Habit cough in children

A habit cough is a repetitive cough that occurs in the absence of any underlying disease. Habit cough (also called psychogenic cough, somatic cough syndrome or tic cough) most frequently affects school age children, usually those in later primary school or early high school, and boys and girls are equally affected.

Habit cough may follow a viral illness, but can go on for weeks, months or even, in extreme cases, years. However, there are treatments available to help with habit cough.

Features of habit cough

In children with habit cough, coughing can occur many times in a minute, and often becomes more severe when other people, such as parents, teachers and health care providers, are around. Sometimes the repeated coughing occurs throughout the day.

The classic type of habit cough is:

  • loud;
  • harsh;
  • honking; and/or
  • barking.

This classic type of habit cough most often affects teenage girls.

Repeated clearing of the throat is another type of habit cough that most commonly affects boys between the ages of around 7 and 10 years.

Even though the habit cough can sound harsh, the child is usually quite comfortable between coughing bouts. Classically, a habit cough only occurs when the child is awake. Also, the cough may not occur when the child is distracted.

Habit cough is not associated with shortness of breath or wheeze. If these symptoms develop, it is likely the cough is related to an underlying disease.

Habit cough diagnosis

Your doctor can diagnose habit cough by confirming the presence of the above-mentioned symptoms and excluding any underlying medical conditions that could be causing the problem. This will require:

Your doctor may refer you to a paediatrician (specialist in children’s health) for further assessment and treatment.

Treatment for habit cough in children

Firstly, it is important to recognise that despite the disruptive nature of the cough, and its often harsh sound, habit cough is not a dangerous condition, and your child in fact is physically healthy. Sometimes the simple reassurance that the cough is not serious and will go away helps resolve the symptoms.

Coughing can irritate the airways and lead to more coughing, so it's important to try to break the cycle. The use of cough lozenges or a sip of water can help suppress the urge to cough.

It is important for parents to give positive reinforcement in the form of praise and positive comments when there is any evidence that the cough is diminishing.

Habit cough is often related to stress or anxiety. Your child might be able to isolate this stress by identifying situations in which the cough gets worse. For example, bullying in the schoolyard and travelling to and from school is a common trigger of habit cough.

If your child is not improving, your doctor may suggest referral to a child psychologist or similar health professional. They may recommend treatments such as counselling and reassurance, hypnosis, distraction or suggestion therapy. Therapy may aim to help the child gradually learn to suppress the cough until they no longer feel the urge to cough.

See your doctor if your child has a persistent cough. Your doctor can make sure there is no physical cause for the coughing, and if habit cough is diagnosed, they can suggest the most appropriate treatment options for your child.

Last Reviewed: 22 May 2017
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References

1. Royal Children’s Hospital Melbourne. Clinical practice guidelines: cough. http://www.rch.org.au/clinicalguide/guideline_index/Cough/ (accessed May 2017).
2. Royal Children’s Hospital Melbourne. Primary Care Liaison. Cough (published Mar 2013). http://www.rch.org.au/kidsconnect/prereferral_guidelines/Cough/ (accessed May 2017).
3. Vertigan AE, Murad MH, Pringsheim T, et al, CHEST Expert Cough Panel. Somatic cough syndrome (previously referred to as psychogenic cough) and tic cough (previously referred to as habit cough) in adults and children: CHEST guideline and Expert Panel report. Chest 2015 Jul;148(1):24-31. http://journal.publications.chestnet.org/article.aspx?articleid=2250092 (accessed May 2017).
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