Stereotypes in childhood: associated types and disorders

On some occasions we will have observed how a child performed repetitive behaviors or movements that, surely, we have directly related to tics, manias of the child or attempts to call the attention. And although in some cases this may be the case, in others it may be child stereotypes.

Throughout this article we will talk about stereotypes in childhoodWe will describe how to identify them, as well as the different classifications, their diagnosis and the possible treatments for them.

• Related article: "The 6 stages of childhood (physical and mental development)"

What are child stereotypes?

Stereotypies or stereotyped movements are considered as a hyperkinetic movement disorder. 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 can be due to a stereotyped movement disorder.

In childhood stereotypes, These can be manifested through semi-voluntary, repetitive and rhythmic movements

, seemingly impulsive or impetuous and that are not carried out 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 rocking, scratching, picking the nose, bruxism, head butting, throwing objects, repetitive vocalizations, biting lips or fingers, clapping 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-volunteers, which means that they can stop if the person wishes.
• Are repetitive.
• They can be rhythmic or in the form of muscle contraction.
• They have no purpose or finality.
• They are coordinated.
• They can stop when the person is distracted or starts some other task or activity.

The incidence of this motor impairment of, approximately, between 3 and 9% of the population between 5 and 8 years, 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 relieve tension, 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 also present as repetitive movementsUnlike stereotypies, 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 do have a purpose, to reduce 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 stereotypes in children, there is a series of theories that point both to the possibility of a psychological or behavioral cause related to the child's learning, and 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 must present for at least 4 weeks to be diagnosed as such.

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

Childhood stereotype types

There are different classifications of childhood stereotypies according to whether they are accompanied by other alterations or not, according to the number of muscle groups involved or according to how they manifest themselves.

1. Primary / secondary stereotypes

Primary stereotypies are considered when they occur in children without any type of disorder or developmental alteration, while secondary ones occur in minors with neurological disorders What autism, intellectual development disorder or sensorimotor deficits.

Furthermore, primary stereotypies, which are not associated with any other alteration, tend to present a better prognosis since, in general, they tend to disappear with time.

2. Motor / phonic stereotypies

In this second subgroup, stereotypes are divided into motor stereotypes, when they manifest through movements, or phonic stereotypes in the case of 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 that if they are more complex and coordinated movements or activities or vocalizations, they are called stereotypies complex.

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 make the correct diagnosis of them.

For this, a clinical evaluation of the child is carried out by direct observation of the child. However, in the event that there may be any doubt about the diagnosis, a series of tests can be carried out physical tests such as EEGs, MRIs, or even evaluation using a series of questionnaires specialized.

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.

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Is there a treatment?

In the vast majority of cases of childhood stereotypes, it is not necessary to resort to treatment since, even in cases of secondary stereotypes, these are not usually harmful. In addition, in primary stereotypes, these tend to remit over time.

Nevertheless, in cases of greater severity or in which the child has developed self-injurious 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 been found to be highly effective in treating stereotypical movements.

Finally, despite the fact that pharmacological treatment has been shown to have a lower success rate, in certain cases it is possible to resort to the administration of drugs such as benzodiazepines, antiepileptics, atypical neuroleptics or selective serotonin reuptake inhibitors (SSRIs), among many others.