At times, we may have observed a child engaging in repetitive behaviors or movements that we may have directly related to tics, child mania, or attempts to get attention. And although in some cases this may be the case, in others it may be childish stereotypes.

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 the possible treatments for them.

What are child stereotypes?

Stereotyped movements are considered a hyperkinetic movement disorder . This means that there is an excess of movements or reactions of the extremities and the face. Although this disorder may occur at any age, it is quite common in children and may be due to a stereotyped movement disorder.

In child stereotypes, these can be manifested through semi-voluntary, repetitive and rhythmic movements , apparently impulsive or impetuous and that are not carried out with any specific purpose or aim. In addition, they are called stereotyped because they always follow a fixed pattern and the child always performs them in the same way.

These movements include rocking, scratching, nose picking, bruxing, head-butting, throwing objects, repetitive vocalizations, lip or finger biting, clapping for no reason or any motor reaction that always presents the same pattern.

To be more specific, stereotypical movements have the following characteristics:

  • They are semi-voluntary, which means that they can be stopped if the person wishes.
  • Are repetitive .
  • They can be rhythmic or in the form of muscle contraction.
  • They have no purpose or aim.
  • They are coordinated .
  • They may stop when the person is distracted or starts some other task or activity.

The incidence of this motor disorder is approximately between 3 and 9% of the population between 5 and 8 years of age, with a higher incidence in children with a diagnosis of Pervasive Developmental Disorder (PDD), within which it occurs with an incidence of between 40% and 45%.

In children without any psychological or motor diagnosis, these movements are often performed unconsciously as a way of relieving stress, as well as in times of frustration or boredom.

Differences with tics and compulsions

Although at first glance they may appear to be very similar movements, there are fundamental differences between stereotypical movements, tics and compulsions.

In the case of tics, although these are also presented as repetitive movements , unlike stereotypes they are completely involuntary, of shorter duration and on many occasions the person does not even perceive that he or she is experiencing them.

On the other hand, compulsions also consist of repetitive movements that require some coordination. However, these do have a purpose, that of diminishing the sensations 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 causes the appearance of stereotypes in children, there are a series of theories that point both to the possibility of a psychological or behavioural cause related to the child’s learning, and to the probability that there is actually a neurobiological basis for it .

In any case, the onset of stereotyped movements tends to occur before the child is 3 years old and must occur for at least 4 weeks before they can be diagnosed as such.

These semi-voluntary movements tend to be more intense during sleep 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 often decrease in intensity or disappear when the child starts some other activity or task. Knowing this, once the movements have been initiated, parents can try to get the child’s attention and involve him/her in some pleasant task so that, in this way, the stereotyped movements cease.

Childhood stereotypical types

There are different classifications of child stereotypes depending on whether they are accompanied by other alterations or not, on the number of muscle groups involved or on how they manifest themselves.

1. Primary/secondary stereotypes

They are considered primary stereotypes when they occur in children without any type of developmental disorder or alteration, while secondary stereotypes occur in minors with neurological conditions such as autism, intellectual development disorder or sensory-motor deficits .

In addition, primary stereotypes, 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 stereotypes

In this second subgroup, the stereotypes are divided into motor stereotypes, when they are manifested through movements, or phonic stereotypes 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 stereotypes, while more complex and coordinated movements or activities or vocalizations are called complex stereotypes.

How can they be diagnosed?

In those cases in which the child’s parents or caregivers perceive a possible presence of mannerisms, it is advisable to 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 such as electroencephalograms, magnetic resonances or even evaluation by means of a series of specialized questionnaires can be carried out.

In this way, it can also be ruled out that stereotypical movements are part of a larger condition such as epileptic disorders, OCD or ADHD .

Is there a treatment?

In the vast majority of cases of childhood stereotypes, no treatment is necessary since, even in cases of secondary stereotypes, these are usually not harmful. Moreover, in primary stereotypes, they usually go into remission over time.

However, in cases of greater severity or in which the child has developed self-injurious behaviour or which pose a danger, a therapeutic approach can be made either through psychological intervention or through pharmacological treatment.

As for psychological interventions, there are a large number of specific therapies, such as mechanical containment therapy or habit reversal , which have proved to be highly effective in the treatment of stereotypical movements.

Finally, despite the fact that drug treatment has been shown to have a lower success rate, in certain cases the administration of drugs such as benzodiazepines, anti-epileptics, atypical neuroleptics or selective serotonin reuptake inhibitors (SSRIs), among many others, may be used.