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Stereotypic Movement Disorder

Stereotypic movement disorder is a motor disorder that develops in childhood and involves repetitive, purposeless movement. Examples of stereotypic movements include hand waving, body rocking, and head banging. A diagnosis is only given if the repetitive movement causes distress in a child and leads to impairment in day-to-day functioning.

Simple stereotypic movements such as rocking are common in young children and do not indicate a movement disorder. Complex stereotypic movements, however, are less common and occur in 3 to 4 percent of children. Motor stereotypies are often diagnosed in people with intellectual disabilities and neurodevelopmental conditions but are also found in typically developing children.

Symptoms

  • Movement that is repetitive, intentional, and purposeless. Stereotypic movements include hand shaking, waving, or wringing, head banging, self-hitting, and self-biting.
  • The movements interfere with daily life, such as by disrupting academics or relationships
  • The behavior begins in childhood
  • The behavior is not due to another disorder such as obsessive compulsive disorder or body-focused repetitive behaviors

The type of repetitive movement varies widely and each child presents with their own individually patterned, “signature” behavior. The repetitive movements may increase with boredom, stress, excitement, and exhaustion. Some children may stop their movements if attention is directed toward them or they are distracted, while others may not be able to stop their repetitive movement.

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Causes

Stereotypic movements are typically first seen within the first three years of life. The cause of stereotypic movement disorder is unknown, but several factors are connected to its development. Social isolation, for example, may lead to self-stimulation in the form of stereotypic movements. Environmental stress, such as difficulty in school or at home, can trigger stereotypic behavior. There may also be a genetic component to the condition.

Stereotypic movements may develop with certain medications and typically go away once the medication is stopped. Stereotypic movements due to severe head injury may be permanent.

The risk for stereotypic movement disorder is greater among individuals with severe intellectual disability. In typically developing children, stereotypic movements can often be suppressed or lessened over time. Among people with intellectual disability, however, the stereotyped, self-injurious behaviors can last for many years.

Treatment

Treatment for stereotypic movement disorder may include psychotherapy and behavioral strategies to reduce repetitive movements and minimize the risk for self-harm. A therapeutic technique called Differential Reinforcement is often used, which relies on positive reinforcement to teach the child to modify his or her behavior. Medications may also be an option, although prescription medication is not typically used for pediatric patients with less severe forms of stereotypic movement disorder because the side effects may outweigh the benefits. As with many conditions that affect children, early identification and treatment leads to better outcomes.

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.    
Ricketts, E. J., Bauer, C. C., Van der Fluit, F., Capriotti, M. R., Espil, F. M., Snorrason, I., ... & Woods, D. W. (2013). Behavior therapy for stereotypic movement disorder in typically developing children: a clinical case series. Cognitive and Behavioral Practice, 20(4), 544-555.
U.S. National Library of Medicine, Medline Plus
Last updated: 08/07/2017