Stereotypies In Childhood: Types And Associated Disorders
On some occasions we will have observed how a child carried out repetitive behaviors or movements that, surely, we will have directly related to tics, the child’s manias or attempts to get attention. And although in some cases this may be the case, in others it may be childhood stereotypies.
Throughout this article We will talk about stereotypes in childhood we will describe how to identify them, as well as the different classifications, their diagnosis and their possible treatments.
Stereotypies or stereotyped movements They are considered a hyperkinetic alteration of movement This means that there is an excess of movements or reactions of the extremities and face. Although this alteration can occur at any age, they are quite common in children and may be due to a stereotyped movement disorder.
In childhood stereotypes, These can be manifested through semi-voluntary, repetitive and rhythmic movements , apparently impulsive or impetuous and not carried out with any specific goal or purpose. Furthermore, they are called stereotyped because they always follow a fixed pattern and the child always carries them out in the same way.
These movements include rocking, scratching, nose picking, bruxism, head butting, throwing objects, repetitive vocalizations, lip or finger biting, clapping for no reason, or any motor reaction that always has the same pattern.
To be more specific, stereotyped movements have the following characteristics:
The incidence of this motor alteration is approximately between 3 and 9% of the population between 5 and 8 years old. with a higher incidence in children with diagnoses of Pervasive Developmental Disorder (TGD), within which it occurs with an incidence of between 40% and 45%.
In children without any type of psychological or motor diagnosis, these movements are usually performed unconsciously as a way to release tension, as well as in moments of frustration or boredom.
Differences with tics and compulsions
Although at first glance they may seem very similar movements, there are fundamental differences between stereotypical movements, tics and compulsions.
In the case of tics, although These also occur as repetitive movements Unlike stereotypies, these are completely involuntary, of shorter duration and in many cases the person does not even realize that they are experiencing them.
On the other hand, compulsions also consist of repetitive movements that require a certain coordination. However, these They do have a purpose, that of reducing feelings of anguish or discomfort caused by the obsessive thoughts that accompany them.
When and why do they appear?
Although it has not yet been possible to determine exactly what is the cause of the appearance of stereotypies in children, there are a series of theories that point both to the possibility of a psychological or behavioral cause related to the child’s learning, as well as to the probability that there is actually a neurobiological basis that causes it
Be that as it may, the onset of stereotyped movements tends to occur before the child reaches 3 years of age and they must be present for at least 4 weeks to be diagnosed as such.
These semi-voluntary movements are usually more intense during sleeping hours, when the child feels very stressed, when anxiety levels increase while performing a task that requires a lot of concentration, when they are tired or bored or when they are subjected to sensory isolation.
As mentioned above, in a large number of cases, these movements usually decrease in intensity or disappear when the child begins some other activity or task. Knowing this, once the movements have started, parents can try to capture the child’s attention and involve him in some pleasant task so that, in this way, the stereotyped movements stop.
Types of childhood stereotypes
There are different classifications of childhood stereotypies depending on whether they are accompanied by other alterations or not, according to the number of muscle groups involved or according to how they manifest.
1. Primary/secondary stereotypies
Primary stereotypies are considered when they occur in children without any type of disorder or developmental alteration, while secondary stereotypes occur in minors with neurological conditions such as autism, intellectual development disorder or sensorimotor deficits
Furthermore, primary stereotypies, which are not associated with any other alteration, tend to have a better prognosis since they generally tend to disappear over time.
2. Motor/phonic stereotypies
In this second subgroup, stereotypies are divided into motor stereotypies, when they are manifested through movements, or phonic stereotypies if they are vocalizations or oral sounds
3. Simple/complex stereotypes
Finally, when the child makes simple movements or guttural noises they can be classified as simple stereotypies, while if they involve more complex and coordinated movements or activities or vocalizations they are called complex stereotypies.
How can they be diagnosed?
In those cases in which the child’s parents or caregivers perceive a possible presence of mannerisms, it is recommended Go to a specialist who can make the correct diagnosis of them
To do this, a clinical evaluation of the child is carried out through direct observation of the child. However, in the event that there may be any doubt about the diagnosis, a series of physical tests can be carried out such as electroencephalograms, magnetic resonance imaging, or even evaluation through a series of specialized questionnaires.
In this way, the possibility that stereotypical movements are part of a larger condition can also be ruled out. such as epileptic disorders, OCD or ADHD
Is there a treatment?
In the vast majority of cases of childhood stereotypies, it is not necessary to resort to treatment since, even in cases of secondary stereotypies, these are not usually harmful. Furthermore, in primary stereotypies, these usually subside over time.
Nevertheless, when it comes to more serious cases or in which the child has developed self-harming behaviors or that pose a danger, a therapeutic approach can be carried out either through psychological intervention or through pharmacological treatment.
Regarding psychological interventions, there are a large number of specific therapies, such as mechanical restraint therapy or habit reversal which have proven to be highly effective in the treatment of stereotypical movements.
Finally, although it has been shown that pharmacological treatment has a lower success rate, in certain cases the administration of medications such as benzodiazepines, antiepileptics, atypical neuroleptics or selective serotonin reuptake inhibitors (SSRIs) can be used. among many others.
