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1088065 tn?1256661291

Stereotypic behavior/stimming in SPD

Hello Dr.

I have a 34 month old little girl that shows a lot of signs of a problem with her sensory processing skills (sensory modulation) ever since she was a new born; she hit all her milestones on time and even ahead ot time.  Five months ago I noticed a strange behavior in her, she would place her hand with her fingers opened right in front of her eyes and she would look through very quickly and would resume the activity she was doing; she started playing a lot with her fingers, she would wriggle her wrists all the time and sometimes she would make these vocal sounds (nnnnhh-nana-nhhh) while engaging on these behaviors.   From what I have read these are considered stereotypic or stimming behaviors which are a red flag for autism.  I contacted the Early Intervention team in our State and they told me she did not exhibit signs of classic autism because she makes good eye contact, she displays joint attention, she has social skills and her gross and fine motor skills are not delayed; they said that SPD was a possibility.  However she will start speech therapy tomorrow because they found that she's at least 10 months delayed in speech; growing up in a bilingual household has also been a bit confusing for her.
The case manager from early intervention told us that she would go ahead and have an occupational therapist evaluate her as well since we expressed our concerns about the stimming in our daughter.

Is this kind of stimming a crucial indicator of ASD  Is stimming enough to get my daughter diagnosed with autism or PDD-NOS?  Do kids with stand alone sensory processing issues show some sort of stereotypic movements?

Thank you in advance!

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702031 tn?1260479881
Diagnostic criteria for Pervasive Developmental Disorders (including Autism, Aspergers, and others) include delays in social interaction skills, communication skills, and the presence of stereotyped or restricted behavior and interests.  Based on your description, it doesn’t sound as though you have concerns with her social development, and there is a reasonable account for language delays (a bilingual household).  However, direct (in-personal) evaluation by a qualified professional is necessary for any diagnosis.  If you haven’t already brought this to the attention of your pediatrician, I’d recommend doing so now. Be sure to discuss both the behaviors that you are concerned about (“stimming” is more formally referred to as “stereotypy” in the literature), as well as developmental milestones that she is (or is not) meeting.  As to your main question: Engaging in stereotypy does not mean that your child will end up with a diagnosis of developmental delay or an Autism spectrum disorder– plenty of typically-developing infants and children engage in forms of stereotypy.

Regardless of her 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, you may want to consult with a BCBA.  This professional will want to spend time directly observing your child as well as interviewing your family, so that they can provide recommendations on how to best address the issue. A local BCBA can be found at the following site: http://www.bacb.com/consum_frame.html

I don't know anything about the incidence of stereotypy in in children with sensory processing disorders, so I'll have to leave that question unanswered.

Best of luck to you and your family
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