Stereotypic movement disorder is a condition in which a person engages in repetitive, often rhythmic, but purposeless movements. In some cases, the movements may result in self-injury. For this behavior to be considered a disorder, the repetitive movements must continue for at least four weeks, and they must interfere with the person's normal daily functioning. This disorder most often affects children with autism, intellectual disabilities, or developmental disabilities.
What Are the Symptoms of Stereotypic Movement Disorder?
The repetitive movements that are common with this disorder include:
- Banging the head
- Nail biting
- Picking at the skin
- Handshaking or waving
- Mouthing of objects
What Causes Stereotypic Movement Disorder?
The cause of stereotypic movement disorder is not known. However, the movements tend to increase if the person is stressed, frustrated, or bored. Some things which have been known to cause the disorder are certain physical conditions, head injuries, and use of some drugs (such as cocaine).
How Common Is Stereotypic Movement Disorder?
This condition most often affects children with neurological (brain and nerve) disorders, autism and/or mental retardation. It is more common in childhood or adolescence than adulthood but can occur at any age and is more common in boys than in girls.
How Is Stereotypic Movement Disorder Diagnosed?
If symptoms of stereotypic movement disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose stereotypic movement disorder, the doctor may use various tests -- such as neuroimaging studies and blood tests -- to rule out physical illness or medication side effects as the cause of the symptoms.
Diagnosis of stereotypic movement disorder is made if symptoms suggest the disorder, they persist for four weeks or longer, and they interfere with normal functioning.
How Is Stereotypic Movement Disorder Treated?
The goals of treatment are to treat any injuries due to the behavior and to ensure the child's safety, as well as to improve the child's ability to function. The child's surroundings may need to be modified to reduce the risk of injury. For example, a child that bangs his or her head may need to wear a helmet to protect against a head injury.
The most common treatment approaches used for children with this condition are therapies aimed at reducing stress that may trigger the movements and changing behaviors. A child who engages in picking at the skin or hitting may be taught to keep his hands in his pockets when he feels the urge to pick or hit. Relaxation techniques also may be used to help the child resist the urges. A behavioral therapy approach known as Differential Reinforcement of Other Behaviors (DRO) aims to reward socially appropriate behaviors. Another behavioral approach, called Functional Communication Training (FTC), teaches and rewards the person for using alternative responses or verbal strategies to replace stereotypical movements when they are aware that they need something or are feeling distressed.
In some cases, antidepressants such as Luvox, Prozac, and Zoloft (selective serotonin reuptake inhibitors, or SSRIs), or Anafranil (a tricyclic antidepressant) may be helpful. Atypical antipsychotics such as risperidone or aripiprazole also have shown benefit for stereotypic movements in youth with autism spectrum disorders.
What Is the Outlook for People With Stereotypic Movement Disorder?
The outlook for someone with stereotypic movement disorder varies with the severity of the condition. If the disorder is due to drugs, it usually goes away on its own after a few hours. Stereotypic movement disorder due to head trauma may be permanent. All forms can often be lessened with medications.
Can Stereotypic Movement Disorder Be Prevented?
Although it may not be possible to prevent stereotypic movement disorder, recognizing and acting on symptoms when they first appear can reduce the risk of self-injury.