeedback (bruxism) Competing responses Use of bitter-tasting substances (nail biting) Negative practice Use of aversive-tasting substance (thumb sucking)