I was immediately transported back into my childhood, when I saw a video of Chinese girls in an orphanage. Due to the one child policy in the 90s parents where throwing away their daughters. Many of which died in the horrific condition of the orphanages. What I found to relatable was their stocking back and forth in their hight chairs. I did that! Human mostly resort to those stereotypies when they are very anxious or very bored.
Stereotypies are specific movements that are purposeless and executed repetitively (1). Here I am not referring to those that come with other neurological disorders like autism. Normally, stereotypies develop before the age of 24 month but after 36 month only 8% of children still display them (2). Among older children and adolescence (9-20 years old) however, 98% reported they persisted. Common comorbidities were clinical levels of anxiety (73%), ADHS (63%) and OCD (35%). Most of them reported that they learned to manage their stereotypies (3). Even though many report the behavior as soothing (4).
My mother told me I was a bit strange rocking back and forth in my hight chair. Even though she predicted gruesome injuries for me, it was so appeasing that I didn’t stop. Only when I proceeded to sit on normal chairs she forced me to stop. Because it ruins the furniture.
The following years I developed inexplicable irritation. First behind my ear and then at my nose. Again practitioners where clueless about my what ailed me. When asked I said I wasn’t picking my skin. Only when I was a few year older I noticed my subconscious movements. EEG analysis has shown that unlike for voluntary movement the prefrontal cortex is not active for stereotypies (5). Once I had consciously noticed the picking I could suppress that too. Form there I developed further stereotypies which I suppressed again when people noticed. My mother was the only one that called me weird because of it. So she managed my appearance to turn out very adapted. Though the anxiety resided.
In retrospect I find this a missed opportunity for teachers and practitioners to spot my distress. Often a child’s well being is evaluated via care-giver reports. But not all care-givers have the child’s best interest at heart. This should be assumed, especially when children are displaying signs of underlaying distress.
(1) The characterization and out come of stereotypical movements in nonautistic children (1997) A. Tan, M. Salgado, S. Fahn
(2) Non autistic motor stereotypies: clinical features and longitudinal follow-up (2008) K. M. Harris, E. M. Mahone, H. S. Singer
(3) Primary complex motor stereotypies in older children and adolescents: clinical features and longitudinal follow-up (2015) C. Oakley, E. M. Mahone, C. Morris-Berry, T. Kline, H. S. Singer
(4) Stereotypic movement disorder: easily missed (2010) R. D. Freeman, A. Soltanifar, S. Baer
(5) Absent movement-related cortical potentials in children with primary motor stereotypies (2014) E. Houdayer, J. Walthall, B. A. Belluscio, S. Vorbach, H. S. Singer, M. Hallett
