Hand flapping over exited.

[limurf]

Hi i am just concerned about my 4 year old son, he was diagnosed with cerebral palsy (deplegia) in april 09 he is attending pyhsio and a special school, but is going to mainstream in sept...

he is very sociable and very intelligent his pre school teacher reckons he's great in school and wont need an assistant when he transitions to mainstream... the only thing is he seems to get excited and happy flaps since he was younger, it happens when he is excited or over tired...he also seems to jump into a pillow on the chair and looks sideways its like he is in a trance for a second if i occupy him he seems to snap out of it but im worried that this is another thing and not related to cerebral palsy he also gets over excited  and puts his t-shirt to his mouth.

can you explain what this is or hav i anything more to worry about?

[Jessica L Thomason Sassi, Ph.D., BCBA-D]

It does not sound as though he is displaying two of the three diagnosis criteria for Pervasive Developmental Disorders - delays in social interaction skills or communication skills that cannot be attributed to another organic disorder (like cerebral palsy) –  so I would not be overly concerned with pursuing a diagnosis of autism solely based on the fact that he engages in stereotypy ( the hand flapping you described).  

Stereotypic behavior (simple repetitive movements like body rocking, hand flapping, non-functional vocalizations) is a fairly common problem that is seen in both individuals with developmental disorders and in typically- developing infants and children. Research shows that this behavior is typically occurring as a form of self-stimulation (rather than a way to access attention or other events), and that it is not harmful so long as it is not interfering with skill acquisition or producing some type of risk.   If the stereotypy is interfering with his learning, you might try some simple interventions to reduce the stereotypy: if he is supposed to be working, redirect him back to the task; when stereotypy does occur, prompt him to place his hands on the table or his lap; finally, try finding some toys that have stronger sensory properties (vibrating toys, etc.) and allowing him time to play with those.  Because stereotypy is such a common problem, I wouldn’t worry that it has deeper implications or pursue further diagnoses.  

Regardless of his diagnosis, childhood behavior problems like stereotypy can typically be addressed through consultation with a Board-Certified Behavior Analyst (BCBA).  If you feel that the behavior is stigmatizing or interfering with more adaptive behaviors and the simple interventions I noted above haven’t been effective, you may want to consult with a BCBA.  The school district may have a behavior analyst on staff that can provide some recommendations, or you can contact a local BCBA at the following site: http://www.bacb.com/consum_frame.html.

[aspieworld]

Many children on the spectrum do hand flap.  One of them is my 6 year old.  However, you may want to look into Sensory Processing Disorder first.  The behavior you described is sensory based.  If he doesn't show the social aspects of autism I'd start there.  Making an appointment with your local OT is a great place to start.  Make sure they have experience with pediactric/sensory.  If not it is worth your time to go to the closest one who does.  Hope that helps you.