Annie’s Mailbox for Jan. 8, 2011: Don’t rule out infections with children’s rubbing |

Annie’s Mailbox for Jan. 8, 2011: Don’t rule out infections with children’s rubbing

Dear Annie: This is for “Concerned Teacher,” whose 9-year-old pupil rubs herself against her seat all day long. I am a school psychologist. If sexual abuse has been ruled out, she should simply treat it like any other publicly unacceptable behavior, the same way you would treat a child picking his nose in class.

However, kids often engage in self-pleasure when anxious. So the first step should be to track the behavior and see if it happens when certain subjects are taught. The teacher and parents should talk to the child about a signal to let her know when she is doing it because she may not be aware of it at the time. Another point is to make sure she doesn’t have a learning or cognitive disability. Students with mild cognitive disabilities sometimes do not understand the social inappropriateness of this behavior.

— A School Psych

Dear School Psych: Thank you for your expertise. We are grateful for the many readers who weighed in on this, most mentioning that the problem may not be masturbation at all. Read on:

From California: I spent much of second grade doing the same thing. The cause was a chronic low-grade yeast infection that made me constantly itchy. The rubbing made it feel better but caused inflammation, and it was a long time until I was treated properly and the behavior went away. Yeast infections can be triggered by undetected food sensitivities and often go undiagnosed in both boys and girls. The resultant itching (and other people’s reactions) can cause lasting emotional anxiety.

New York: Years ago, my little sister used to do the same thing. Our family doctor discovered that she had pinworms. Our entire family had to be treated, and our mother boiled all our sheets and undergarments to kill the pinworm eggs.

Danbury, Conn.: That child should be examined by a dermatologist for a possible skin condition such as lichen simplex chronicus or lichen sclerosus. These are not uncommon in the genital region and can be treated with topical medications such as cortisone creams.

Ohio: The girl may have an infection or allergic reaction (from soap, bubble baths, laundry detergents, certain foods, etc.) that is causing itching or discomfort. Infections and/or exposure to allergens can come and go, even over several years. A child may say nothing to her parents because she may not realize her symptoms are not normal, and she may have become accustomed to them.

Texas: We had the same situation with a pupil at our school. The girl’s third grade teacher came up with a solution. She met with the student and her mother, and found a simple gesture the teacher could use to signal the student when the behavior was happening. In this case, the teacher tapped her own chin with her finger. It was so subtle, no one else was even aware of it, but the student knew to stop the behavior. When the child entered my fourth grade class, this information was passed on to me, and I only had to signal her once.

Poughkeepsie, N.Y.: My daughter had chronic urinary tract infections that itched terribly. At that age, she may not be cleaning herself properly after using the bathroom. Antibiotics should clear it up.

Florida: In special education, some of our students do not fully understand how to be appropriate in public. We explain, privately, what we want and then, in the classroom, remind her to “sit up” when she reverts to her “comfortable” position. It is not humiliating to be reminded to sit up. With boys who use their hands under the desk, we ask them to put their hands up on the table. This is done matter-of-factly, without any classroom disruption.

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