is nervous. I noticed this behavior earlier this year after a transition to a new school. I spoke with her about it and discovered she was having difficulty adapting to the new school, the teacher and making new friends. I monitored the situation for a while, and I spoke with her teacher about it. I bought her a series of books on self esteem, etc., and it seemed to help her so she stopped. Over the summer she was fine.

I recently noticed her fingers and saw they were red and raw. When I asked her about it, she was embarrassed and did not want to talk about it. Last week I had a parent-teacher conference and her teacher had nothing but good things to say about her and her work.

I spoke to my daughter about it later on and she told me she bites her finger tips during chorus. She said her chorus teacher yells a lot and this gets her nervous. She has chorus twice a week. This is a new teacher at the school. I told my daughter I will call and speak to the teacher about it, but frankly, I don't know where to begin. Could you give me some pointers?

Answer:Talking to both your daughter and her teachers was a very good start. You want to gather as much information as possible to understand how your daughter copes with her anxiety. From your account, after she adjusted to her new school, she stopped biting her fingers. Then she began again when she was confronted with a new stressor; the yelling chorus teacher. It looks like a pattern is forming. When your daughter is anxious she relieves her stress by biting her finger tips. As you are aware, this is not an effective coping strategy and if left untreated, could lead to even more serious self-injurious behaviors.

You mentioned that you had her read self-esteem books. I think it is important to look at all the factors that contribute to self-esteem. We are complex beings that respond to life depending on a variety of factors of both nature and nurture. It is possible that your daughter is more susceptible to anxiety, but that does not necessarily mean she doesn't feel good about herself. What could affect her esteem is her embarrassment over her compulsive behavior.

This is nothing to be ashamed of. We all have different coping styles. It would be important to seek out professional treatment to help your daughter better understand her anxiety. A behavioral pediatrician, licensed psychologist or child therapist can help your daughter learn better coping skills. Make sure the professional has training in anxiety/compulsive disorders.

Lastly, I would encourage you not to wait and see if it goes away again. You are correct in being concerned and the sooner your daughter learns to manage her anxiety, the better she will be prepared for life's many challenges.

Debra Collins is a licensed marriage and family therapist. Debra has worked in both primary and middle schools as a school counselor. She gives workshops to teachers and students on a variety of topics concerning youth and families and offers parenting classes and parent coaching to parents throughout the Bay Area. Debra is also a mental health assessor for the San Francisco Unified School District.

Advice from our experts is not a substitute for medical or other professional advice and services from a qualified health-care provider familiar with your unique situation. We recommend consulting a qualified professional if you have concerns about your child's medical or emotional condition. .

August 2006