Stereotypic movement disorder
Encyclopedia
Stereotypic movement disorder is a disorder of childhood involving repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury, and persists for four weeks or longer. The behavior must not be due to the direct effects of a substance or another medical condition. In cases when mental retardation
is present, the stereotypic or self-injurious behavior must be of sufficient severity to become the focus of treatment. The behavior is not better explained as a compulsion (e.g., OCD), a tic
, a stereotypy
as part of a Pervasive Developmental Disorder
, or hair pulling (trichotillomania
).
Former versions of the DSM
(Diagnostic Manual and Statistical Manual of Mental Disorders) used the term Stereotypy/Habit Disorder to designate repetitive habit behaviors that caused impairment to the child.
The repetitive movements that are common with this disorder include thumb sucking
, nail biting
, nose-picking
, breath holding, bruxism
, head banging, rocking/rhythmic movements, self-biting, self-hitting, picking at the skin, hand shaking, hand waving, and mouthing of objects.
Habits can range from relatively benign behaviors (e.g., nail biting) to noticeable or self-injurious behaviors, such as teeth grinding (bruxism
). Many habits of childhood are a benign, normal part of development, do not rise to the diagnostic level of a disorder, and typically remit without treatment.
When stereotyped behaviors cause significant impairment in functioning, an evaluation for stereotypic movement disorder is warranted. There are no specific tests for diagnosing this disorder, although some tests may be ordered to rule out other conditions. Other conditions which feature repetitive behaviors in the differential diagnosis include obsessive–compulsive disorder, trichotillomania
, vocal and tic disorder
s (e.g., Tourette syndrome
). Although not necessary for the diagnosis, stereotypic movement disorder most often affects children with mental retardation and developmental disorders. It is more common in boys, and can occur at any age. The cause of this disorder is not known.
Stereotypic movement disorder is often misdiagnosed as tics or Tourette's. Unlike the tics of Tourette's, which tend to appear around age six or seven, repetitive movements typically start before age two, are more bilateral than tics, and consist of intense patterns of movement for longer runs than tics. Tics are less likely to be stimulated by excitement. Children with Stereotypic movement disorder do not always report being bothered by the movements as a child with tics might.
Prognosis depends on the severity of the disorder. Recognizing symptoms early can help reduce the risk of self-injury, which can be lessened with medications. Stereotypic movement disorder due to head trauma may be permanent. If anxiety or affective disorders are present, the behaviors may persist.
Mental retardation
Mental retardation is a generalized disorder appearing before adulthood, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors...
is present, the stereotypic or self-injurious behavior must be of sufficient severity to become the focus of treatment. The behavior is not better explained as a compulsion (e.g., OCD), a tic
Tic
A tic is a sudden, repetitive, nonrhythmic, stereotyped motor movement or vocalization involving discrete muscle groups. Tics can be invisible to the observer, such as abdominal tensing or toe crunching. Common motor and phonic tics are, respectively, eye blinking and throat clearing...
, a stereotypy
Stereotypy
A stereotypy is a repetitive or ritualistic movement, posture, or utterance, found in people with mental retardation, autism spectrum disorders, tardive dyskinesia and stereotypic movement disorder. Stereotypies may be simple movements such as body rocking, or complex, such as self-caressing,...
as part of a Pervasive Developmental Disorder
Pervasive developmental disorder
Pervasive developmental disorders is a diagnostic category refers to a group of disorders characterized by delays or impairments in communication, social behaviors, and cognitive development.Pervasive developmental disorders include Autism, Asperger's syndrome, Rett's syndrome, Childhood...
, or hair pulling (trichotillomania
Trichotillomania
Trichotillomania, which is classified as an impulse control disorder by DSM-IV, is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat....
).
Former versions of the DSM
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
(Diagnostic Manual and Statistical Manual of Mental Disorders) used the term Stereotypy/Habit Disorder to designate repetitive habit behaviors that caused impairment to the child.
The repetitive movements that are common with this disorder include thumb sucking
Thumb sucking
Thumb sucking is a behavior found in humans, chimpanzees, captive Ring-tailed Lemurs, and other primates. It usually involves placing the thumb into the mouth and rhythmically repeating sucking contact for a prolonged duration...
, nail biting
Nail biting
Onychophagia, or nail biting, is a common oral compulsive habit in children and adults.-Classification:Nail biting is considered an impulse control disorder in the DSM-IV-R; the ICD-10 classifies it as "other specified behavioral and emotional disorders with onset usually occurring in childhood and...
, nose-picking
Nose-picking
Nose-picking is the act of extracting dried nasal mucus or foreign bodies from the nose with a finger. Despite being a very common habit, it is a mildly taboo activity in most cultures, and the observation of the activity in another person may provoke mixed feelings of disgust and amusement...
, breath holding, bruxism
Bruxism
Bruxism is characterized by the grinding of the teeth and typically includes the clenching of the jaw. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem...
, head banging, rocking/rhythmic movements, self-biting, self-hitting, picking at the skin, hand shaking, hand waving, and mouthing of objects.
Habits can range from relatively benign behaviors (e.g., nail biting) to noticeable or self-injurious behaviors, such as teeth grinding (bruxism
Bruxism
Bruxism is characterized by the grinding of the teeth and typically includes the clenching of the jaw. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem...
). Many habits of childhood are a benign, normal part of development, do not rise to the diagnostic level of a disorder, and typically remit without treatment.
When stereotyped behaviors cause significant impairment in functioning, an evaluation for stereotypic movement disorder is warranted. There are no specific tests for diagnosing this disorder, although some tests may be ordered to rule out other conditions. Other conditions which feature repetitive behaviors in the differential diagnosis include obsessive–compulsive disorder, trichotillomania
Trichotillomania
Trichotillomania, which is classified as an impulse control disorder by DSM-IV, is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat....
, vocal and tic disorder
Tic disorder
Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders based on type and duration of tics...
s (e.g., Tourette syndrome
Tourette syndrome
Tourette syndrome is an inherited neuropsychiatric disorder with onset in childhood, characterized by multiple physical tics and at least one vocal tic; these tics characteristically wax and wane...
). Although not necessary for the diagnosis, stereotypic movement disorder most often affects children with mental retardation and developmental disorders. It is more common in boys, and can occur at any age. The cause of this disorder is not known.
Stereotypic movement disorder is often misdiagnosed as tics or Tourette's. Unlike the tics of Tourette's, which tend to appear around age six or seven, repetitive movements typically start before age two, are more bilateral than tics, and consist of intense patterns of movement for longer runs than tics. Tics are less likely to be stimulated by excitement. Children with Stereotypic movement disorder do not always report being bothered by the movements as a child with tics might.
Prognosis depends on the severity of the disorder. Recognizing symptoms early can help reduce the risk of self-injury, which can be lessened with medications. Stereotypic movement disorder due to head trauma may be permanent. If anxiety or affective disorders are present, the behaviors may persist.