Stereotypies in childhood: types and associated disorders
On some occasions we will have observed how a child performed repetitive behaviors or movements that, surely, we will have directly related to tics, hobbies of the child or attempts to attract attention. And although in some cases this may be the case, in others it may be childish stereotypies.
Throughout this article we will talk about stereotypies in childhood , we will describe how to identify them, as well as the different classifications, their diagnosis and the possible treatments of these.
- Related article: "The 6 stages of childhood (physical and psychic development)"
What are child stereotypes?
Stereotypes or stereotyped movements they are considered as a hyperkinetic alteration of the movement . This means that there is an excess of movements or reactions of the extremities and the face. Although this alteration can occur at any age, they are quite common in children and may be due to a disorder of stereotyped movements.
In children's stereotypies, These can be manifested through semi-voluntary, repetitive and rhythmic movements , apparently impulsive or impetuous and that are not performed for any specific purpose or purpose. In addition, 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 swaying, scratching, nose poking, bruxism, headbutting, throwing objects, repetitive vocalizations, biting lips or fingers, applauding for no reason or any motor reaction that always presents the same pattern.
To be more specific, stereotyped movements have the following characteristics:
- They are semi-voluntary, which means they can stop if the person wishes.
- They are repetitive .
- They can be rhythmic or in the form of muscle contraction.
- They have no purpose or purpose.
- They are coordinated .
- They may cease when the person is distracted or initiates some other task or activity.
The incidence of this motor disorder of approximately between 3 and 9% of the population between 5 and 8 years old, with a higher incidence in children diagnosed with Pervasive Developmental Disorder (TGD), within which 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 appear as repetitive movements , unlike stereotypes, these are completely involuntary, of shorter duration and in many cases the person does not even perceive that he is experiencing them.
On the other hand, compulsions also consist of repetitive movements that require some coordination. However, these they have a purpose, that of diminishing the feelings of anguish or discomfort caused by the obsessive thoughts that accompany them.
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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 beginning of stereotyped movements tends to occur before the child reaches 3 years of age and must present at least 4 weeks in order to be diagnosed as such.
These semi-voluntary movements tend to be more intense during the hours of sleep, When the child feels very stressed, when levels of anxiety increase , while doing some task that requires a lot of concentration, when they are tired or bored or when they are subjected to a sensory isolation.
As mentioned above, in a large number of cases, these movements tend to diminish in intensity or disappear when the child starts some other activity or task. Knowing this, once the movements are initiated, the parents can try to capture the child's attention and involve them in some pleasant task so that, in this way, the stereotyped movements stop.
Stereotypic types for children
There are different classifications of child stereotypes depending on whether they are accompanied by other alterations or not, depending on the number of muscle groups involved or how they manifest themselves.
1. Primary / secondary stereotypes
Primary stereotypies are considered when they occur in children without any disorder or developmental disorder, while secondary stereotypies occur in children with neurological conditions such as autism, intellectual development disorder or sensorimotor deficits .
In addition, primary stereotypies, which are not associated with any other alteration, tend to have a better prognosis since, in general, they tend to disappear with time.
2. Motor / phonic stereotypes
In this second subgroup, stereotypies are divided into motor stereotypes, when they manifest through movements, or phonic stereotypies if it is vocalizations or oral sounds .
3. Simple / complex stereotypes
Finally, when the child makes simple movements or guttural noises can be classified as simple stereotypes, while if it is more complex and coordinated movements or activities or vocalizations are called complex stereotypes.
How can they be diagnosed?
In those cases in which the parents or caregivers of the child perceive a possible presence of mannerisms, it is recommended go to a specialist who can perform the correct diagnosis of them .
To do this, a clinical evaluation of the child is made through direct observation of the child. However, in case there is any doubt about the diagnosis, a series of physical tests such as electroencephalograms, magnetic resonances or even the evaluation through a series of specialized questionnaires can be carried out.
In this way, we can also rule out the possibility that stereotypical movements are part of a larger condition such as epileptic disorders, OCD or ADHD .
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Is there a treatment?
In the great majority of cases of infantile stereotypies, it is not necessary to resort to a treatment since, even in cases of secondary stereotypies, these are not usually harmful. In addition, in primary stereotypies, these usually remit over time.
However, in the case of more serious cases or in which the child has developed self-injurious behavior 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 the mechanical containment therapy or the inversion of habits , which have proved to be highly effective in the treatment of stereotypical movements.
Finally, despite the fact that it has been shown that pharmacological treatment has a lower success rate, in certain cases it is possible to resort to the administration of drugs such as benzodiazepines, antiepileptic drugs, atypical neuroleptics or selective serotonin reuptake inhibitors (SSRIs). among many others.